No abstract

Работа посвящена изучению особенностей регенерации костной ткани на модели экспериментальной костной раны кролика при использовании клеточно-инженерной конструкции, сформированной из ксеногенной коллагеновой матрицы («Коллатамп ИГ» Collatamp EG, «СинтколлГмбХ», Германия) и аллогенных мезенхимальных стволовых клеток костного мозга (МСК-КМ). С помощью методов флуоресцентной микроскопии показано, что МСК-КМ кролика сохраняют жизнеспособность и морфологическую однородность при культивировании на матрице («Коллатамп ИГ» Collatamp EG, «СинтколлГмбХ», Германия) в течение не менее 120 ч. Исследование in vivo выполнено на 25 кроликах породы «Серый великан». Фрезой диаметром 4,0 мм вдоль оси кости формировали стандартизированный дефект надкостницы, кортикального слоя и губчатого вещества размерами 8,0х4,0 мм и глубиной 4,0 мм. Сформированный дефект в опытной группе заполняли конструктом. Контрольная группа была представлена животными, у которых происходило спонтанное заживление костного дефекта. Наблюдение за размерами дефекта, особенностями формы и структуры костной ткани в области очага, его точным расположением, конфигурацией осуществляли в сроки 4, 8, 12 недель с помощью рентгенографии и гистологического исследования, выполненного с использованием световой микроскопии, с применением стандартных методов окрашивания. Проведенное исследование показало эффективность конструкции на основе аллогенных МСК-КМ и матрицы-«Коллатамп ИГ» (Collatamp EG, «СинтколлГмбХ», Германия), для восстановления дефектов костной ткани в эксперименте.

BACKGROUND: Periprosthetic infection after primary hip replacement is a serious complication. For the anesthetic support of revision operations, both general and neuroaxial anesthesia methods can be used. The question of choosing an anesthetic aid that, with adequate modulation of the operational stress response, would have a minimal immunosuppressive effect is relevant. AIM: To examine the effect of general and combined spinalepidural anesthesia during revision operations in patients with periprosthetic hip joint infection on the parameters of cellular immunity. MATERIALS AND METHODS: An open prospective randomized study was performed on 25 patients (11 women and 14 men). The patients underwent surgical interventions of revision prosthetics with the replacement of all components of the prosthesis. Group 1 (n=10) underwent general anesthesia (GA), and group 2 (n=15) underwent surgery under combined spinalepidural anesthesia (CSEA). The indices of cellular immunity, namely, CD4+, CD8+, CD4+/CD8+, and B-lymphocytes, were evaluated. Blood sampling was performed in the morning on the day of surgery and then on days 1, 3, 5, and 7 after surgery. RESULTS: The CD4+ (%) level in the CSEA group was significantly higher than in the GA group on days 3 and 7 after surgery (p 0.05). Changes in the percentage of CD8+ lymphocytes, the immunoregulatory index, and the percentage of B-lymphocytes between the groups had no statistically significant differences. CONCLUSION: The CD4+ (%) level in the CSEA group was significantly higher than that in the GA group on days 3 and 7 after surgery (p 0.05). Statistically significant differences in the dynamics of CD8+, immunoregulatory index, and B-lymphocytes were not found, which may indicate a lesser effect of the type of anesthesia on these indicators.

Introduction. The article describes an experimental model of chronic suppurative osteomyelitis in a rabbit. As new therapeutic and diagnostic algorithms for the supervision of patients with osteomyelitis appear, there is an growing need to compare the methods of surgical debridement and plasty of bone defects in an infectious process, in order to create experimental standardized pathological conditions as close to the clinical course of the disease in humans as possible. The aim of the study was to develop an experimental model of a standardized chronic purulent bone cavity, suitable for a comprehensive assessment of surgical debridement effectiveness and osteoplastic properties of bone substitute materials. Materials and methods. A standardized defect of the tibia in 24 rabbits was formed. The Staphylococcusaureus strain was used as an infectious agent. A dynamic assessment of the main indicators of blood counts in animals was carried out. The formation of chronic osteomyelitis was evaluated using radiography, com-puted tomography methods and histological studies. Results. It was shown that purulent bone wound developed in experimental animals with the technique cre-ated, and a defect with signs of a chronic purulent-inflammatory process was demonstrated. Conclusion. The proposed model of chronic osteomyelitis is reproducible. Operational flexibility and identi-cal in size and location bone defects allow to use this model in new osteoplastic material research. Keywords: chronic osteomyelitis, experiment, experimental animals

The aim of the study was to develop a technology for repairing an osteomyelitic bone defect using autologous adipose tissue mesenchymal stromal cells (MSCs) bound to a collagen matrix and to test the efficacy of this technique. Materials and Methods. The study was carried out with 17 rabbits. A bone defect was created using a milling cutter applied to the proximal third of the leg. The wound (8.0×4.0 mm and a depth of 4.0 mm) involved the periosteum, cortical layer, and cancellous substance. Staphylococcus aureus strain was used as an infectious agent. After the development of chronic osteomyelitis, the animals underwent osteonecrectomy. In the study group, autologous MSCs in Collatamp EG collagen carrier were placed into the bone defect. MSCs were obtained from adipose tissue and cultured in the matrix for 5 days. In control, the defect was filled with the collagen matrix without cells. Results. On day 14 upon the initiation of chronic osteomyelitis, bacteriological examination of the discharge from the fistula showed the presence of mixed bacterial flora (Staphylococcus aureus and Escherichia coli) in all operated animals. Results of X-ray, laboratory, and histological tests confirmed the formation of a focus of chronic osteomyelitis. Two months after the treatment (collagen with or without MSCs) began, all animals of the study group showed mature bone tissue regenerated in the affected zone. In the control group, proliferation of osteoblasts on the surface of the bone trabeculae was also observed; however, mature osteoid tissue was more often detected in the study group (35.0 vs 20.0% in control). In the study group (MSCs + collagen matrix), there was a decrease in bone marrow fibrosis (50.0 vs 100.0% in control) and cartilage formation (30.0 and 66.7%, respectively). After full treatment, newly formed bone trabeculae were detected more often (100.0 vs 60.0% in control); they were more mature and filled the defect area more efficiently. Conclusion. Our results indicate that the use of a collagen matrix with autologous MSCs is a promising plastic material for repairing osteomyelitic defects following necrectomy. The MSCs were able to increase the density of the filling material in the bone cavity, significantly accelerate the formation of bone beams around the matrix, and increase the tissue volume around the implant. The presence of MSCs significantly decreased the interference of a connective tissue component with osteogenesis and chondrogenesis.