中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (52): 9746-9749.doi: 10.3969/j.issn.1673-8225.2011.52.013

• 人工假体 artificial prosthesis • 上一篇    下一篇

骨髓间充质干细胞、骨形态发生蛋白和骨发生潜力与髋关节置换后假体的稳定性

李晓淼1，沈  奕1，王伟力1，任卫平2   

  1. 1上海交通大学医学院附属仁济医院骨科，上海市  200127
    2Providence Hospital and Medical Centers, Southfield, MI and Department of Biomedical Engineering, Wayne State University, Detroit, MI 
  • 收稿日期:2011-08-18 修回日期:2011-10-28 出版日期:2011-12-24 发布日期:2011-12-24
  • 通讯作者: 王伟力，主任医师，教授，上海交通大学医学院附属仁济医院骨科，上海市 200127 drwangwl@126.com
  • 作者简介:李晓淼★，男，1980年生，上海市人，汉族，2009年上海交通大学医学院毕业，硕士，主要从事髋关节置换后假体松动的相关机制研究。 leexm1123@hotmail.com
  • 基金资助:

    上海市科委非政府间国际科技合作项目(09410706100)，课题名称：髋关节置换术股骨假体周围BMSC与BMP7含量和术后假体融合率中期随访的相关性研究。

Factors to influence the stability of the prosthesis after total hip replacement: Bone marrow mesenchymal stromal cells, bone morphogenetic protein and osteogenic potential

Li Xiao-miao1, Shen Yi1, Wang Wei-li1, Ren Wei-ping2   

  1. 1Department of Orthopedics, Renji Affiliated Hospital, Medical College of Shanghai Jiao Tong University, Shanghai  200127, China;  
    2Providence Hospital and Medical Centers, Southfield, MI and Department of Biomedical Engineering, Wayne State University, Detroit, MI
  • Received:2011-08-18 Revised:2011-10-28 Online:2011-12-24 Published:2011-12-24
  • Contact: Wang Wei-li, Chief physician, Professor, Department of Orthopedics, Renji Affiliated Hospital, Medical College of Shanghai Jiao Tong University, Shanghai 200127, China drwangwl@126.com
  • About author:Li Xiao-miao★, Master, Department of Orthopedics, Renji Affiliated Hospital, Medical College of Shanghai Jiao Tong University, Shanghai 200127, China leexm1123@hotmail.com
  • Supported by:

    Non-governmental International Scientific and Technological Cooperation Projects of Shanghai Science and Technology Committee, No. 09410706100*

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被引次数

1

摘要：

背景：骨髓微环境的成骨潜力与全髋关节置换后假体长期稳定性之间的关系尚不清楚。作者提出一个观点，通过骨髓成骨潜力的分析可以预测假体的契合强度。
目的：以线性回归分析评估全髋关节置换患者骨髓间充质干细胞活力、成骨蛋白信号通路相关基因表达与成骨发生在假体稳定性中的相关性。
方法：选择12例接受全髋关节置换的患者，置换过程中取股骨近端的骨髓组织在体外扩增至子一代，取出细胞进行流式细胞学或RNA检测，以线性回归分析评估成骨潜力各项指标之间的相关性。
结果与结论：患者骨髓间充质干细胞中Stro-1阳性细胞的数量、碱性磷酸酶活性以及成骨相关基因的表达情况具有较大的个体差异。Stro-1阳性细胞比率与骨形成蛋白受体1a，MSX2，Runx2、碱性磷酸酶活性存在显著相关性(P < 0.05)，细胞经成骨培养后碱性磷酸酶活性与Runx2表达也存在显著相关性(P < 0.05)。提示在全髋关节置换患者中骨髓微环境的成骨潜力具有较大的个体差异，而骨髓间充质干细胞各项指标对于全关节置换长期稳定性的潜在影响有待进一步深入研究。

关键词: 假体稳定性, 全髋关节置换, 骨髓间充质干细胞, 成骨潜力, 骨形态发生蛋白

Abstract:

BACKGROUND: The relationship between the osteogenic potential of the bone marrow microenvironment and long term stability after total hip replacement is not clear yet. The author makes a point, the fit intensity of the prosthesis can be predict through the osteogenic potential analysis of the bone marrow.
OBJECTIVE: To investigate the relationship between the activities of bone marrow mesenchymal stem cells, expression of osteogenic protein-signaling pathway related genes, osteogenic potential and the stability of the prosthesis.
METHODS: Bone marrow mesenchymal stem cells (BMSCs) were prepared from bone marrow aspirate obtained from the proximal femur metaphysis during total hip replacement (THR) surgery. Twelve patients were included in this study (8 men and 4 women, ages 50-84, body mass index 21.5-50). The isolated BMSCs were culture-expanded to passage one; non-confluent, undifferentiated cells were harvested for flow cytometry or for RNA isolation. Linear regression analysis was used to assess the correlation among indicators of osteogenic potential.
RESULTS AND CONCLUSION: The number of Stro-1+ cells, activity of alkaline phosphatase and expression of osteoblasts-related genes from BMSCs of these 12 patients varied significantly. There was a positive correlation between cells expressing the Stro-1 surface marker and bone morphogenetic protein receptor 1a, MSX2, Runx2 and the activity of alkaline phosphatase (P < 0.05), there was a significant correlation between the activity of alkaline phosphatase and the expression of Runx2 after the cells was cultured by osteoblats (P < 0.05). There was a highly diverse of the bone marrow microenvironment osteogenic potential among THR patients. The potential impact of the BMSCs profiles on the long term outcome of total joint replacement patients warrants further investigation.

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