Treatment of steroid-induced femoral head necrosis by hypoxia-induced bone marrow stromal stem cell transplantation

doi:10.3969/j.issn.2095-4344.1821

Abstract

Abstract:

BACKGROUND: Bone marrow stromal stem cell transplantation has been explored for the treatment of femoral head necrosis at present, but there are some problems to be solved such as unsatisfactory therapeutic effect.
OBJECTIVE: To observe the effect of hypoxic preconditioning of bone marrow stromal stem cells on steroid-induced femoral head necrosis in rabbits.
METHODS: Rabbit bone marrow stromal cells were isolated, purified and cultured. They were cultured in a hypoxic incubator (2% O2) for 48 hours. Cell counting kit-8, flow cytometry, and ELISA assay were used to detect cell viability, apoptosis and secretion of cytokines, respectively. Forty New Zealand rabbits were randomly divided into control group, model group, stem cell group and hypoxia-treated stem cell group, 10 in each group. Steroid-induced femoral head necrosis model was established in the latter three groups. Bone marrow stromal stem cells that were normally cultured or induced by hypoxia were transplanted in the latter two groups. After 6 weeks of transplantation, femoral head tissue from each rabbit was taken out for general observation and hematoxylin-eosin staining.
RESULTS AND CONCLUSION: (1) After hypoxic preconditioning, the viability of bone marrow stromal stem cells increased significantly, while the cell apoptosis decreased considerably. The levels of cytokines such vascular endothelial growth factor, growth factor and insulin-like growth factor 1 released into the supernatant increased markedly. (2) The surface of the femoral head of the model group was damaged and collapsed. The surface of the femoral head of the model group was dark in color and congested, and the bone became brittle. The surface of the femoral head of the stem cell group was light-colored, and the congestion alleviated. The surface of the femoral head of the hypoxia-treated stem cell group was smooth, flat and light-colored, with no obvious congestion. In this group, the femoral head was close to the normal bone of the control group. (3) In the control group, the trabecular structure was intact and osteoclasts were evenly dispersed. In the model group, the trabeculae disappeared obviously, and empty bone lacunae appeared. A large number of osteoclasts were observed. In the stem cell group, the trabeculae were blurred and the osteoclasts were still densely arranged. In the hypoxia-treated stem cell group, the trabecular structure remained intact and the accumulation of osteoclasts decreased. These results suggest that the transplantation of bone marrow stromal stem cells after hypoxic preconditioning has a better effect on the treatment of steroid-induced avascular necrosis of the femoral head.

Key words: steriod-induced femoral head necrosis, bone marrow stromal stem cell transplantation, hypoxia, vascular endothelial growth factor, hepatocyte growth factor, insulin-like growth factor 1

CLC Number:

Dong Wentao, Zhou Yongfang, Zhang Jian, Zhang Fei, Wu Jianhua, Wang Qiang, Xu Fengyang, Peng Wuxun. Treatment of steroid-induced femoral head necrosis by hypoxia-induced bone marrow stromal stem cell transplantation[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(33): 5307-5311.

Figures/Tables 5

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