关节内注射 N-乙酰葡萄糖胺和透明质酸联合 PLGA 支架修复兔的骨软骨缺损。

Intra-articular injection of N-acetylglucosamine and hyaluronic acid combined with PLGA scaffolds for osteochondral repair in rabbits.

机构信息

Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.

Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

PLoS One. 2018 Dec 31;13(12):e0209747. doi: 10.1371/journal.pone.0209747. eCollection 2018.

Abstract

Repairing damaged articular cartilage is particularly challenging because of the limited ability of cartilage to perform self-repair. Intra-articular injections of N-acetylglucosamine (GlcNAc) comprise a method of repairing full-thickness articular cartilage defects in the rabbit knee joint model. To date, the effects of administration of GlcNAc and hyaluronic acid (HA) have been investigated only in the context of osteoarthritis treatment. Therefore, we evaluated the therapeutic effects of using cell-free porous poly lactic-co-glycolic acid (PLGA) graft implants and intra-articular injections of GlcNAc or HA in a rabbit model of osteochondral regeneration to investigate whether they have the potential for inducing osteochondral regeneration when used alone or simultaneously. Twenty-four rabbits were randomized into one of four groups: the scaffold-only group (PLGA), the scaffold with intra-articular injections of GlcNAc (PLGA+G) group, twice per week for four weeks; the scaffold with intra-articular injections of HA group (PLGA+HA) group, once per week for three weeks; and the scaffold with intra-articular injections of GlcNAc and HA (PLGA+G+HA) group, once per week for three weeks. Knees were evaluated at 4 and 12 weeks after surgery. At the end of testing, only the PLGA+G+HA group exhibited significant bone reconstruction, chondrocyte clustering, and good interactions with adjacent surfaces at 4 weeks. Additionally, the PLGA+G+HA group demonstrated essentially original hyaline cartilage structures that appeared to have sound chondrocyte orientation, considerable glycosaminoglycan levels, and reconstruction of the bone structure at 12 weeks. Moreover, the PLGA+G+HA group showed organized osteochondral integration and significantly higher bone volume per tissue volume and trabecular thickness. However, there were no significant differences between the PLGA+G and PLGA+HA groups except for gap formation on subchondral bone in the PLGA+G group. This study demonstrated that PLGA implantation combined with intra-articular injections of GlcNAc and HA allowed for cartilage and bone regeneration and significantly promoted osteochondral regeneration in rabbits without supplementation of exogenous growth factors. And the combination of this two supplements with PLGA scaffold could also prolong injection interval and better performance than either of them alone for the reconstruction of osteochondral tissue in the knee joints of rabbits.

摘要

修复受损的关节软骨具有挑战性,因为软骨自身修复能力有限。关节内注射 N-乙酰氨基葡萄糖(GlcNAc)是修复兔膝关节全层关节软骨缺损的一种方法。迄今为止,仅在骨关节炎治疗的背景下研究了 GlcNAc 和透明质酸(HA)的给药效果。因此,我们评估了在兔骨软骨再生模型中使用无细胞多孔聚乳酸-共-羟基乙酸(PLGA)移植物植入物和关节内注射 GlcNAc 或 HA 的治疗效果,以研究它们是否具有诱导骨软骨再生的潜力,无论是单独使用还是同时使用。24 只兔子被随机分为四组之一:支架仅组(PLGA)、支架联合关节内注射 GlcNAc 组(PLGA+G),每周两次,共四周;支架联合关节内注射 HA 组(PLGA+HA),每周一次,共三周;支架联合关节内注射 GlcNAc 和 HA 组(PLGA+G+HA),每周一次,共三周。手术后 4 周和 12 周时对膝关节进行评估。在测试结束时,只有 PLGA+G+HA 组在 4 周时表现出明显的骨重建、软骨细胞聚集和与相邻表面的良好相互作用。此外,PLGA+G+HA 组在 12 周时表现出基本原始的透明软骨结构,似乎具有良好的软骨细胞取向、相当高的糖胺聚糖水平和骨结构重建。此外,PLGA+G+HA 组表现出有序的骨软骨整合,并且骨体积/组织体积和小梁厚度明显增加。然而,PLGA+G 组和 PLGA+HA 组之间除了在软骨下骨形成间隙外,没有其他显著差异。本研究表明,PLGA 植入物联合关节内注射 GlcNAc 和 HA 可促进软骨和骨再生,并显著促进兔膝关节的骨软骨再生,无需外源性生长因子的补充。并且这两种补充剂与 PLGA 支架的联合应用可以延长注射间隔,并且比单独使用任何一种都能更好地发挥作用,从而更好地重建兔膝关节的骨软骨组织。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39d7/6312252/e2359103e8e5/pone.0209747.g001.jpg

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