Inui K, Maeda M, Sano A, Fujioka K, Yutani Y, Sakawa A, Yamano Y, Kato Y, Koike T
Department of Orthopaedic Surgery, Osaka City University Medical School, 1-5-7 Asahimachi Abeno-Ku, Osaka 545-8585, Japan.
Calcif Tissue Int. 1998 Dec;63(6):490-5. doi: 10.1007/s002239900563.
Fibroblast growth factor (FGF) has been reported to increase the volume of callus in a fracture model of rats. There are, however, no reports of successful repair of segmental bony defects by application of an FGF solution. In this study, the effects of basic FGF on the repair of segmental bony defects in the rabbit femur were examined. Minipellet, a new drug delivery system using atelocollagen, was employed to ensure effective delivery of FGF. Segmental bony defects (10 mm in length) were created in the right femurs of 19 rabbits. In pilot studies, no defects of this size healed spontaneously within 6 weeks. Bones were stabilized with miniexternal fixators. Minipellets containing basic FGF were implanted between fragments so as to bridge the two fragments. The healing processes were monitored radiographically and studied histologically. In rabbits in which FGF was added to the defect site at doses of 1.4 microgram or higher, approximately 90% of the defects were filled with new bone and cartilage within 6 weeks after minipellet implantation. In rabbits receiving placebo minipellets, however, approximately 15% of the defects were filled by callus within 6 weeks. Furthermore, this callus did not change into mature bone. An injection of 2 microgram of FGF solution to bony defects had no effect on the repair of segmental bony defects. These findings suggest that FGF plays a role in the production of adequate volumes of callus particularly in the initial stages of fracture healing and that sustained local release enables FGF to be effective at a low dose. In summary, large segmental bony defects healed after insertion of low-dose FGF minipellets. An adequate dose of FGF and an appropriate delivery system are required for successful healing of large bony defects. These findings imply the potential value of FGF minipellets in clinical practice.
据报道,成纤维细胞生长因子(FGF)可增加大鼠骨折模型中骨痂的体积。然而,尚无应用FGF溶液成功修复节段性骨缺损的报道。在本研究中,检测了碱性FGF对兔股骨节段性骨缺损修复的影响。采用一种使用去端胶原蛋白的新型药物递送系统——微型颗粒,以确保FGF的有效递送。在19只兔子的右侧股骨上制造节段性骨缺损(长度为10毫米)。在前期研究中,这种大小的缺损在6周内不会自行愈合。用微型外固定器固定骨骼。将含有碱性FGF的微型颗粒植入骨折碎片之间以连接两个碎片。通过X线摄影监测愈合过程,并进行组织学研究。在以1.4微克或更高剂量向缺损部位添加FGF的兔子中,微型颗粒植入后6周内,约90%的缺损被新骨和软骨填充。然而,在接受安慰剂微型颗粒的兔子中,6周内约15%的缺损被骨痂填充。此外,这种骨痂并未转变为成熟骨。向骨缺损注射2微克FGF溶液对节段性骨缺损的修复没有影响。这些发现表明,FGF在产生足够体积的骨痂中发挥作用,特别是在骨折愈合的初始阶段,持续的局部释放使FGF能够在低剂量下起作用。总之,低剂量FGF微型颗粒植入后,大的节段性骨缺损得以愈合。大的骨缺损成功愈合需要足够剂量的FGF和合适的递送系统。这些发现暗示了FGF微型颗粒在临床实践中的潜在价值。