Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Key Laboratory of Tissue Engineering, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200011, China.
Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Stem Cell Res Ther. 2018 Nov 28;9(1):331. doi: 10.1186/s13287-018-1064-1.
Bone tissue engineering is not widely used in clinical treatment. Two main reasons hide behind this: (1) the seed cells are difficult to obtain and (2) the process of tissue engineering bone construction is too complex and its efficiency is still relatively low. It is foreseeable that in the near future, the problem of seed cell sources could be solved completely in tissue engineering bone repair. As for the complex process and low efficiency of tissue engineering bone construction, usually two strategies would be considered: (1) the construction strategy based on injectable bone tissue and (2) the construction strategy based on osteogenic cell sheets. However, the application of injectable bone tissue engineering (iBTE) strategy and osteogenic cell sheet strategy is limited and they could hardly be used directly in repairing defects of large segmental bone, especially load-bearing bone.
In this study, we built an osteogenic micro-tissue with simple construction but with a certain structure and composition. Based on this, we established a new iBTE repair strategy-osteogenic micro-tissue in situ repair strategy, mainly targeting at solving the problem of large segmental bone defect. The steps are as follows: (1) Build the biodegradable three-dimensional scaffold based on the size of the defect site with 3D printing rapid prototyping technology. (2) Implant the three-dimensional scaffold into the defect site. This scaffold is considered as the "steel framework" that could provide both mechanical support and space for bone tissue growth. (3) Inject the osteogenic micro-tissue (i.e., the "cell-extracellular matrix" complex), which could be considered as "concrete," into the three-dimensional scaffold, to promote the bone tissue regeneration in situ. Meanwhile, the digested cells were injected as the compared group in this experiment. After 3 months, the effect of in situ bone defect repair of osteogenic micro-tissue and digested cells was compared.
It is confirmed that osteogenic micro-tissue could achieve a higher efficiency on cell usage and has a better repair effect than the digested cells.
Osteogenic micro-tissue repairing strategy would be a more promising clinical strategy to solve the problem of large segmental bone defect.
骨组织工程在临床治疗中尚未得到广泛应用。这主要有两个原因:(1)种子细胞难以获取;(2)组织工程骨构建过程过于复杂,效率仍然相对较低。可以预见,在不久的将来,组织工程骨修复中种子细胞来源的问题将得到彻底解决。至于组织工程骨构建过程复杂、效率低的问题,通常会考虑两种策略:(1)基于可注射骨组织的构建策略;(2)基于成骨细胞片的构建策略。然而,可注射骨组织工程(iBTE)策略和成骨细胞片策略的应用受到限制,很难直接用于修复大段骨,特别是承重骨的缺损。
本研究构建了一种结构和组成具有一定复杂性但构建简单的成骨微组织。在此基础上,建立了一种新的 iBTE 修复策略——成骨微组织原位修复策略,主要针对大段骨缺损的问题。步骤如下:(1)利用 3D 打印快速成型技术,根据缺损部位的大小构建可生物降解的三维支架。(2)将三维支架植入缺损部位。该支架被认为是提供机械支撑和骨组织生长空间的“钢框架”。(3)将成骨微组织(即“细胞-细胞外基质”复合物),可视为“混凝土”,注入三维支架内,促进原位骨组织再生。同时,在实验中,将消化细胞作为对照组注入。3 个月后,比较成骨微组织和消化细胞原位骨缺损修复的效果。
证实成骨微组织在细胞利用效率上更高,修复效果优于消化细胞。
成骨微组织修复策略有望成为解决大段骨缺损问题的更有前途的临床策略。