Rapid Isolation of Human Stem Cells (Connective Tissue Progenitor Cells) From the Proximal Humerus During Arthroscopic Rotator Cuff Surgery
Rapid Isolation of Human Stem Cells (Connective Tissue Progenitor Cells) From the Proximal Humerus During Arthroscopic Rotator Cuff Surgery
复制标题
DOI：
10.1177/0363546509360924
复制
发表时间：
2010-07-01
影响因子：
4.8
通讯作者：
Drissi, Hichann
中科院分区：
文献类型：
--
作者：
Mazzocca, Augustus D.;McCarthy, Mary Beth R.;Drissi, Hichann
背景：肩部骨到腱的愈合可能是不可预测的。本研究的目的是：(1)在肩袖修复过程中，通过关节镜下从肱骨近端获取骨髓抽吸物；(2)有效地提纯和浓缩手术室中的结缔组织前体细胞(CTPs)；(3)通过其分化为骨细胞的能力，确认这些细胞是干细胞。研究设计：队列研究；证据水平3；描述性实验室研究。方法：23例患者在关节镜下肩袖修复过程中，通过肱骨头锚隧道采集骨髓抽吸物。从临床登记中选择了23名匹配的对照组，以评估并发症发生率的增加。用两种公认的方法分离结缔组织前体细胞，并与一种设计用于手术室的新的、快速的方法进行比较。结果：逆转录-聚合酶链式反应分析和细胞染色证实了这些CTP的成骨能力。在单项评估数字评估得分(吸气，86.3+/-10.5；对照组，83.6+/-15.1；P=.54)、活动范围(术后外旋：吸气，65.0度+/-20.4度；对照组，62.5度+/-17.1度；P=.67；术后前仰卧位：吸气，163.0度+/-30.6度；对照组，145.7度+/-41.4度；P=.12)，或术后强度测量(中位数，5；抽吸范围：抽吸组为4-5，对照组为4-5；P>；0.05)。结论：在关节镜下肩袖手术中，利用锚定隧道，可以安全、有效地将结缔组织祖细胞从肱骨近端抽吸出来。这些细胞可能在涉及肩袖修复的基于细胞的治疗中发挥重要作用。
Background: Bone-to-tendon healing in the shoulder can be unpredictable. Biologic augmentation, through the implementation of adult mesenchymal stem cells, may improve this healing process.Purpose: The purpose of this study was to (1) arthroscopically obtain bone marrow aspirates from the proximal humerus during rotator cuff repair, (2) purify and concentrate the connective tissue progenitor cells (CTPs) in the operating room efficiently, and (3) confirm these are stem cells through their ability to differentiate into bone cells. We hypothesize that CTPs can be quickly and efficiently isolated from bone marrow during arthroscopic surgery and that these cells are capable of osteogenesis.Study Design: Cohort study; Level of evidence, 3; and Descriptive laboratory study.Methods: Bone marrow aspirates were harvested through the anchor tunnel of the humeral head during arthroscopic rotator cuff repair in 23 patients. Twenty-three matched controls were selected from a clinical registry to evaluate for increased incidence of complication. Connective tissue progenitor cells were isolated using 2 accepted methods and compared with a novel, rapid method designed for use in the operating room. Osteogenic potential was assessed by cytochemical and molecular analysis.Results: Reverse transcription polymerase chain reaction analysis and cellular staining confirmed the osteogenic potential of these CTPs. There was no statistical significant difference in the Single Assessment Numeric Evaluation score (aspirate, 86.3 +/- 10.5; control, 83.6 +/- 15.1; P=.54), range of motion measures (postoperative external rotation: aspirate, 65.0 degrees +/- 20.4 degrees; control, 62.5 degrees +/- 17.1 degrees; P=.67; postoperative forward elevation: aspirate, 163.0 degrees +/- 30.6 degrees; control, 145.7 degrees +/- 41.4 degrees; P=.12), or postoperative strength measures between groups (median, 5; range, 4-5 in the aspirate group compared with median, 5; range, 4-5 in the control group; P>.05).Conclusion: Connective tissue progenitor cells can be safely and efficiently aspirated from the proximal humerus using the anchor tunnel created during arthroscopic rotator cuff surgery. These cells may play an important role in cell-based therapies involving rotator cuff repair.