Meniscal rasping for the treatment of the longitudinal tear in the avascular zone of the menisci and transplantation of synovial cells and chondrocytes transinfected with TGF-beta 1

1.我们已经开发了一种新的外科手术方法，即用锉刀锉削关节面，以修复无血管区的撕裂。经证实，该手术可刺激撕裂处的血管诱导，从而实现良好愈合。为了阐明愈合的机制，在兔的两个内侧半月板的前段的无血管区中创建长度为5 mm的全厚度纵向撕裂。然后在左半月板的股骨表面上从半月板旁滑膜到包括纵向撕裂的内部进行深度约0.5mm的半月板锉削，而右半月板不作处理作为对照。术后1、7、14和7天，在锉削表面，白细胞介素-1 α、转化生长因子β 1、血小板衍生生长因子和增殖细胞核抗原的免疫反应阳性率分别明显增加。此后，免疫反应性逐渐下降。这些结果表明，骨锉强烈诱导骨锉表面的细胞因子-细胞因子网络，这可能是解释良好愈合的关键.为探讨TGF-β 1基因转导对胶原包埋的兔滑膜细胞的影响，采用电穿孔法转导TGF-β 1和绿色荧光蛋白（GFP）基因。3周后确认基因的表达。观察聚集蛋白聚糖和软骨调节素的表达。培养液中TGF-β 1是对照的1.4倍。TGF-β 1基因转导的滑膜细胞促进软骨样组织的形成TGF-β 1基因转染的滑膜细胞移植可能是治疗无血管区滑膜撕裂的一种有效方法。

1. We have developed a new surgical procedure of rasping a meniscal surface in order to repair a tear in the avascular zone. This procedure was demonstrated to stimulate vascular induction to the tear, resulting in good healing. To elucidate the mechanism of the healing, a full thickness-longitudinal tear of 5 mm in length was created in the avascular zone of the anterior segment of both medial menisci of rabbits. Meniscal rasping of about 0.5 mm in depth was then done on the femoral surface of the left meniscus from the parameniscal synovium to the inner portion including the longitudinal tear, while the right meniscus was left untreated as control. In the rasped surface, positive ratio was remarkably increased in immunoreactivity of interleukin-1 α, transforming growth factor β 1, platelet derived growth factor, and proliferating cell nuclear antigen at 1, 7, 14 , and 7 days after surgery, respectively. Thereafter their immunoreactivities gradually declined. These results suggested that meniscal rasping induces strongly the cytokine-cytokine network on the rasped meniscal surface that is likely to be the key to explain the good healing.2. To evaluate the effects of the gene transduction of TGF beta1 on rabbit synovial cells embedded in collagen, TGF-beta1 and green fluorescent protein (GFP) genes were transduced by electroporation. The expression of the gene was confirmed for 3 weeks. Expression of aggrecan and chondromodulin was observed. TGF-beta1 in the culture media was 1.4 times higher than that of control. TGF-beta1 gene transduced synovial cells facilitate the formation of cartilage-like tissue in vitro. Transplantation TGF-beta1 gene transduced synovial cells might be a potential treatment for torn menisci in avascular area.