骨髄由来間葉系幹細胞を用いた腱板再生 −組織評価と力学強度測定−

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In irreparable rotator cuff repair we usually perform patch graft by using autologous femoral fascia or a polytetrafluoroethylene sheet. However, these methods have problems regarding sacrifice of normal self-tissue and foreign body reaction. We performed experimental study about the rotator cuff regeneration using mesenchymal stem cells with a tissue engineering technique. The infraspinatus tendons of Japanese white rabbits were reconstructed with poly-lactide caprolactone (PLC) (PLC group), PGA sheet (PGA group), and PGA sheet with cultured mesenchymal stem cells (MSC group). We sacrificed them at 4, 8 and 16 weeks after operation, and evaluated them histologically with H-E, Safranin O, and Azan stain and type I and III collagen immunohistochemical stain. And we measured the ultimate mechanical strengths and Young moduli of these regenerated tendons at 4 and 16 weeks. In the PLC group, we found massive foreign body reaction around the PLC fibers, and the arrangement of cells and fibers were irregular and the cartilage formation in insertion was not found. In the PGA group, PGA fibers were almost absorbed at 16 weeks and regenerated fibrous tissues showed the crimp pattern. In the insertion we found the 4 layer cartilage pillar pattern but it mainly consisted of type III collagen. In the MSC group, we found the 4 layer cartilage pillar pattern regularly in insertion at 8 weeks and more type I collagen was found than type III at 16 weeks. The results of mechanical properties show that the regenerated tendons in MSC group had adequate ultimate tensile strengths but had low Youngs moduli, that is, are easy to elongate. Therefore, rotator cuff regeneration with bone marrow derived mesenchymal stem cells had a good capacity of regenerating tendon-bone insertion and producing type I collagen. We thought this method quite useful for regeneration of a rotator cuff defect clinically.
日本肩関節学会の論文

骨髄由来間葉系幹細胞を用いた腱板再生 −組織評価と力学強度測定−

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