The effect of adipose-derived stem cells on enthesis healing after repair of acute and chronic massive rotator cuff tears in rats
The effect of adipose-derived stem cells on enthesis healing after repair of acute and chronic massive rotator cuff tears in rats
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DOI：
10.1016/j.jse.2018.08.044
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发表时间：
2019-04-01
影响因子：
3
通讯作者：
Musahl, Volker
中科院分区：
文献类型：
--
作者：
Rothrauff, Benjamin B.;Smith, Catherine A.;Musahl, Volker
背景：慢性大面积肩袖撕裂愈合不良，经常复发。本研究探讨了脂肪源性干细胞（ADSCs）和转化生长因子- β 3 （tgf - β 3）在两种水凝胶（纤维蛋白或甲基丙烯酸明胶[GelMA]）中的一种中对大鼠急性或慢性大块性肩袖撕裂修复后椎体愈合的影响。方法：48只成年雄性Lewis大鼠行双侧横断冈上和冈下肌腱，肌内注射肉毒毒素A。8周后，动物接受8种干预措施中的1种（n = 12肩/组）：(1)无修复，(2)仅修复，或用(3)纤维蛋白，(4)GelMA,(5)纤维蛋白+ ADSCs， (6) GelMA + ADSCs,(7)纤维蛋白+ ADSCs + tgf - β 3，或(8)GelMA + ADSCs + tgf - β 3增强修复。等量的动物接受急性肌腱横断并立即应用8种干预措施中的1种。修复后4周，通过显微计算机断层扫描、组织学和力学测试评估端部愈合情况。结果：慢性撕裂与急性撕裂相比，骨质流失增加，结构特性降低。在纤维蛋白+ ADSCs和GelMA + ADSCs增强的慢性撕裂修复中，肱骨近端骨矿物质密度高于未修复的慢性撕裂。在急性眼泪中没有看到类似的改善。没有干预措施增强急性或慢性撕裂的组织学外观或结构特性。结论：与急性撕裂相比，ADSCs增强的手术修复可能对慢性撕裂提供更多的益处，尽管补充tgf - β 3的ADSCs没有额外的益处。(C) 2018年《肩关节外科杂志》理事会理事。版权所有。
Background: Chronic massive rotator cuff tears heal poorly and often retear. This study investigated the effect of adipose-derived stem cells (ADSCs) and transforming growth factor-beta 3 (TGF-beta 3) delivered in 1 of 2 hydrogels (fibrin or gelatin methacrylate [GelMA]) on enthesis healing after repair of acute or chronic massive rotator cuff tears in rats.Methods: Adult male Lewis rats underwent bilateral transection of the supraspinatus and infraspinatus tendons with intramuscular injection of botulinum toxin A (n = 48 rats). After 8 weeks, animals received 1 of 8 interventions (n = 12 shoulders/group): (1) no repair, (2) repair only, or repair augmented with (3) fibrin, (4) GelMA, (5) fibrin + ADSCs, (6) GelMA + ADSCs, (7) fibrin + ADSCs + TGF-beta 3, or (8) GelMA + ADSCs + TGF-beta 3. An equal number of animals underwent acute tendon transection and immediate application of 1 of 8 interventions. Enthesis healing was evaluated 4 weeks after the repair by microcomputed tomography, histology, and mechanical testing.Results: Increased bone loss and reduced structural properties were seen in chronic compared with acute tears. Bone mineral density of the proximal humerus was higher in repairs of chronic tears augmented with fibrin + ADSCs and GelMA + ADSCs than in unrepaired chronic tears. Similar improvement was not seen in acute tears. No intervention enhanced histologic appearance or structural properties in acute or chronic tears.Conclusions: Surgical repair augmented with ADSCs may provide more benefit in chronic tears compared with acute tears, although there was no added benefit to supplementing ADSCs with TGF-beta 3. (C) 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.