Characterization of the inflammatory response to four commercial bone graft substitutes using a murine biocompatibility model.
Characterization of the inflammatory response to four commercial bone graft substitutes using a murine biocompatibility model.
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DOI：
10.2147/jir.s21411
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发表时间：
2012
影响因子：
4.5
通讯作者：
Wooley PH
中科院分区：
文献类型：
--
作者：
Markel DC;Guthrie ST;Wu B;Song Z;Wooley PH
骨移植几乎应用于所有骨科专科和大多数解剖区域。骨移植替代品有可能提供与自体移植物相似的功效，而不会产生收获后的发病率。几项研究已经注意到新一代骨替代产品的功效，但很少有研究评估其安全性。本研究描述并量化了四种不同市售骨移植替代品的炎症反应，并使用体内鼠气囊生物相容性模型进行了检查。选择一种珊瑚羟基磷灰石产品作为纯骨传导材料的示例。选择三种脱矿骨基质产品来代表既具有骨传导性又具有骨诱导性的产品。将样本植入小鼠气囊中，14 天后在原位采集。提取储袋液体，分离 mRNA，并进行逆转录聚合酶链反应以检测作为炎症标志物的白细胞介素 1 基因表达。此外，还检查了多种组织学特征，以量化细胞对植入材料的反应。与阴性对照相比，所有骨移植替代物均诱导显着的炎症反应。组织学和聚合酶链反应数据表明，脱矿骨基质与载体比例较高的材料中炎症反应水平升高。羟基磷灰石产品产生较低的炎症反应。总之，本研究使用生物相容性体内模型来证明使用植入骨移植替代物时会发生显着的炎症反应。在选择骨移植方法时，外科医生应考虑所用方法和材料的有效性和安全性。需要进一步的研究来确定理想的骨移植材料，以最大限度地提高疗效，同时最大限度地降低发病率。
Bone grafting is utilized in nearly all orthopedic subspecialties and in most anatomic regions. Bone graft substitutes have the potential to offer similar efficacy as autogenous grafts without the morbidity of harvest. Several studies have noted the efficacy of new-generation bone substitute products, but few studies have evaluated their safety. This study characterizes and quantifies the inflammatory reaction to four different commercially available bone graft substitutes, which were examined using the in vivo murine air pouch biocompatibility model. One coralline hydroxyapatite product was chosen as an example of a purely osteoconductive material. Three demineralized bone matrix products were chosen to represent products that are both osteoconductive and osteoinductive. Samples were implanted in a murine air pouch and harvested after 14 days in situ. Pouch fluid was extracted, mRNA isolated, and reverse transcription polymerase chain reactions carried out to detect interleukin-1 gene expression as a marker for inflammation. In addition, multiple histological characteristics were examined to quantify cellular responses to the implanted materials. All bone graft substitutes induced a significant inflammatory response compared with negative controls. Histology and polymerase chain reaction data indicated that the level of inflammatory reaction was elevated in materials with a higher demineralized bone matrix to carrier proportion. The hydroxyapatite product generated a low inflammatory reaction. In conclusion, this study used an in vivo model of biocompatibility to demonstrate that a significant inflammatory reaction occurs when using implanted bone graft substitutes. When choosing a bone grafting method, surgeons should consider both the efficacy and safety of methods and materials used. Further studies are necessary to determine the ideal bone graft material to maximize efficacy while minimizing morbidity.