The application of osteoblast-like cells and platelet rich plasma gels transplantation for accelerating the bone regeneration in the distraction osteogenesis.

牵张成骨术已成功地应用于因骨骼发育不良而导致肢体长度不一致、严重身材矮小的患者的肢体延长。虽然这种治疗方法是生物学的，对于这些病理情况有很多优点，但外固定和骨成熟的时间较长，导致较高的并发症发生率，如针轨感染、关节挛缩、针松动、延迟巩固和骨折。牵张成骨被认为是一种人体骨再生模型。因此，我们建立了大鼠模型，并研究了细胞与合适的支架相结合促进分散愈伤组织成骨的可能性。骨髓中含有一群多能间充质干细胞（MSCs），如果在地塞米松、β-甘油磷酸酯和抗坏血酸的存在下培养，它们可以在体外定向成骨。利用大鼠肢体延长模型，我们发现骨髓源性成骨细胞样细胞与胶原凝胶一起移植到分散的骨痂中，促进了新骨的形成，缩短了固结期。hrFGF-2和hrBMP-2可促进基质合成和成骨样细胞的增殖。大鼠间充质干细胞的成骨潜能随着传代而降低。在P3细胞中，成骨潜能被严重抑制。在获得这些见解之后，我们规划了成骨样细胞移植的临床应用。在名古屋大学医院的机构评审委员会的监督下，我们开始了用成骨细胞样细胞和富板血浆凝胶对软骨发育不全和软骨发育不全患者进行四肢延长的临床研究。虽然结果是初步的，但移植成骨细胞样细胞和PRP可以通过加速牵张成骨过程中的骨再生来缩短治疗期。显然，为了改善临床结果，需要建立允许间充质干细胞快速扩增的培养条件。少

Distraction osteogenesis has been successfully used for limb lengthening in patients with limb length discrepancy, severe short stature due to skeletal dysplasias. Although this treatment method is biological and has many advantages for these pathological conditions, the periods of external fixation and bone maturation is long which results in higher rates of complications such as pin track infection, joint contractures, pin loosening, delayed consolidations and fractures. The distraction osteogenesis is considered as bone regeneration models in human. So we developed rat models, and to investigate the possibility of accelerating bone formation of the distracted callus with usage of combination of cells and suitable scaffold. Bone marrow contains a population of multipotent mesenchymal stem cells(MSCs) that can be directed towards the osteogenic lineage in vitro if cultured in the presence of dexamethasone, β-glycerophosphate and ascorbic acid. Using the rat limb lengthening model, we … More revealed that transplantation of marrow derived osteoblast-like cells with collagen gel into the distracted callus promoted new bone formation and shortened the consolidation period. Also the hrFGF-2 and hrBMP-2 could stimulate the matrix synthesis and proliferation of this osteoblast-like cells derived from MSCs. The osteogenic potential of rat MSCs were reduced with passaging. In the P3 cells, osteogenic potential was severely suppressed. After acquiring these insights, we planed the clinical application of osteoblast-like cell transplantation. We started the clinical research of limb lengthening with osteoblast-like cells and plate rich plasma gels for achondroplasia and hypochondoroplasia patients under the supervision of institutional reviewer boards in Nagoya university hospital. Although the results were preliminary, transplantation of osteoblast-like cells and PRP could shorten the treatment period by acceleration of bone regeneration during distraction osteogenesis. It was clearly demantrated that eatablishiment of the culture conditions permitting the rapid expansion of MSCs is required for improvement of clinical results. Less