Characteristics of the rat supraspinatus tendon during tendon-to-bone healing after acute injury
Characteristics of the rat supraspinatus tendon during tendon-to-bone healing after acute injury
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DOI：
10.1002/jor.20067
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发表时间：
2006-03-01
影响因子：
2.8
通讯作者：
Thomopoulos, S
中科院分区：
文献类型：
--
作者：
Galatz, LM;Sandell, LJ;Thomopoulos, S
肩袖修复术的失败率很高。人们对肩袖修复部位的自然愈合过程知之甚少，因此，几乎没有什么方法可以提高肌腱的愈合能力。本研究的目的是研究早期修复部位的胶原形成，以及在早期愈合过程中转化生长因子β1和3的定位，并将它们的水平与细胞增殖和组织学变化进行比较。60只大鼠双侧冈上肌腱切断修复。分别在0、1、3、7、10、28和56天采集标本并进行评估。对组织切片进行细胞形态评价。免疫组织化学和原位杂交检测I型、III型胶原和转化生长因子β1、3型胶原蛋白和mRNA的表达。增殖细胞核抗原(PC NA)法检测细胞增殖，计数细胞数确定细胞密度。对其生物力学性能进行评价。修复组织在第1天和第3天出现多核细胞，第7天和第10天出现淋巴细胞和浆细胞，修复组织表现为最初的炎症反应。毛细血管增殖开始于3d，10d达到高峰。在所研究的时间段内，极限力显著增加。I型胶原蛋白和信使核糖核酸在第10天显著增加，在第28天和56天达到高峰。III型胶原蛋白表现出类似的趋势，早期增加，并一直保持在较高水平，直到56d。转化生长因子β1定位于形成的创面组织，并在第10天出现明显的峰值。在愈合插入部位未发现TGFP-3。细胞增殖和密度与转化生长因子β-1的变化趋势一致。伤口愈合反应确实发生在愈合的肩袖插入部位，然而，愈合后的肌腱特征与所研究的最长时间点的未损伤肌腱插入部位有显著不同。一个独特的胶原重塑过程发生了，最初I型和III型胶原的形成增加，然后下降到0时的基线水平。生长因子转化生长因子β-1定位于修复组织，并与细胞增殖和细胞密度的高峰期一致。与先前描述的未损伤的插入部位相比，修复部位在组织学和生物力学方面仍然较差。(C)2006年骨科研究会。由威利期刊出版公司出版。
Rotator cuff repair is known to have a high failure rate. Little is known about the natural healing process of the rotator cuff repair site, hence little can be done to improve the tendon's ability to heal. The purpose of this study was to investigate the collagen formation at the early repair site and to localize TGF beta-1 and 3 during early healing and compare their levels to cell proliferation and histological changes. Bilateral supraspinatus tendons were transected and repaired in 60 rats. Specimens were harvested and evaluated at 0, 1, 3, 7, 10, 28, and 56 days. Histological sections were evaluated for cell morphology. Immunohistochemistry and in situ hybridization was performed to localize protein and mRNA for collagen types I and III and TGF beta-1 and 3. Proliferating cell nuclear antigen (PCNA) assay was performed to measure cell proliferation, and cells were counted to determine cell density. Biomechanical properties were evaluated. Repair tissue demonstrated an initial inflammatory response with multinucleated cells present at 1 and 3 days, and lymphocytes and plasma cells presents at 7 and 10 days. Capillary proliferation began at 3 days and peaked at 10 days. Ultimate force increased significantly over the time period studied. Collagen I protein and mRNA significantly increased at 10 days, and reached a plateau by 28 and 56 days. Collagen III showed a similar trend, with an early increase, and remained high until 56 days. TGF beta-1 was localized to the forming sear tissue and showed a distinct peak at 10 days. TGFP-3 was not seen at the healing insertion site. Cell proliferation and density followed the same trend as TGF beta-1. A wound healing response does occur at the healing rotator cuff insertion site, however, the characteristics of the tendon after healing differ significantly from the uninjured tendon insertion site at the longest time-point studied. A distinctive collagen remodeling process occurred with an initial increase in the formation of collagen types I and III followed by a decrease toward baseline levels seen at time 0. Growth factor TGF beta-1 was localized to repair tissue and coincided with a peak in cell proliferation and cellularity. Repair sites remained unorganized histologically and biomechanically inferior in comparison to previously described uninjured insertion sites. (c) 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.