Guided bone regeneration using resorbable membrane and different bone substitutes: Early histological and molecular events
Guided bone regeneration using resorbable membrane and different bone substitutes: Early histological and molecular events
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DOI：
10.1016/j.actbio.2015.10.005
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发表时间：
2016-01-01
影响因子：
9.7
通讯作者：
Omar, Omar
中科院分区：
文献类型：
--
作者：
Elgali, Ibrahim;Turri, Alberto;Omar, Omar
骨量不足仍然是骨锚固植入物的主要挑战。引导骨再生(GBR)与骨强化相结合是一种公认的骨修复方法。然而，对骨替代物和GBR膜材料与骨愈合环境之间的相互作用缺乏正确的了解。本研究旨在探讨GBR膜与不同的磷酸钙(CaP)材料复合后骨愈合的早期事件及细胞活性。在大鼠股骨小梁区建立缺损区，用脱蛋白牛骨(DBB)、羟基磷灰石(HA)或掺锶HA(SrHA)填充或留置空白(Sham)。所有的缺损处都被一层细胞外基质膜覆盖。分别于12h、3d、6d取材进行组织学/组织形态计量学、免疫组织化学及基因表达分析。组织学检查显示，6天时，所有的缺损处均有新生骨形成。在SrHA填充的缺损处可观察到较多的骨量。这与破骨细胞基因(CR和CatK)和破骨细胞-破骨细胞偶联基因(RANKL)在SrHA缺损区的表达减少是平行的。免疫组织化学显示，在SrHA缺损处破骨细胞较少。膜内CD68和Periostin表达细胞的观察表明，膜可能参与了缺损区的修复过程。结论：锶在体内的促骨作用是通过减少分解代谢和成骨细胞-破骨细胞偶联过程而实现的。本研究为人工合成含锶羟基磷灰石(SrHA)替代材料与可吸收引导骨再生(GBR)膜结合促进早期骨再生提供了新的分子、细胞和结构证据。主要基于体外数据的流行观点认为，锶的有益作用是通过刺激骨形成细胞(成骨细胞)和抑制骨吸收细胞(破骨细胞)发挥的。相反，本研究表明，锶在体内的局部作用主要是通过抑制破骨细胞的数量和活性以及减少成骨细胞-破骨细胞偶联来实现的。这些实验数据将为临床研究奠定基础，将这种材料用作引导骨再生的有趣的骨替代材料。(C)2015年Acta Materialia Inc.由爱思唯尔有限公司出版。这是CC BY-NC-ND许可证(http://creativecommons.org/licenses/by-nc-nd/4.0/).下的一篇开放获取文章
Bone insufficiency remains a major challenge for bone-anchored implants. The combination of guided bone regeneration (GBR) and bone augmentation is an established procedure to restore the bone. However, a proper understanding of the interactions between the bone substitute and GBR membrane materials and the bone-healing environment is lacking. This study aimed to investigate the early events of bone healing and the cellular activities in response to a combination of GBR membrane and different calcium phosphate (CaP) materials. Defects were created in the trabecular region of rat femurs, and filled with deproteinized bovine bone (DBB), hydroxyapatite (HA) or strontium-doped HA (SrHA) or left empty (sham). All the defects were covered with an extracellular matrix membrane. Defects were harvested after 12 h, 3 d and 6 d for histology/histomorphometry, immunohistochemistry and gene expression analyses. Histology revealed new bone, at 6 d, in all the defects. Larger amount of bone was observed in the SrHA-filled defect. This was in parallel with the reduced expression of osteoclastic genes (CR and CatK) and the osteoblast-osteoclast coupling gene (RANKL) in the SrHA defects. Immunohistochemistry indicated fewer osteoclasts in the SrHA defects. The observations of CD68 and periostin-expressing cells in the membrane per se indicated that the membrane may contribute to the healing process in the defect. It is concluded that the bone-promoting effects of Sr in vivo are mediated by a reduction in catabolic and osteoblast-osteoclast coupling processes. The combination of a bioactive membrane and CaP bone substitute material doped with Sr may produce early synergistic effects during GBR.Statement of significanceThe study provides novel molecular, cellular and structural evidence on the promotion of early bone regeneration in response to synthetic strontium-containing hydroxyapatite (SrHA) substitute, in combination with a resorbable, guided bone regeneration (GBR) membrane. The prevailing view, based mainly upon in vitro data, is that the beneficial effects of Sr are exerted by the stimulation of bone-forming cells (osteoblasts) and the inhibition of bone-resorbing cells (osteoclasts). In contrast, the present study demonstrates that the local effect of Sr in vivo is predominantly via the inhibition of osteoclast number and activity and the reduction of osteoblast-osteoclast coupling. This experimental data will form the basis for clinical studies, using this material as an interesting bone substitute for guided bone regeneration. (C) 2015 Acta Materialia Inc. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).