中国组织工程研究 ›› 2015, Vol. 19 ›› Issue (38): 6140-6144.doi: 10.3969/j.issn.2095-4344.2015.38.013

• 组织工程骨及软骨材料 tissue-engineered bone and cartilage materials • 上一篇    下一篇

聚羟基烷酸酯聚合物负载软骨细胞修复同种异体喉软骨缺损

吴延平1,吴 方2   

  1. 1河北省邯郸市第三医院耳鼻咽喉头颈外科,河北省邯郸市 056001;
    2河北医科大学第一医院,河北省石家庄市 050031
  • 通讯作者: 吴延平,河北省邯郸市第三医院耳鼻咽喉头颈外科,河北省邯郸市 056001
  • 作者简介:吴延平,男,1965年生,河北省邯郸市人,副主任医师。
  • 基金资助:

    河北省卫生厅项目(20140136)

Polyhydroxyalkanoate polymer carrying chondrocytes for repair of allogeneic laryngeal cartilage defects

Wu Yan-ping1, Wu Fang2   

  1. 1Department of Otolaryngology/Head and Neck Surgery, Third Hospital of Handan, Handan 056001, Hebei Province, China; 
    2First Affiliated Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei Province, China
  • Contact: Wu Yan-ping, Department of Otolaryngology/Head and Neck Surgery, Third Hospital of Handan, Handan 056001, Hebei Province, China
  • About author:Wu Yan-ping, Associate chief physician, Department of Otolaryngology/Head and Neck Surgery, Third Hospital of Handan, Handan 056001, Hebei Province, China
  • Supported by:

     the Health Department of Hebei Province, No. 20140136

摘要:

背景:喉软骨组织缺损发病率较高,患者发病后主要以疼痛、肿胀、功能障碍等为主。目前,临床上对于喉软骨组织损伤更多的以修复手术治疗为主,常规材料虽然能够有效的改善患者症状,但是长期疗效欠佳。近年来,软骨组织工程在临床上研究相对较多,但是在耳鼻咽喉科实际使用相对较多。

目的:探讨聚羟基烷酸酯聚合物负载软骨细胞在同种异体喉软骨缺损修复中的效果。
方法:将聚羟基丁酸酯与聚羟基己酸酯共聚物材料设为细胞外基质,采用组织工程技术制备细胞-材料复合物,将初级组织工程软骨组织直接移植于兔甲状软骨缺损的修复,或将初级组织工程软骨组织体内植入一定时期形成较成熟组织工程软骨再应用于甲状软骨缺损的修复。实验设单纯聚羟基丁酸酯与聚羟基己酸酯共聚物材料修复组和单纯软骨细胞修复组进行对照,对甲状软骨缺损修复效果进行大体和组织学评价。

结果与结论:初级组软骨在电镜扫描下能够看见软骨细胞表现为串珠状,培养4周后能够看见大量胶冻形状的基质。在电子显微镜下进行观察结果显示:细胞分布在复合材料表面和海绵状空隙中,显示多个类圆形小突起;入选新西兰兔均取得手术成功,并且手术后并未出现呼吸困难、进食困难等现象;实验初级组织工程软骨组1只兔出现短暂喘鸣;实验较成熟组织工程软骨组1只动物术后2周死于腹泻。大体测试负载软骨细胞的聚羟基丁酸酯与聚羟基己酸酯共聚物有一定硬度。皮下植入4周后成熟细胞表现为白色片状,材料具有弹性。植入后4,8周两组修复区与原有软骨间光滑平淡,但是修复区域则色发黄。单纯聚羟基丁酸酯与聚羟基己酸酯共聚物材料修复组和单纯软骨细胞修复组修复区均凹陷,仅见结缔组织。实验组兔不良反应发生率显著低于对照组(P < 0.05)。结果证实,聚羟基烷酸酯聚合物负载软骨细胞移植修复同种异体喉软骨缺损效果较好。

中国组织工程研究杂志出版内容重点:生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程

关键词: 生物材料, 软骨生物材料, 喉软组织缺损, 聚羟基烷酸酯聚合物, 软骨细胞, 同种异体, 电子显微镜, 组织学, 修复效果, 浸润反应, 影响因素, 组织工程技术

Abstract:

BACKGROUND: Laryngeal cartilage defect has a higher incidence, mainly presenting with pain, swelling, and dysfunction after onset. Currently, surgical treatment is the most used in clinical treatment of laryngeal cartilage defect. Although conventional materials can effectively improve symptoms, there is a poor long-term efficacy. In recent years, there are many clinical studies on cartilage tissue engineering, but less about the actual use in the otorhinolaryngology department.
OBJECTIVE: To investigate the effect of polyhydroxyalkanoate polymer carrying chondrocytes on the repair of allogeneic laryngeal cartilage defects.
METHODS: Poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHH) served as the extracellular matrix. Tissue engineering technology was used to prepare cell-material composite. Primary tissue-engineered cartilage tissue was transplanted directly into rabbit thyroid cartilage defect (experimental group A), or implanted into a more mature tissue-engineered cartilage for the repair of thyroid cartilage defect (experimental group B). In the experiment, PHBHH group and simple chondrocyte group were set as controls. Repairing effects on thyroid cartilage defect were evaluated through gross and histological observation.
RESULTS AND CONCLUSION: Chondrocytes in the primary tissue-engineered cartilage tissues were beaded under scanning electron microscope, and after 4 weeks of culture, a large amount of jelly-shaped substrates were visible. Findings from electron microscope observation showed that the cells were distributed on the surface of composite material and cavernous voids, displaying a plurality of small round projections. Surgical treatment was successful in all the rabbits, and there was no dyspnea and eating difficulties after surgery. One rabbit appeared to have brief wheezing in the experimental group A, two rabbits died of diarrhea in the experimental B group at 2 weeks after surgery. PHBHH composite carrying chondrocytes had certain hardness. At 4 weeks after subcutaneous implantation, mature cells were shaped as white sheets, and the material had elasticity. After 4 and 8 weeks, the space between repair zone and original cartilage tissue was smooth and plain, but the repair zone was colored yellow. In the simple PHBHH and chondrocyte groups, the repair zones were both depressed, only the connective tissues could be seen. Rabbits in the two experimental groups showed less adverse reactions compared with the two control groups (P < 0.05). These findings indicate that PHBHH composite carrying chondrocytes has better effects to repair allogeneic laryngeal cartilage defects.


中国组织工程研究
杂志出版内容重点:
生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程

 

Key words: Tissue Engineering, Cartilage, Larynx

中图分类号: