Noishiki Y, Tomizawa Y, Yamane Y, Matsumoto A
First Department of Surgery, Yokohama City University School of Medicine, Japan.
Nat Med. 1996 Jan;2(1):90-3. doi: 10.1038/nm0196-90.
Synthetic vascular prostheses are foreign bodies, so that blood coagulation can occur on their luminal surfaces, causing graft occlusion very frequently in prostheses of small diameter. A vascular prosthesis needs angiogenesis for endothelialization of the luminal surface, as endothelial cells have natural and permanent antithrombogenic properties. To induce capillary growth into the graft, we developed a method of transplanting bone marrow cells, which are primitive, strong enough to survive, and create blood cells, resulting in the inducement of capillary growth. In an animal experiment, marrow cells were infiltrated into the walls of long-fibril expanded polytetrafluoroethylene (ePTFE) vascular grafts. The grafts were implanted in the abdominal aortic position of 24 dogs autologously. Marrow cells survived and continued exogenous hemopoiesis for up to six months and were immunohistochemically reactive to basic fibroblast growth factor (bFGF). All the grafts older than three weeks had complete endothelialization and maintained their patency. Twenty grafts without bone marrow were implanted as controls. Endothelialization was present at anastomotic sites, but other areas were covered with fresh thrombi. Four out of seven control grafts were patent with endothelial cell lining at six months, but three were occluded and one of the four grafts was still covered with a thrombus layer. Bone marrow with its unique native properties produced autocrine angiogenicity in the graft.
合成血管假体是异物，因此血液凝固可在其管腔表面发生，导致小直径假体中移植血管闭塞非常频繁。血管假体需要血管生成以使管腔表面内皮化，因为内皮细胞具有天然且持久的抗血栓形成特性。为了诱导毛细血管向移植物内生长，我们开发了一种移植骨髓细胞的方法，骨髓细胞原始、足够强壮以存活并产生血细胞，从而诱导毛细血管生长。在一项动物实验中，将骨髓细胞浸润到长纤维膨体聚四氟乙烯（ePTFE）血管移植物的壁中。这些移植物自体植入24只狗的腹主动脉位置。骨髓细胞存活并持续外源性造血长达六个月，并且对碱性成纤维细胞生长因子（bFGF）具有免疫组织化学反应性。所有三周以上的移植物都有完全的内皮化并保持通畅。植入20个没有骨髓的移植物作为对照。吻合部位存在内皮化，但其他区域覆盖有新鲜血栓。七个对照移植物中有四个在六个月时通畅，内皮细胞衬里完好，但三个闭塞，四个移植物中的一个仍覆盖有血栓层。具有独特天然特性的骨髓在移植物中产生自分泌血管生成作用。
