Expression of matrix metalloproteinases and tissue inhibitors of matrix metalloproteinase in the encapsulation process against titanium implant

钛种植体已广泛应用于口腔癌的修复和下颌骨骨折的骨内固定，种植体周围的纤维化组织由活化的成纤维细胞组成，并被重塑。组织重塑是细胞外基质合成与分解平衡的结果。基质金属蛋白酶（MMP）和基质金属蛋白酶组织抑制剂（TIMP）在纤维化组织内的梭形细胞（成纤维细胞或巨噬细胞）、血管内皮细胞和平滑肌细胞中的表达如下。MMP-1、MMP-3、MMP-8、MMP-9均为阴性。TIMP-2呈强阳性。而瘢痕组织中的成纤维细胞则不表达MMPs和TIMPs。此外，我们还研究了钛种植体包膜组织周围皮瓣的炎症反应。在大多数病例中观察到显著的炎症变化。皮瓣出现炎症改变，白色念珠菌感染。真皮内浸润的白细胞为表达CD 4/CD 45 RO的记忆型T淋巴细胞。这些淋巴细胞与朗格汉斯细胞（CD la+）成簇。真皮朗格汉斯细胞为B7-2+/CD-83+，与记忆型T淋巴细胞接触密切。CD 4 + T淋巴细胞的Ki-67标记指数高于CD 8 + T淋巴细胞。在淋巴管中观察到大量成熟的朗格汉斯细胞。这些朗格汉斯细胞为B7-2+/B7-1+/CD 83+。这些结果表明，朗格汉斯细胞在钛种植体的包封过程中起着重要作用。

Titanium implant has been widely used for the reconstruction surgery of oral cancer and for the osteosynthesis of mandibular fracture.The fibrogenic tissue surrounding the implants consists of activated fibroblasts and is remodeled throughout. Tissue remodeling is made up of the balance between synthesis and decomposition of extracellular matrix. Expression of matrix metalloproteinases (MMP) and tissue inhibitors of matrix metalloproteinase (TIMP) in the spindle-shaped cells (fibroblasts or macrophages), vascular endothelial cells and smooth muscle cells within the fibrogenic tissue was as follows. MMP-1, MMP-3, MMP-8 and MMP-9 were negative. TIMP-2 was strongly positive. By contrast, fibroblasts within the scar tissue expressed neither MMPs nor TIMPs.Furthermore, we investigated the inflammatory response of skin flaps surrounding the encapsulation tissue of titanium implant. Prominent inflammatory changes were observed in most cases. Skin flaps showing inflammatory changes were infected by Candida albicans. Infiltrating leukocytes to the dermis were memory-type T lymphocytes expressing CD4/CD45RO. These lymphocytes were clustered with Langerhans cells (CD la+). Langerhans cells in the dermis were B7-2+/CD-83+, and intimately touched to the memory -type T lymphocytes. Ki-67 labeling index of CD4+ T lymphocytes was higher than that of CD8+ T lymphocytes. Numerous mature Langerhans cells were observed in the lymphatic vessels. These Langerhans cells were B7-2+/B7-1+/CD83+. These results suggest that Langerhans cells play an important roles in the encapsulation process against titanium implant.