Zusammenfassung
Fragestellung: Die Rekonstruktion von Sehnengewebe stellt oftmals ein chirurgisches Problem dar. Stark destruiertes Gewebe kann häufig nicht primär genäht, sondern muss durch aufwändige Sehnentransplantationen oder -transpositionen rekonstruiert werden. Hierfür müssen nicht selten intakte Sehnen oder funktionell wichtige motorische Einheiten verwendet werden. In der vorliegenden Studie sollte untersucht werden, ob sich langstreckige sehnenähnliche Konstrukte in vitro aus humanen mesenchymalen Stammzellen (MSZ) und einem Kollagengel durch zyklische Dehnung herstellen lassen.
Material und Methoden: MSZ wurden durch eine Knochenmarkaspiration aus dem Beckenkamm gewonnen. Die Zellen wurden in einem Kollagen Typ I Gel suspendiert und in einem Glaszylinder mit definierten Abmessungen polymerisiert. Die hergestellten Konstrukte wurden in einem speziell angefertigten Bioreaktor für 14 Tage statisch und im Anschluss für 21 Tage zyklisch gedehnt. Als Kontrolle dienten ungedehnte Konstrukte.
Ergebnisse: Makroskopisch hatten die gedehnten Konstrukte, verglichen mit den Kontrollen, eine verminderte Lichtdurchlässigkeit und eine glatte Oberflächenstruktur. Bei den gedehnten Konstrukten zeigten sich vermehrt spindelförmige, longitudinal ausgerichtete Zellen, eine sehnenähnliche Organisation der Kollagenmatrix und eine parallele Anordnung der Kollagenfasern in der Hämatoxylin/Eosin- und Elastica-Färbung.
Schlussfolgerung: Langstreckige Sehnenkonstrukte, die sehnenähnliche parallele Faserverläufe und spindelförmige Zellen ausbilden, konnten aus MSZ in einem Kollagen Typ I Gel durch zyklische Dehnung in vitro hergestellt werden. Sie bieten das Potenzial für die Entwicklung therapeutisch einsetzbarer autologer Sehnenersatzmaterialien.
Abstract
Background and Purpose: Reconstruction of tendon tissue is problematic in many cases. Since direct tendon suture is often impossible, major reconstruction with the use of free tendon transplants or tendon transposition is necessary. Important motor units often have to be sacrificed for reconstructive purposes. In this study we investigated whether long tendon-like substitutes can be fabricated in vitro from human mesenchymal stem cells (MSCs) and a collagen type I gel when cultured under cyclic stretching conditions.
Material and Methods: MSCs were obtained from bone marrow aspirates of the iliac crest. Cells were suspended in a collagen type I gel and polymerized in a glass-cylinder with defined size. The fabricated tendon substitutes underwent static stretching for 14 days followed by cyclic stretching for 21 days in a special manufactured bioreactor. Non-stretched substitutes served as a control.
Results: Macroscopically the stretched tendon substitutes showed an increased opacity and a smoother surface structure compared to the non-stretched control. The stretched substitutes displayed more spindle-shaped, longitudinal orientated cells, a tendon-like organization of the collagen matrix, and a parallel organization of the collagen fibers when stained with Hematoxylin/Eosin and Elastica.
Conclusion: Long tendon substitutes could be fabricated from MSCs and a collagen type I gel by cyclic stretching and showed tendon-like parallel collagen fibers and spindle-shaped cells. The use of MSCs in combination with adequate scaffold materials has great therapeutic potential for the development of autologous transplantable tendon substitutes.
Schlüsselwörter
Tissue engineering - Sehne - humane mesenchymale Stammzellen (MSZ) - Bioreaktor
Key words
Tissue engineering - tendon - human mesenchymal stem cells (MSCs) - bioreactor
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Dr. med. Susanne Kall
Klinik für Plastische, Hand- und Wiederherstellungschirurgie der Medizinischen Hochschule Hannover, Zentrum für Schwerbrandverletzte Klinikum Oststadt
Podbielskistraße 380
30659 Hannover
Email: kall.susanne@mh-hannover.de