富血小板血浆生长因子鸡尾酒效应激活内源髓核间充质干细胞修复早期椎间盘退变的生物学机制研究

The pathological mechanism of the intervertebral disc degeneration(IDD) is still unclear.Current treatments for IDD are only able to relieve the symptoms, but could not address the cause of the degeneration. Our previous study has already revealed that platelet-rich plasma (PRP) contains various kinds of growth factors, contributing to the regeneration of the early degenerated intervertebral discs. However, the biological mechanism of PRP for the treatment of IDD is still unknown. Our recent study has suggested that the nucleus pulposus contains stem cells of multilineage differentiation potential. These stem cells (nucleus pulposus mesenchymal stem cells) may have great impact on the reverse of the IDD. Based on this hypothesis, we will firstly investigate the number, proliferation and differentiation capacity of the normal and early degenerated nucleus pulposus stem cells derived from human and rabbits. Then, the impact of autologous PRP on the proliferation and differentiation capacity of the nucleus pulposus mesenchymal stem cells will be further investigated, clarifying the cellular mechanism of PRP for the regeneration of early degenerated intervertebral discs. This study may provide a brand-new view for the study of cellular mechanism of IDD, and lay a solid foundation for the clinical application of PRP for IDD.

椎间盘退变（intervertebral disc degeneration,IDD）的病理机制尚未阐明，其临床治疗方案虽可缓解症状，却难以扭转其退变过程。我们既往研究证实，富血小板血浆（platelet-rich plasma,PRP）富含的多种生长因子形成的“鸡尾酒”效应可以逆转兔早期IDD，但是具体生物学机制尚不明确。近期我们从髓核组织中分离出具有多系分化潜能的干细胞（髓核间充质干细胞），我们猜测PRP可能通过激活髓核间充质干细胞，促进其成髓核细胞分化，分泌髓核基质实现IDD修复。基于以上假设，本研究首先比较人、兔正常和早期退变髓核组织内的干细胞数量，体外增殖和分化能力；其次，研究自体PRP对兔早期退变椎间盘髓核干细胞增殖和成髓核分化功能，探索PRP修复退变椎间盘的细胞生物学机制，并为临床治疗应用提供坚实的理论依据。

椎间盘退变（intervertebral disc degeneration,IDD）的病理机制仍在探索，当前临床治疗方案大多可缓解症状，但是仍未能有效促进椎间盘生物学再生。我们既往研究证实，富血小板血浆（platelet-rich plasma,PRP）富含的多种生长因子形成的“鸡尾酒”效应可以逆转兔早期IDD，我们猜测PRP可能通过激活髓核间充质干细胞，促进其成髓核细胞分化，分泌髓核基质实现IDD修复。基于以上假设，本研究首先比较正常和早期退变髓核组织内的干细胞数量，体外增殖和分化能力；其次，研究自体PRP对兔早期退变椎间盘髓核干细胞增殖和成髓核分化功能。我们研究结果证实：①髓核来源干细胞具有体外增殖、多系分化潜能；②PRP能够有效促进早期退变椎间盘髓核干细胞增殖和成髓核细胞分化；③剔除PRP中白细胞，获取纯PRP能够更为有效降低炎症反应，激活髓核干细胞，促进髓核组织再生。该研究结果进一步探索PRP修复退变椎间盘的细胞生物学机制，并为临床治疗应用提供坚实的理论依据。