Repaire of Large Segmental Bone Defects by Marrow Stromal Cells Transplant with Demineralized Bone Matrix

Zhao Xie, F. Luo, Jian-Zhong Xu, Shi-wu Dong
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Abstract

The aim of this study was to determine the healing potential of large segmental bone defects using tissue-engineered constructs in a large animal model before it can be introduced into a clinical trial. Isolated Autologous marrow stromal cells (aMSCs) were cultured in vitro, then seeded into allogenic demineralized bone matrix (aDBM) and co-cultivated for 7 days to construct DBM-MSCs complex. 24 goats were randomly divided into three groups (8 in each), on which 3 cm diaphyseal femoral defects were created unilaterally and subsequently filled with the DBM-MSCs complex, DBM alone and untreated control, respectively. A semiquantitative grading score was applied for radiological analysis after 12 weeks and 24 weeks. DBM-MSCs group increased the radiological scoring and biomechanical strength significantly and superiored over DBM only group. The animals in DBM-MSCs group total bone regeneration was observed in X-ray, whereas most of animal of DBM only group showed partial bone regeneration, while untreated showed no defect healing. Bone regeneration of DBM-MSCs group was histologically better than in DBM only controls and failed in untreated group. In summary, this study confirmed that the goat critical size defect was appropriate in size to produce large defect nonunions model, and our results strongly encourage the application of the transplantation of bone marrow stromal cells within demineralized bone matrix for bone regeneration of large segmental bone defects.
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脱矿化骨基质骨髓间质细胞移植修复大节段骨缺损
本研究的目的是在将组织工程构建物引入临床试验之前,在大型动物模型中确定大节段性骨缺损的愈合潜力。体外培养分离的自体骨髓基质细胞(aMSCs),然后将其植入同种异体脱矿骨基质(aDBM)中共培养7 d,构建DBM-MSCs复合物。将24只山羊随机分为3组(每组8只),分别单侧制造3cm股骨骨干缺损,随后填充DBM- mscs复合物、单独DBM和未处理对照组。12周和24周后采用半定量评分法进行放射学分析。DBM- mscs组放射学评分和生物力学强度显著提高,优于单纯DBM组。x线观察DBM- mscs组动物全骨再生,而仅DBM组大部分动物骨部分再生,未处理动物无缺损愈合。DBM- mscs组骨再生在组织学上优于单纯DBM对照组,未治疗组骨再生失败。综上所述,本研究证实山羊临界尺寸缺损适合制作大缺损不愈合模型,我们的研究结果强烈鼓励将骨髓基质细胞移植到脱矿骨基质中用于大节段性骨缺损的骨再生。
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