游离体作为自体软骨细胞移植新型细胞来源的定性与定量评估
简介
该研究从10例关节镜手术中获取游离体，按组织学分为正常、异常和无软骨组，评估其作为自体软骨细胞移植（ACI）细胞来源的潜力。结果显示，正常和异常软骨组游离体来源的3D培养软骨细胞增殖率显著高于自体软骨，糖胺聚糖产量无差异；20%的游离体（正常组中50%）满足全部评估标准。提示适当筛选的游离体可成为ACI的替代细胞来源，减少供区并发症。
英文摘要
BACKGROUND: Autologous chondrocyte implantation (ACI) has recently produced successful outcomes, but donor site morbidity remains an urgent issue to be resolved. Thus, alternative cell sources are highly desirable to minimize donor site morbidity. PURPOSE: To qualitatively and quantitatively evaluate the potential of loose bodies as a novel cell source for ACI. STUDY DESIGN: Controlled laboratory study. METHODS: Loose bodies were obtained from 10 patients during arthroscopic surgery. They were evaluated by gross appearance and histology and classified into normal, abnormal, and no-cartilage groups. Then, 3-dimensional (3D)-cultured cartilage was prepared using chondrocytes from the loose bodies, and cell proliferation and glycosaminoglycan production in the 3D-cultured cartilage were compared with those from native cartilage obtained from patients who underwent total knee arthroplasty. Finally, expression of 42 genes by primary chondrocytes from the loose bodies was analyzed by chondrocyte gene spatial mapping analysis (CGSMA) and compared with that of reference chondrocytes to visualize their global properties, including ossification and denaturation. RESULTS: Of 10 loose bodies, 4 were histologically classified into the normal cartilage group, 4 into the abnormal cartilage group, and 2 into the no-cartilage group. The mean cell proliferation rate of 3D-cultured cartilage from the loose bodies in the normal and abnormal cartilage groups was significantly higher than that of the native cartilage (P = .020), while there was no significant difference in mean glycosaminoglycan production. Scores for the chondrocyte gene spatial mapping analysis showed that the 3D-cultured cartilage produced from 2 loose bodies exhibited gene expression within the reference range of native cartilage. While 2 of the 10 loose bodies (20%) met the predefined criteria across all 3 evaluations, this proportion increased to 50% (2 of 4) when the analysis was restricted to loose bodies classified in the normal cartilage group. CONCLUSION: A subset of loose bodies demonstrated matrix-producing capacity without ossification or denaturation, supporting their potential as a cell source for ACI. CLINICAL RELEVANCE: Appropriately selected loose bodies are a potential cell source for ACI while minimizing donor site morbidity.