可注射型纤维蛋白凝胶转化生长因子β1复合骨髓间充质干细胞移植治疗椎间盘退变

背景：纤维蛋白凝胶主体胶与催化剂未混合前为液态，具有可注射的优点，注射混合后凝固成凝胶状，与髓核相似，并且凝固时间可控性强，作为间充质干细胞的载体植入到椎间盘内有诸多优点。 目的：观察可注射型纤维蛋白凝胶转化生长因子β1复合骨髓间充质干细胞移植抑制椎间盘退变的可行性。 方法：将新西兰大白兔随机分为退变模型组、纤维蛋白凝胶组，骨髓干细胞+纤维蛋白凝胶组。3组采用针刺法诱导建立退变模型后，纤维蛋白凝胶组及干细胞+纤维蛋白凝胶组分别移植入纤维蛋白凝胶转化生长因子β1复合物及骨髓间充质干细胞纤维蛋白凝胶转化生长因子β1复合物，于植入后2，6，10周行CR、MRI及病理检查。 结果与结论：退变模型组与纤维蛋白凝胶组椎间隙高度下降明显，并与时间呈正相关，干细胞+纤维蛋白凝胶组下降较缓慢(P < 0.01)。免疫组织化学及组织学检查显示，退变模型组髓核细胞的数量及Ⅱ型胶原含量进行性减少，细胞凋亡率明显增加，纤维蛋白凝胶组与退变模型组相似，干细胞+纤维蛋白凝胶组髓核细胞数量及Ⅱ型胶原含量较退变模型组及纤维蛋白凝胶组明显增多，细胞凋亡率下降。说明骨髓间充质干细胞联合纤维蛋白凝胶转化生长因子β1能很好抑制椎间盘退变，而单纯纤维蛋白凝胶转化生长因子β1移植不能抑制椎间盘退变。

Bone marrow mesenchymal stem cells combined with injectable fibrinous gel transforming growth factor-beta 1 transplantation for treatment of intervertebral disc degeneration

BACKGROUND:The main part of fibrinous gel is liquid state before mixing with catalytic agent, and it is injectable, solidifying after mixing them, this is similar with nucleus pulposus, the solidify time is strongly controllable, and it is advantageous to implant in nucleus pulposus as a carrier of mesenchymal stem cells (MSCs). OBJECTIVE:To explore the feasibility of bone marrow MSCs compound injectable fibrinous gel transforming growth factor-β1 (TGF-β1) transplantation on inhibiting intervertebral disc degeneration. METHODS:New Zealand white rabbits are randomly divided into three groups: degeneration model group, pure fibrinous gel group and MSCs+fibrinous gel group. The degeneration models were produced in three groups by means of puncturing the annulus fibrosus, then the pure fibrinous gel group and MSCs + fibrinous gel group were respectively transplanted with fibrinous gel TGF-β1 complex and MSCs + fibrinous gel TGF-β1 complex. CR, MRI and pathological examinations were carried out at 4, 8 and 12 weeks after transplant. RESULTS AND CONCLUSION:The disc height index obviously decreased in the degeneration model group and the pure fibrinous gel group, which is positively correlated with time; but the index decreased slowly in MSCs + fibrinous gel group (P < 0.01). An immunohistochemistry study and a histological examination indicated a decreasing quantity of the nucleus pulposus cells and the content of type Ⅱ collagen in the degeneration model group, as well as an obviously increasing rate of cells apoptosis. The pure fibrinous gel group was similar to the degeneration model group. The MSCs + fibrinous gel group showed an obviously increasing quantity of nucleus pulposus cells and type Ⅱ collagen content compared with the degeneration group and the pure fibrinous gel group, while the cells apoptosis rate decreased. Bone marrow MSCs in combination with fibrinous gel TGF-β1 can prohibit intervertebral disc degeneration, but pure fibrinous gel TGF-β1 cannot.