三种可降解聚合物构建组织工程心脏瓣膜的可行性对照*☆
周 栋1,邹良建1,汪 钢2,金 海1,杨 勇1
Feasibility of three kinds of biodegradable polymer scaffolds
for fabricating tissue engineering heart valve*☆
Abstract
AIM:To evaluate the histocompatibility and hypodermic absorbability of three biodegradable polymer scaffolds [polyglycolic acid/polylactic acid (PLGA), poly-hydroxybutyrate/hydroxyvalerate (PHBV) and polyhydroxybutyrate (PHB)], and investigate the feasibility of applying biodegradable materials on constructing tissue engineering heart valve.
METHODS: The experiment was carried out in Cardiothoracic Surgery Institute, Changhai Hospital of Second Military Medical University of Chinese PLA from December 2004 to October 2005.①Constructive characteristics of three biodegradable polymer scaffolds were observed by scanning electron microscope (SEM).②A total of 18 New Zealand rabbits were adopted to induce 3 incisions at both sides of rabbit dorsal spine, and every 6 rabbits were embedded with one kind of absorptive material, 6 pieces in each rabbit.③The histocompatibility and absorbability of three biodegradable polymer scaffolds were compared after hypodermic implantation for 2, 4, 6, 8 and 12 weeks. In addition, thickness of polymer scaffolds was measured.
RESULT: All 15 rabbits were involved in the result analysis.①Porous structure were observed by SEM, the diameter of PHB was 110 μm, PHBV was 130 μm, and PLGA was 170 μm.②After hypodermic implantation for 2 weeks, PHBV and PLGA had no obvious demarcation with muscular tissue, loose fibrous tissue were present in porous polymers, neutrophilic granulocyte and lymphocyte penetrated in polymers, and multinuclear giant cells could be observed. PHBV and PLGA were completely degraded at the 10th and 12th weeks, and substituted by collagen fibers. PHB presented loose connective tissue at the 2nd week, accompanying neutrophil, lymphocyte, plasmacyte infiltration and fibroblast diffuse proliferation, together with appearance of multinuclear giant cells. At the 8th week, membrane thickened and lymphocyte infiltration was dominant. At the 10th week, membrane became thinner, inflammatory cells were decreased obviously, and fibroblast transformed to fusiform fibrocyte.③The thickness of PHBV and PLGA were lighter than PHB after hypodermic implantation for 2, 4, 6, 8 and 10 weeks.
CONCLUSION: The histocompatibility and absorbability of PLGA and PHBV is better than that of PHB. So PLGA and PHBV can be used to fabricate a biodegradable tissue engineering scaffold for heart valve.
Zhou D, Zou LJ, Wang G, Jin H, Yang Y.Feasibility of three kinds of biodegradable polymer scaffolds for fabricating tissue engineering heart valve.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 200
1Department of Cardiothoracic Surgery, Changhai Hospital of Second Military Medical University of Chinese PLA, Cardiothoracic Surgery Institute of Chinese PLA, Shanghai 200433, China; 2Department of Cardiac Surgery, Affiliated Hospital of Medical College of Chinese People’s Armed Police Forces, Cardiovascular Disease Institute of Chinese People’s Armed Police Forces, Tianjin 300162, China
Zhou Dong☆, Studying for doctorate, Attending physician, Department of Cardiothoracic Surgery, Changhai Hospital of Second Military Medical University of Chinese PLA, Cardiothoracic Surgery Institute of Chinese PLA, Shanghai 200433, China
zhoudong515@yahoo.com.cn
Supported by: the National Natural Science Foundation of China, No.39970733*
Received: 2006-03-08
Accepted: 2006-07-29
摘要
目的:评价作为组织工程心脏瓣膜支架的聚乙醇酸/聚乳酸共聚物,聚羟基丁酸/聚羟基戊酸共聚物,聚羟基丁酯3种生物可吸收材料的组织相容性和皮下吸收情况。探讨应用生物可降解材料构建组织工程心脏瓣膜的可行性。
方法:实验于2004-12/2005-10在解放军第二军医大学长海医院全军胸心外科研究所完成。①应用扫描电镜观察聚乙醇酸/聚乳酸共聚物,聚羟基丁酸/聚羟基戊酸共聚物,聚羟基丁酯3种材料的结构特点。②新西兰大白兔18只,在兔背胸腰段脊柱两侧各作3个切口,每只兔分别植入6块可吸收材料,每种材料6只。③分别于术后2,4,6,8,10和12周各取6块材料,进行大体和组织学观察,并测量纤维包裹组织的厚度。
结果:15只兔全部进入结果分析。①3种材料的结构特点:扫描电镜下3种材料均呈网孔状泡沫结构,聚羟基丁酯孔径约110 μm, 聚羟基丁酸/聚羟基戊酸共聚物孔径约130 μm,聚乙醇酸/聚乳酸共聚物孔径约170 μm。②组织学检查结果:聚羟基丁酸/聚羟基戊酸共聚物和聚乙醇酸/聚乳酸共聚物2周包膜纤维疏
松,与其下肌肉组织分界不清,网孔中有疏松纤维组织长入,炎细胞以中性粒细胞和淋巴细胞为主,可见多核巨细胞。10周聚羟基丁酸/聚羟基戊酸共聚物材料完全吸收,12周聚乙醇酸/聚乳酸共聚物材料完全吸收,均为胶原纤维所代替。聚羟基丁酯2周包膜结缔组织疏松,伴中性粒细胞、淋巴细胞、浆细胞浸润和成纤维细胞弥漫性增生,也可见多核巨细胞。8周时包膜增厚,以淋巴细胞浸润为主。10周材料包膜较8周
薄,炎性细胞明显减少,成纤维细胞转变为梭形的纤维细胞。③包膜厚度测量结果:包埋后2,4,6,8,10周聚羟基丁酸/聚羟基戊酸共聚物和聚乙醇酸/聚乳酸共聚物材料厚度测量值均显著小于聚羟基丁酯。
结论:聚乙醇酸/聚乳酸共聚物、聚羟基丁酸/聚羟基戊酸共聚物在组织相容性和降解率方面优于聚羟基丁酯,更适合于作为组织工程心脏瓣膜的支架材料。
关键词:聚乙醇酸;乳酸;聚合物;组织工程;心脏瓣膜,人工;生物降解
周栋,邹良建,汪钢,金海,杨勇.三种可降解聚合物构建组织工程心脏瓣膜的可行性对照[J].中国组织工程研究与临床康复,2007,11(1):55-57 [www.zglckf.com/zglckf/ejournal/upfiles/07-1/1k-55(ps).pdf]
1解放军第二军医大学长海医院胸心外科,解放军胸心外科研究所,上海市 200433;2武警医学院附属医院心脏外科,武警部队心血管病研究所,天津市 300162
周 栋☆,男,1972年生,甘肃省兰州市人,汉族,解放军第二军医大学在读博士,主治医师,主要从事心胸外科临床研究。
zhoudong515@yahoo.com.cn
国家自然科学基金资助项目(39970733)*
中图分类号:R318.11 文献标识码:A
文章编号:1673-8225
(2007)01-00055-03
收稿日期:2006-03-08 修回日期:2006-07-29 (06-50-3-1903/W·Y)
热点资讯:组织工程心脏瓣膜作为目前瓣膜外科研究的重大课题?熏支架材料的研究是其中重要方面之一。国内外研究表明当前组织工程心脏瓣膜的支架材料主要有可降解人工合成材料和天然生物材料两大类。但有的合成材料降解时间太长?熏 这会造成后期的异体反应?熏 达不到组织工程心脏瓣膜的目的。有的降解时间过短,自体组织还来不及形成支架时,人工合成材料已经完全降解了。但是什么是合适的降解时间?芽 究竟在人体内需要多长时间能够由自体组织来完全取代合成材料并形成牢固的支架?芽 目前并无定论,还需要进行深入的研究。
创新要点:组织工程心脏瓣膜的研究仍处于起步阶段,要构建一个满意和实用的组织工程心脏瓣膜,还有很多问题需要解决?押可降解材料机械性质、理化性能、与天然瓣膜基质的差距以及如何改善支架的构型均是研究的热点、难点。本实验结果初步筛选了聚乙醇酸/聚乳酸共聚物、聚羟基丁酸/聚羟基戊酸共聚物作为组织工程心脏瓣膜支架材料的可行性。相信随着对正常心脏瓣膜结构、功能、代谢及其分子生物学的深入了解,多学科合作,组织工程心脏瓣膜在不远的将来造福于人类。
同行评价:文章对比评价了组织工程心脏瓣膜支架用的聚乙醇酸/聚乳酸共聚物,聚羟基丁酸/聚羟基戊酸共聚物,聚-β-羟基丁酯3种生物可吸收材料的组织相容性和皮下吸收情况。该实验对选用生物可降解材料构建组织工程心脏瓣膜具有科学意义与参考价值,研究方法有一定的新意。本文论据较充足、数据可靠、结构较严谨。
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