Chinese Journal of Tissue Engineering Research ›› 2010, Vol. 14 ›› Issue (19): 3446-3450.doi: 10.3969/j.issn.1673-8225.2010.19.006

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Extracorporeal shock wave effects on osteogenic differentiation of bone marrow mesenchymal stem cells at the non-necrotic area of patients with steroid-induced avascular necrosis of the femoral head

Zhai Lei1, Sun Nan1, Jiang Chuan1, Xu Lei1, Xing Geng-yan2   

  1. 1Affiliated Hospital of Medical College of Chinese People's Armed Police Force, Tianjin  300162, China;
    2Department of Orthopedics, General Hospital of Chinese People's Armed Police Force, Beijing  100039, China
  • Online:2010-05-07 Published:2010-05-07
  • Contact: Xing Geng-yan, Professor, Master’s supervisor, Department of Orthopedics, General Hospital of Chinese People's Armed Police Force, Beijing 100039, China jstzzl2000@yahoo.com.cn
  • About author:Zhai Lei, Master, Physician, Affiliated Hospital of Medical College of Chinese People's Armed Police Force, Tianjin 300162, China jstzzl2000@yahoo.com.cn
  • Supported by:

    the National Natural Science Foundation of China, No. 30371430*;
    the Capital Medical Development and Scientific Research Foundation of China, No. 2002-3037*

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Abstract:

BACKGROUND: Avascular necrosis of the femoral head involves pimelosis changes of bone marrow progenitor cells on the proximal end of the femur, and leads to difficulties in repairing the bone remodeling. It still remains unclear whether bone marrow mesenchymal stem cells (BMSCs) can be induce-differentiated into osteoblast precursor at autologous non-osteonecrosis region using in vitro extracorporeal shock wave therapy, and then transplanted in autologous osteonecrosis region, contributing to bone remodeling in the zone of necrosis.
OBJECTIVE: To investigate the effect of extracorporeal shock wave on the BMSC differentiation in the non-necrotic area of steroid-induced osteonecrosis of the femoral head in patients.
METHODS: This study took the bone marrow of steroid-induced osteonecrosis of the femoral head patients who donated voluntarily. BMSCs were isolated and cultured in vitro by density gradient centrifugation and adherence method. Primary cultured BMSCs were cultured with serum-free medium for 24 hours, and intervened by extracorporeal shock wave of 5 kV/500 frequency for 10 minutes. No extracorporeal shock wave was given in the blank control group.
RESULTS AND CONCLUSION: Cells after passage in the extracorporeal shock wave group entered the peak phase of proliferation early, showing osteogenic differentiation trend. Cells in the blank control group presented multi-directional differentiation into other cell types. Proliferation speed was significantly greater in the extracorporeal shock wave group than in the blank control group at various time points (except at day 1) (P < 0.01). Mean positive rate of alkaline phosphatase was about 90% at day 24 in the extracorporeal shock wave group, and about 50% at day 36 in the blank control group. At day 20, alizarin red staining exhibited that mineralized nodules in the extracorporeal shock wave group was (7.0 ± 1.3) per field, but no obvious mineralized nodules were found, and staining was always negative in the blank control group. Core binding factor α1 mRNA expression in the extracorporeal shock wave group was significantly stronger than the blank control group at various time points (except at day 3) (P < 0.01). Osteocalcin mRNA expression was significantly stronger in the extracorporeal shock wave group than in the blank control group at various time points (except at days 3 and 6) (P < 0.01). Results have suggested that appropriate intensity of extracorporeal shock wave can promote proliferation and induce osteoblastic differentiation of BMSCs at non-necrotic region of patients with steroid-induced osteonecrosis of the femoral head.

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