Maturation of tissue engineered cartilage implanted in injured and osteoarthritic human knees
Maturation of tissue engineered cartilage implanted in injured and osteoarthritic human knees
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DOI：
10.1089/ten.2006.12.1787
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发表时间：
2006-07-01
影响因子：
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通讯作者：
Abatangelo, Giovanni
中科院分区：
文献类型：
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作者：
Hollander, Anthony P.;Dickinson, Sally C.;Abatangelo, Giovanni
受损器官的再生需要工程组织在植入损伤或疾病部位时成熟。我们使用新的分析技术来确定膝关节损伤患者接受新型软骨组织工程疗法治疗后的组织再生程度，以及预先存在的骨关节炎对再生过程的影响。我们治疗了23例患者，平均年龄35.6岁，膝关节软骨缺损面积为1.5 cm（2）至11.25 cm（2）（平均5.0 cm（2））。其中9名患者有骨关节炎的X线证据。从关节镜下取出的健康软骨中分离软骨细胞。将细胞培养14天，接种到酯化的透明质酸支架（Hyalograft（（R））C）上，并在植入前再生长14天。术后6 ~ 30个月（平均16个月）对每例患者进行二次活检.在标准组织学分析后，使用新开发的生化方案进一步分析未切割的组织，该方案涉及用胰蛋白酶消化和II型胶原蛋白、I型胶原蛋白和蛋白聚糖以及成熟和未成熟胶原蛋白交联的特异性定量测定。早在植入后11个月就观察到了软骨再生，23例患者中有10例。即使将植入物放置在已经发展为骨关节病的关节中，也发现组织再生。软骨损伤可以有效地修复使用组织工程，骨关节炎不抑制再生过程。
The regeneration of damaged organs requires that engineered tissues mature when implanted at sites of injury or disease. We have used new analytic techniques to determine the extent of tissue regeneration after treatment of knee injury patients with a novel cartilage tissue engineering therapy and the effect of pre-existing osteoarthritis on the regeneration process. We treated 23 patients, with a mean age of 35.6 years, presenting with knee articular cartilage defects 1.5 cm(2) to 11.25 cm(2) (mean, 5.0 cm(2)) in area. Nine of the patients had X-ray evidence of osteoarthritis. Chondrocytes were isolated from healthy cartilage removed at arthroscopy. The cells were cultured for 14 days, seeded onto esterified hyaluronic acid scaffolds (Hyalograft((R)) C), and grown for a further 14 days before implantation. A second- look biopsy was taken from each patient after 6 to 30 months (mean, 16 months). After standard histological analysis, uncut tissue was further analyzed using a newly developed biochemical protocol involving digestion with trypsin and specific, quantitative assays for type II collagen, type I collagen, and proteoglycan, as well as mature and immature collagen crosslinks. Cartilage regeneration was observed as early as 11 months after implantation and in 10 out of 23 patients. Tissue regeneration was found even when implants were placed in joints that had already progressed to osteoarthrosis. Cartilage injuries can be effectively repaired using tissue engineering, and osteoarthritis does not inhibit the regeneration process.