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Angiogenesis and proliferation index in patients with acute leukemia: a prospective study. 急性白血病患者血管生成和增殖指数的前瞻性研究。
Pub Date : 2014-01-01 Epub Date: 2014-03-31 DOI: 10.1155/2014/634874
Prabhavati Jothilingam, Debdatta Basu, Tarun K Dutta

Angiogenesis and proliferation as measured by microvessel density (MVD) and proliferation index (PI) are essential correlates of malignancy. The aim of our study was to evaluate difference between these values in AML and ALL and also to study the modulation in these parameters following achievement of remission in acute lymphoblastic leukemia. Differences between adult and adolescent cases of acute leukemia in relation to these values were also studied. We also tried to assess the relationship between angiogenesis and proliferation. Fifty-five patients with acute leukemia were included in the study. Trephine biopsies were immunostained with CD34 and factor VIIIrAg to demonstrate angiogenesis measured as MVD. Immunostaining with PCNA and Ki-67 was done to study proliferation. We found a significant increase in MVD and PI in cases when compared with controls (P < 0.0001). In addition cases with ALL had a significantly higher MVD compared to those with AML (P < 0.01). The patients with ALL who went into remission showed a significant reduction in MVD; PI remained high. The cases which did not achieve remission showed no significant reduction in either MVD or PI. All adolescent cases of ALL were similar to adults with respect to MVD and PI.

微血管密度(MVD)和增殖指数(PI)测量血管生成和增殖是恶性肿瘤的重要相关指标。我们研究的目的是评估AML和ALL中这些值的差异,并研究急性淋巴细胞白血病缓解后这些参数的调节。成人和青少年急性白血病病例在这些数值上的差异也进行了研究。我们也试图评估血管生成和增殖之间的关系。55名急性白血病患者参与了这项研究。Trephine活检组织用CD34和viirag免疫染色,以MVD测量血管生成。用PCNA和Ki-67免疫染色观察细胞增殖情况。我们发现,与对照组相比,病例中MVD和PI显著增加(P < 0.0001)。ALL患者的MVD明显高于AML患者(P < 0.01)。进入缓解期的ALL患者MVD显著降低;PI仍然很高。未达到缓解的病例显示MVD或PI均无显著降低。所有青少年All病例在MVD和PI方面与成人相似。
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引用次数: 11
Bone marrow vascular niche: home for hematopoietic stem cells. 骨髓血管生态位:造血干细胞的家园。
Pub Date : 2014-01-01 Epub Date: 2014-04-14 DOI: 10.1155/2014/128436
Ningning He, Lu Zhang, Jian Cui, Zongjin Li

Though discovered later than osteoblastic niche, vascular niche has been regarded as an alternative indispensable niche operating regulation on hematopoietic stem cells (HSCs). As significant progresses gained on this type niche, it is gradually clear that the main work of vascular niche is undertaking to support hematopoiesis. However, compared to what have been defined in the mechanisms through which the osteoblastic niche regulates hematopoiesis, we know less in vascular niche. In this review, based on research data hitherto we will focus on component foundation and various functions of vascular niche that guarantee the normal hematopoiesis process within bone marrow microenvironments. And the possible pathways raised by various research results through which this environment undergoes its function will be discussed as well.

血管生态位虽然被发现晚于成骨细胞生态位,但一直被认为是造血干细胞不可缺少的另一生态位。随着对这种类型生态位的研究取得重大进展,人们逐渐清楚血管生态位的主要工作是支持造血。然而,与成骨细胞生态位调节造血的机制相比,我们对血管生态位的了解较少。本文将根据迄今为止的研究资料,重点介绍骨髓微环境中保证正常造血过程的血管生态位的组成基础和各种功能。并将讨论各种研究结果提出的这种环境实现其功能的可能途径。
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引用次数: 65
Autologous Graft versus Host Disease: An Emerging Complication in Patients with Multiple Myeloma. 自体移植物抗宿主病:多发性骨髓瘤患者的新并发症
Pub Date : 2014-01-01 Epub Date: 2014-05-04 DOI: 10.1155/2014/891427
Anu Batra, Michele Cottler-Fox, Terry Harville, Bobbie S Rhodes-Clark, Issam Makhoul, Mayumi Nakagawa

Autologous graft versus host disease (autoGVHD) is a rare transplant complication with significant morbidity and mortality. It has been hypothesized that patients with multiple myeloma might be predisposed to autoGVHD through dysregulation of the immune response resulting from either their disease, the immunomodulatory agents (IMiDs) used to treat it, or transplant conditioning regimen. Hematopoietic progenitor cell (HPC) products were available from 8 multiple myeloma patients with biopsy-proven autoGVHD, 16 matched multiple myeloma patients who did not develop autoGVHD, and 7 healthy research donors. The data on number of transplants prior to developing autoGVHD, mobilization regimens, exposure to proteasome inhibitors, use of IMiDs, and class I human leukocyte antigen types (HLA A and B) were collected. The HPC products were analyzed by flow cytometry for expression of CD3, CD4, CD8, CD25, CD56, and FoxP3. CD3(+) cell number was significantly lower in autoGVHD patients compared to unaffected controls (P = 0.047). On subset analysis of CD3(+) cells, CD8(+) cells (but not CD4(+) cells) were found to be significantly lower in patients with autoGVHD (P = 0.038). HLA-B55 expression was significantly associated with development of autoGVHD (P = 0.032). Lower percentages of CD3(+) and CD8(+) T-cells and HLA-B55 expression may be predisposing factors for developing autoGVHD in myeloma.

自体移植物抗宿主病(autoGVHD)是一种罕见的移植并发症,发病率和死亡率都很高。据推测,多发性骨髓瘤患者可能由于自身疾病、用于治疗的免疫调节剂(IMiDs)或移植调理方案导致的免疫反应失调而易患自身gvhd。造血祖细胞(HPC)产品来自8名活检证实为autoGVHD的多发性骨髓瘤患者,16名匹配的未发生autoGVHD的多发性骨髓瘤患者和7名健康的研究供体。收集发生自身gvhd前的移植数量、动员方案、暴露于蛋白酶体抑制剂、使用IMiDs和I类人白细胞抗原类型(HLA A和B)的数据。流式细胞术检测HPC产物中CD3、CD4、CD8、CD25、CD56和FoxP3的表达。与未受影响的对照组相比,autoGVHD患者的CD3(+)细胞数量显著降低(P = 0.047)。在CD3(+)细胞的亚群分析中,发现CD8(+)细胞(而不是CD4(+)细胞)在autoGVHD患者中显著降低(P = 0.038)。HLA-B55的表达与autoGVHD的发生有显著相关性(P = 0.032)。低百分比的CD3(+)和CD8(+) t细胞和HLA-B55表达可能是骨髓瘤发生自身gvhd的易感因素。
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引用次数: 8
TET2 Inhibits Differentiation of Embryonic Stem Cells but Does Not Overcome Methylation-Induced Gene Silencing. TET2抑制胚胎干细胞分化,但不能克服甲基化诱导的基因沉默。
Pub Date : 2014-01-01 Epub Date: 2014-08-25 DOI: 10.1155/2014/986571
Louis Norman, Paul Tarrant, Timothy Chevassut

TET2 is a methylcytosine dioxygenase that is frequently mutated in myeloid malignancies, notably myelodysplasia and acute myeloid leukemia. TET2 catalyses the conversion of 5'-methylcytosine to 5'-hydroxymethylcytosine within DNA and has been implicated in the process of genomic demethylation. However, the mechanism by which TET2 loss of function results in hematopoietic dysplasia and leukemogenesis is poorly understood. Here, we show that TET2 is expressed in undifferentiated embryonic stem cells and that its knockdown results in reduction of 5'-hydroxymethylcytosine in genomic DNA. We also present DNA methylation data from bone marrow samples obtained from patients with TET2-mutated myelodysplasia. Based on these findings, we sought to identify the role of TET2 in regulating pluripotency and differentiation. We show that overexpression of TET2 in a stably integrated transgene leads to increased alkaline phosphatase expression in differentiating ES cells and impaired differentiation in methylcellulose culture. We speculate that this effect is due to TET2-mediated expression of stem cell genes in ES cells via hydroxylation of 5'-methylcytosines at key promoter sequences within genomic DNA. This leads to relative hypomethylation of gene promoters as 5'-hydroxymethylcytosine is not a substrate for DNMT1-mediated maintenance methylation. We sought to test this hypothesis by cotransfecting the TET2 gene with methylated reporter genes. The results of these experiments are presented.

TET2是一种甲基胞嘧啶双加氧酶,在髓系恶性肿瘤中经常发生突变,特别是髓系异常增生和急性髓系白血病。TET2催化DNA内5'-甲基胞嘧啶向5'-羟甲基胞嘧啶的转化,并参与基因组去甲基化过程。然而,TET2功能丧失导致造血发育不良和白血病发生的机制尚不清楚。在这里,我们发现TET2在未分化的胚胎干细胞中表达,它的敲低导致基因组DNA中5'-羟甲基胞嘧啶的减少。我们还提供了从tet2突变骨髓异常增生患者的骨髓样本中获得的DNA甲基化数据。基于这些发现,我们试图确定TET2在调节多能性和分化中的作用。我们发现,在稳定整合的转基因中,TET2的过表达导致分化的ES细胞中碱性磷酸酶表达增加,甲基纤维素培养中的分化受损。我们推测,这种影响是由于tet2介导的干细胞基因在胚胎干细胞中通过基因组DNA关键启动子序列上5'-甲基胞嘧啶的羟基化表达。这导致基因启动子的相对低甲基化,因为5'-羟甲基胞嘧啶不是dnmt1介导的维持甲基化的底物。我们试图通过将TET2基因与甲基化的报告基因共转染来验证这一假设。最后给出了实验结果。
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引用次数: 2
The RAG Model: A New Paradigm for Genetic Risk Stratification in Multiple Myeloma. RAG模型:多发性骨髓瘤遗传风险分层的新范式。
Pub Date : 2014-01-01 Epub Date: 2014-09-11 DOI: 10.1155/2014/526568
Steven M Prideaux, Emma Conway O'Brien, Timothy J Chevassut
Molecular studies have shown that multiple myeloma is a highly genetically heterogonous disease which may manifest itself as any number of diverse subtypes each with variable clinicopathological features and outcomes. Given this genetic heterogeneity, a universal approach to treatment of myeloma is unlikely to be successful for all patients and instead we should strive for the goal of personalised therapy using rationally informed targeted strategies. Current DNA sequencing technologies allow for whole genome and exome analysis of patient myeloma samples that yield vast amounts of genetic data and provide a mutational overview of the disease. However, the clinical utility of this information currently lags far behind the sequencing technology which is increasingly being incorporated into clinical practice. This paper attempts to address this shortcoming by proposing a novel genetically based “traffic-light” risk stratification system for myeloma, termed the RAG (Red, Amber, Green) model, which represents a simplified concept of how complex genetic data may be compressed into an aggregate risk score. The model aims to incorporate all known clinically important trisomies, translocations, and mutations in myeloma and utilise these to produce a score between 1.0 and 3.0 that can be incorporated into diagnostic, prognostic, and treatment algorithms for the patient.
分子研究表明,多发性骨髓瘤是一种高度遗传异质性的疾病,可能表现为任意数量的不同亚型,每种亚型具有不同的临床病理特征和结果。鉴于这种遗传异质性,治疗骨髓瘤的通用方法不太可能对所有患者都成功,相反,我们应该努力实现个性化治疗的目标,使用合理的有针对性的策略。目前的DNA测序技术允许对骨髓瘤患者样本进行全基因组和外显子组分析,从而产生大量的遗传数据,并提供疾病的突变概况。然而,这些信息的临床应用目前远远落后于越来越多地纳入临床实践的测序技术。本文试图通过提出一种新的基于遗传的骨髓瘤“红绿灯”风险分层系统来解决这一缺点,称为RAG (Red, Amber, Green)模型,它代表了如何将复杂的遗传数据压缩成总体风险评分的简化概念。该模型旨在纳入骨髓瘤中所有已知的临床上重要的三体、易位和突变,并利用这些来产生1.0到3.0之间的评分,该评分可以纳入患者的诊断、预后和治疗算法。
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引用次数: 6
Human mesenchymal stromal cell-mediated immunoregulation: mechanisms of action and clinical applications. 人间充质间质细胞介导的免疫调节:作用机制和临床应用。
Pub Date : 2013-01-01 Epub Date: 2013-09-29 DOI: 10.1155/2013/203643
Akaitz Dorronsoro, Jon Fernández-Rueda, Karoline Fechter, Izaskun Ferrin, Juan Manuel Salcedo, Emma Jakobsson, César Trigueros

Mesenchymal stromal cells (MSCs) are multipotent cells found in connective tissues that can differentiate into bone, cartilage, and adipose tissue. Interestingly, they can regulate immune responses in a paracrine way and allogeneic MSCs do not elicit immune response. These properties have encouraged a number of clinical trials in a broad range of regenerative therapies. Although these trials were first focused on their differentiation properties, in the last years, the immunosuppressive features have gained most of the attention. In this review, we will summarize the up-to-date knowledge about the immunosuppressive mechanisms of MSCs in vivo and in vitro and the most promising approaches in clinical investigation.

间充质间质细胞(MSCs)是存在于结缔组织中的多能细胞,可以分化为骨、软骨和脂肪组织。有趣的是,它们可以以旁分泌的方式调节免疫反应,而同种异体间充质干细胞不会引起免疫反应。这些特性鼓励了大量再生疗法的临床试验。虽然这些试验最初集中在它们的分化特性上,但在过去的几年里,免疫抑制特性获得了大部分的关注。在本文中,我们将对MSCs体内和体外免疫抑制机制的最新知识和最有前途的临床研究方法进行综述。
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引用次数: 35
Incidence and Pattern of Graft-versus-Host Disease in Patients Undergoing Allogeneic Transplantation after Nonmyeloablative Conditioning with Total Lymphoid Irradiation and Antithymocyte Globulin. 全淋巴细胞照射和抗胸腺细胞球蛋白非清髓性治疗后同种异体移植患者移植物抗宿主病的发病率和模式
Pub Date : 2013-01-01 Epub Date: 2013-04-17 DOI: 10.1155/2013/414959
Lauren Veltri, Michael Regier, Aaron Cumpston, Sonia Leadmon, William Tse, Michael Craig, Mehdi Hamadani

Nonmyeloablative (NMA) conditioning with total lymphoid irradiation and antithymocyte globulin (TLI/ATG) has been shown to protect against acute graft-versus-host disease (GVHD). We report here our institutional experience with allogeneic transplantation following NMA conditioning with TLI/ATG (n = 21). GVHD prophylaxis consisted of a combination of a calcineurin inhibitor and mycophenolate mofetil. Median patient age was 59 years. The median followup of surviving patients is 545 days. One patient experienced primary graft rejection. The median time to neutrophil engraftment was 18 days and platelet engraftment was 9.5 days. The cumulative incidence (CI) of grade II-IV acute GVHD at day +100 was 28.6% and 38.1% at day +180. The CI for grade III-IV acute GVHD was 28.6% at day +180. CI of chronic GVHD was 45.2% at 1 year. The CI of disease relapse was 9.5% at 1 year. The rate of nonrelapse mortality (NRM) was 0% at day +100 and only 9.5% at 1 year. The overall and progression free survival at 1 year was 81% and 80.4%, respectively. Our limited, retrospective data show encouraging relapse and NRM rates with TLI/ATG-based NMA conditioning, but with higher than previously reported rates of acute and chronic GVHD, underscoring the need for novel strategies designed to effectively prevent GVHD.

非清髓性(NMA)调节与全淋巴照射和抗胸腺细胞球蛋白(TLI/ATG)已被证明可预防急性移植物抗宿主病(GVHD)。在此,我们报告了我们在TLI/ATG治疗NMA后同种异体移植的机构经验(n = 21)。GVHD预防包括钙调磷酸酶抑制剂和霉酚酸酯的组合。患者中位年龄为59岁。存活患者的中位随访时间为545天。1例患者出现原发性移植排斥反应。中性粒细胞移植的中位时间为18天,血小板移植的中位时间为9.5天。第100天II-IV级急性GVHD的累积发病率(CI)为28.6%,第180天为38.1%。III-IV级急性GVHD的CI为28.6%。慢性GVHD患者1年时CI为45.2%。1年时疾病复发的CI为9.5%。第100天非复发死亡率(NRM)为0%,第1年仅为9.5%。1年总生存率和无进展生存率分别为81%和80.4%。我们有限的回顾性数据显示,基于TLI/ atg的NMA调节的复发率和NRM率令人鼓舞,但急性和慢性GVHD的发生率高于之前报道的,这强调了设计有效预防GVHD的新策略的必要性。
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引用次数: 11
Validation of the EBMT Risk Score for South Brazilian Patients Submitted to Allogeneic Hematopoietic Stem Cell Transplantation. 巴西南部接受同种异体造血干细胞移植患者EBMT风险评分的验证
Pub Date : 2013-01-01 Epub Date: 2013-12-12 DOI: 10.1155/2013/565824
Beatriz Stela Pitombeira, Alessandra Paz, Annelise Pezzi, Bruna Amorin, Vanessa Valim, Alvaro Laureano, Andrea Wieck, Lisandra Rigoni, Erica Ottoni, Gustavo Fisher, Liane Daudt, Lucia Silla

Background. Allogeneic hematopoietic stem cell transplantation (HSCT) is still associated with a high transplant-related mortality rate. In 2009, the EBMT risk score was validated as a simple tool to predict the outcome after allogeneic HSCT for acquired hematological disorders. Objectives. The aim of this study was to validate the applicability of the EBMT risk score for allogeneic HSCT on South Brazilian patients. Methods. A retrospective observational study was performed based on patients' records and data base at Hospital de Clínicas de Porto Alegre, including all allogeneic transplants for malignant and severe aplastic anemia from 1994 to 2010. Patients were categorized according to EBMT risk score and overall survival (OS). Nonrelapse mortality (NRM) and relapse rate (RR) were analyzed. Results. There were 278 evaluable patients. OS, NRM, and RR at five years median followup were 48.7%, 40.7%, and 30.7%, respectively. The OS was 81.8% for risk score 0 and 0% for score 6 (P < 0.001), and NRM was 13.6% and 80% for risk scores 0 and 6, respectively (P = 0.001). Conclusion. The EBMT risk score can be utilized as a tool for clinical decision making before allogeneic HSCT for malignant hematological diseases and severe aplastic anemia at a single center in Brazil.

背景。同种异体造血干细胞移植(HSCT)仍然与移植相关的高死亡率相关。2009年,EBMT风险评分被证实是预测获得性血液病同种异体造血干细胞移植后预后的简单工具。目标。本研究的目的是验证EBMT风险评分对巴西南部患者同种异体造血干细胞移植的适用性。方法。基于Clínicas阿雷格里港医院的患者记录和数据库进行了一项回顾性观察性研究,包括1994年至2010年恶性和严重再生障碍性贫血的所有同种异体移植。根据EBMT风险评分和总生存期(OS)对患者进行分类。分析非复发死亡率(NRM)和复发率(RR)。结果。278例可评估患者。5年中位随访时OS、NRM和RR分别为48.7%、40.7%和30.7%。0分和6分的OS分别为81.8%和0% (P < 0.001), 0分和6分的NRM分别为13.6%和80% (P = 0.001)。结论。EBMT风险评分可作为巴西单一中心恶性血液病和严重再生障碍性贫血同种异体造血干细胞移植前的临床决策工具。
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引用次数: 11
Adenoviral Delivery of the VEGF and BMP-6 Genes to Rat Mesenchymal Stem Cells Potentiates Osteogenesis. 腺病毒向大鼠间充质干细胞传递VEGF和BMP-6基因促进成骨。
Pub Date : 2013-01-01 Epub Date: 2013-02-26 DOI: 10.1155/2013/737580
Jesse Seamon, Xiuli Wang, Fuai Cui, Tom Keller, Abhijit S Dighe, Gary Balian, Quanjun Cui

The combined delivery of mesenchymal stem cells (MSCs), vascular endothelial growth factor (VEGF), and bone morphogenetic protein (BMP) to sites of bone injury results in enhanced repair compared to the administration of a single factor or a combination of two factors. Based on these findings, we hypothesized that coexpression of VEGF and BMP-6 genes would enhance the osteoblastic differentiation of rat bone-marrow-derived stem cells (rMSCs) and osteogenesis by comparison to rMSCs that do not express VEGF and BMP-6. We prepared a GFP tagged adenovirus vector (Ad-VEGF+BMP-6) that contained DNA encoding the hVEGF and hBMP-6 genes. rMSCs were transduced with the virus, and the successful transduction was confirmed by green fluorescence and by production of VEGF and BMP-6 proteins. The cells were cultured to assess osteoblastic differentiation or administered in the Fischer 344 rats to assess bone formation. Mineralization of rMSCs transduced with Ad-VEGF+BMP-6 was significantly enhanced over the nontransduced rMSCs. Only transduced rMSCs could induce osteogenesis in vivo, whereas Ad-VEGF+BMP-6 or nontransduced rMSCs alone did not induce osteogenesis. The data suggests that the combined delivery of MSCs, VEGF, and BMP-6 is an attractive option for bone repair therapy.

将间充质干细胞(MSCs)、血管内皮生长因子(VEGF)和骨形态发生蛋白(BMP)联合递送至骨损伤部位,与单一或两种因素联合递送相比,可增强骨损伤的修复。基于这些发现,我们假设与不表达VEGF和BMP-6的rMSCs相比,VEGF和BMP-6基因的共表达会增强大鼠骨髓干细胞(rMSCs)的成骨分化和成骨作用。我们制备了一种GFP标记的腺病毒载体(Ad-VEGF+BMP-6),该载体含有编码hVEGF和hBMP-6基因的DNA。用病毒转染rmsc,通过绿色荧光和VEGF和BMP-6蛋白的产生证实了成功的转导。这些细胞被培养以评估成骨细胞分化,或被给予Fischer 344大鼠以评估骨形成。与未转导的rmsc相比,用Ad-VEGF+BMP-6转导的rmsc的矿化明显增强。只有经过转导的rMSCs才能在体内诱导成骨,而单独的Ad-VEGF+BMP-6或未经过转导的rMSCs不能诱导成骨。数据表明,MSCs、VEGF和BMP-6联合递送是骨修复治疗的一个有吸引力的选择。
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引用次数: 17
High-Frequency Vibration Treatment of Human Bone Marrow Stromal Cells Increases Differentiation toward Bone Tissue. 高频振动治疗人骨髓基质细胞促进向骨组织分化。
Pub Date : 2013-01-01 Epub Date: 2013-03-25 DOI: 10.1155/2013/803450
D Prè, G Ceccarelli, L Visai, L Benedetti, M Imbriani, M G Cusella De Angelis, G Magenes

In order to verify whether differentiation of adult stem cells toward bone tissue is promoted by high-frequency vibration (HFV), bone marrow stromal cells (BMSCs) were mechanically stimulated with HFV (30 Hz) for 45 minutes a day for 21 or 40 days. Cells were seeded in osteogenic medium, which enhances differentiation towards bone tissue. The effects of the mechanical treatment on differentiation were measured by Alizarin Red test, (q) real-time PCR, and protein content of the extracellular matrix. In addition, we analyzed the proliferation rate and apoptosis of BMSC subjected to mechanical stimulation. A strong increase in all parameters characterizing differentiation was observed. Deposition of calcium was almost double in the treated samples; the expression of genes involved in later differentiation was significantly increased and protein content was higher for all osteogenic proteins. Lastly, proliferation results indicated that stimulated BMSCs have a decreased growth rate in comparison with controls, but both treated and untreated cells do not enter the apoptosis process. These findings could reduce the gap between research and clinical application for bone substitutes derived from patient cells by improving the differentiation protocol for autologous cells and a further implant of the bone graft into the patient.

为了验证高频振动(HFV)是否促进成体干细胞向骨组织的分化,我们用HFV (30 Hz)每天45分钟的机械刺激骨髓间质细胞(BMSCs),持续21或40天。将细胞植入成骨培养基中,增强向骨组织的分化。采用茜素红试验(Alizarin Red test)、实时荧光定量PCR (real-time PCR)和细胞外基质蛋白含量检测机械处理对分化的影响。此外,我们还分析了机械刺激下BMSC的增殖率和凋亡情况。观察到所有表征分化的参数都有明显的增加。在处理过的样品中,钙的沉积几乎增加了一倍;与后期分化相关的基因表达显著增加,所有成骨蛋白的蛋白含量均较高。最后,增殖结果表明,与对照组相比,受刺激的骨髓间充质干细胞的生长速度下降,但处理和未处理的细胞都不进入凋亡过程。这些发现可以通过改进自体细胞的分化方案和进一步将骨移植物植入患者体内来缩小来自患者细胞的骨替代物的研究与临床应用之间的差距。
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引用次数: 29
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Bone Marrow Research
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