Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Department of Research and Development, Shanghai Cryowise Medical Technology Co. Ltd., Shanghai, China.
J Tissue Eng Regen Med. 2020 Aug;14(8):1009-1018. doi: 10.1002/term.3052. Epub 2020 Jun 22.
Whether tendon regeneration can be induced using the umbilical cord as a whole-graft structure is unknown. In this study, we explored the potential for tendon regeneration induction using an umbilical cord graft in a rabbit model of patella tendon defects. In 52 of 54 New Zealand White rabbits, the central third of the patella tendons of both hind legs was removed to create tendon defects. The rabbits were randomly divided into four groups, nonfilling (empty defect), refilling (defect refilled with resected tendon portion), Wharton's jelly (WJ) outside (WJO; defect filled with umbilical cord graft, WJ side facing outward), and WJ inside (WJI; same as WJO with WJ side facing inward) groups. Four rabbits from WJO and WJI groups were sacrificed for human CD 105 evaluation 1 month after surgery. Further histological, biomechanical, and gene expression analyses were performed at 3 and 6 months after surgery. The untreated patella tendons in the remaining two rabbits were harvested as normal biomechanical controls. Histological evaluation showed that the formed tissue structure fibers in the tendon defect area were much denser and more mature in the WJI group than in all other groups. Biomechanical testing showed that the failure load of the final tissue structure was the highest in the WJI group. Real-time polymerase chain reaction indicated that the expression of most tendon-related genes was upregulated in the WJI group at 6 months after surgery. We concluded that umbilical cord grafting induces effective tendon regeneration, particularly when the WJ side faces inward.
是否可以使用脐带作为整体移植物结构来诱导肌腱再生尚不清楚。在这项研究中，我们通过兔髌腱缺损模型探索了使用脐带移植物诱导肌腱再生的潜力。在 54 只新西兰白兔中，52 只后腿的髌腱中部被切除以造成腱缺损。兔子被随机分为四组：非填充组（空缺损）、再填充组（缺损用切除的腱部分填充）、Wharton 胶外填充组（WJO；缺损用脐带移植物填充，WJ 侧向外）和 Wharton 胶内填充组（WJI；与 WJO 相同，WJ 侧向内）。手术后 1 个月，从 WJO 和 WJI 组的 4 只兔子中取出用于人 CD105 评估。术后 3 个月和 6 个月进行了进一步的组织学、生物力学和基因表达分析。其余 2 只兔子的未处理髌腱被作为正常生物力学对照进行了收获。组织学评估显示，WJI 组腱缺损区域形成的组织结构纤维比其他所有组都更密集、更成熟。生物力学测试表明，WJI 组最终组织结构的失效负荷最高。实时聚合酶链反应表明，手术后 6 个月，WJI 组中大多数与肌腱相关的基因表达上调。我们得出结论，脐带移植可有效诱导肌腱再生，尤其是当 WJ 侧向内时。
