Journal of the Chinese Medical Association
Volume 71, Issue 2 , Pages 66-73, February 2008

Comparison of the Effectiveness of Autologous Fibrin Glue and Macroporous Biphasic Calcium Phosphate as Carriers in the Osteogenesis Process With or Without Mesenchymal Stem Cells

  • Li-Tzu Lee

      Affiliations

    • Departments of Oral and Maxillofacial Surgery, Taichung, Taipei, Taiwan, R.O.C.
    • ,
  • Po-Cheung Kwan

      Affiliations

    • Departments of Pathology, Taichung Veterans General Hospital, Taichung, Taipei, Taiwan, R.O.C.
    • ,
  • Ya-Fang Chen

      Affiliations

    • Departments of Oral and Maxillofacial Surgery, Taichung, Taipei, Taiwan, R.O.C.
    • ,
  • Yong-Kie Wong

      Affiliations

    • Departments of Oral and Maxillofacial Surgery, Taichung, Taipei, Taiwan, R.O.C.
    • School of Dentistry, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Yong-Kie Wong, Department of Oral and Maxillofacial Surgery, Taichung Veterans General Hospital, 160, Section 3, Taichung-Kang Road, Taichung 407, Taiwan, R.O.C

Received 24 September 2007; accepted 23 January 2008.

Article Outline

Background

Facial bone reconstruction has been a challenge for oral and maxillofacial surgeons for a long time. Recently, some studies have reported the use of stem cells in facial reconstruction to achieve osteogenesis. However, to ensure that stem cells remain in the recipient site, a biocompatible carrier is needed to transfer the stem cells. Fibrin glue has been shown to promote hemostasis in wound management and accelerate soft tissue healing, but the role of fibrin glue in bone regeneration remains debatable. The purpose of this study was to compare the effectiveness of autologous fibrin glue and macroporous biphasic calcium phosphate (MBCP) as carriers in the osteogenesis process with/without mesenchymal stem cells.

Methods

Fifteen New Zealand white rabbits were used in this study. Mesenchymal stem cells were harvested from the iliac bone, and autologous fibrin glue was made from peripheral blood. Three cranial defects with a diameter of 6 mm were created over the cranial bone in each rabbit. The 15 animals were separated into 2 groups. The first group contained 12 rabbits. The grafted substances placed over the regions of defect were: (1) stem cells plus autologous fibrin glue; (2) stem cells plus MBCP; (3) defect alone as control. In the second group of 3 rabbits, the cranial defects were grafted with: (1) autologous fibrin glue alone; (2) MBCP alone; (3) defect alone as control. Rabbits were sacrificed at 1, 2 and 3 months post operation. Radiography and histology were used to detect bone formation.

Results

Stem cells plus autologous fibrin glue induced more bone formation 2 months post operation and more mature bone was found 3 months post operation compared with the other groups. MBCP with or without stem cells showed moderate tissue reaction, including giant cell, histiocyte and eosinophil cell accumulation.

Conclusion

Using stem cells plus autologous fibrin glue as the carrier may accelerate new bone regeneration.

Key Words:  autologous fibrin glue , biphasic calcium phosphate , osteogenesis , stem cells

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References 

  1. Aghaloo TL , Moy PK , Freymiller EG . Evaluation of platelet-rich plasma in combination with freeze-dried bone in the rabbit cranium. A pilot study . Clin Oral Implants Res . 2005;16:250–257
  2. Ohya M , Yamada Y , Ozawa R , Ito K , Takahashi M , Ueda M . Sinus floor elevation applied to tissue-engineered bone: comparative study between mesenchymal stem cells/platelet-rich plasma (PRP) and autogenous bone with PRP complexes in rabbits . Clin Oral Implants Res . 2005;16:622–629
  3. Watanabe K , Niimi A , Ueda M . Autogenous bone grafts in the rabbit maxillary sinus . Oral Surg Oral Med Oral Pathol Oral Radiol Endod . 1999;88:26–32
  4. Lerouxel E, Weiss P, Giumelli B, Moreau A, Pilet P, Guicheux J, et al  Injectable calcium phosphate scaffold and bone marrow graft for bone reconstruction in irradiated areas: an experimental study in rats . Biomaterials . 2006;27:4566–4572
  5. Schliephake H , Knebel JW , Aufderheide M , Tauscher M . Use of cultivated osteoprogenitor cells to increase bone formation in segmental mandibular defects: an experimental pilot study in sheep . Int J Oral Maxillofac Surg . 2001;30:531–537
  6. Malard O, Guicheux J, Bouler JM, Gauthier O, de Montreuil CB, Aquado E, et al  Calcium phosphate scaffold and bone marrow for bone reconstruction in irradiated areas: a dog study . Bone . 2005;36:323–330
  7. Le Nihouannen D, Guehennen LL, Rouillon T, Pilet P, Bilban M, Lavrolle P, et al. Micro-architecture of calcium phosphate granules and fibrin glue composites for bone tissue engineering . Biomaterials . 2006;27:2716–2722
  8. Teixeira CC , Nemelivsky Y , Karkia C , Legeros RI . Biphasic calcium phosphate: a scaffold for growth plate chondrocyte maturation . Tissue Eng . 2006;12:2283–2289
  9. Bluteau G, Pilet P, Bourges X, Bilban M, Spaethe R, Daculsi G, et al. The modulation of gene expression in osteoblasts by thrombin coated on biphasic calcium phosphate ceramic . Biomaterials . 2006;27:2934–2943
  10. Mann KG , Brummel K , Butenas S . What is all that thrombin for? . J Thromb Haemost . 2003;1:1504–1514
  11. Sarpel U , Roayaie S , Schwartz ME , Labow DM . The role of fibrin sealants in hepatic surgery . Surg Technol Int . 2007;16:31–36
  12. Spotnitz WD , Mintz PD , Avery N , Bithell TC , Kaul S , Nolan SP . Fibrin glue from stored human plasma: an inexpensive and efficient method for local blood bank preparation . Am Surg . 1987;53:460–462
  13. Clark RA . Fibrin glue for wound repair: facts and fancy . Thromb Haemost . 2003;90:1003–1006
  14. Clark RA . Fibrin sealant in wound repair: a systematic survey of the literature . Expert Opin Investig Drugs . 2000;9:2371–2392
  15. Schilelphake H . Bone growth factors in maxillofacial skeletal reconstruction . Int J Oral Maxillofac Surg . 2002;31:469–484
  16. Derner R , Anderson AC . The bone morphogenic protein . Clin Podiatr Med Surg . 2005;22:607–618
  17. Nevins M, Giannobile WV, McGuire MK, Kao RT, Mellonig T, Hinrichs E, et al  Platelet-derived growth factor stimulates bone fill and rate of attachment level gain: results of a large multicenter randomized controlled trial . J Periodontol . 2005;76:2205–2215
  18. Anitua E , Andia I , Ardanza B , Nurden P , Nurden AT . Autologous platelets as a source of proteins for healing and tissue regeneration . Thromb Haemost . 2004;91:4–15
  19. Sanchez AR , Sheridan PJ , Kupp LI . Is platelet-rich plasma the perfect enhancement factor? A current review . Int J Oral Maxillofac Implants . 2003;18:93–103
  20. Rose LF , Rosenberg E . Bone grafts and growth and differentiation factors for regenerative therapy: a review . Pract Proced Aesthet Dent . 2001;13:725–734
  21. Yang D , Jin D , Chen J , Jing Z , Wu D . Modulation of transforming growth factor beta to platelet-derived growth factor receptor-alpha of human osteoblasts . Chin Med J (Engl) . 2000;113:621–624
  22. Gosain AK, Song LS, Santoro T, Weihrauch D, Bosi BO, Corrao MA, et al. Effects of transforming growth factor-beta and mechanical strain on osteoblast cell counts: an in vitro model for distraction osteogenesis . Plast Reconstr Surg . 2000;105:130–139
  23. Thorn JJ , Sorensen H , Weis-Fogh U , Andersen M . Autologous fibrin glue with growth factors in reconstructive maxillofacial surgery . Int J Oral Maxillofac Surg . 2004;33:95–100
  24. Alhadlaq A , Mao JJ . Tissue-engineered neogenesis of human-shaped mandibular condyle from rat mesenchymal stem cells . J Dent Res . 2003;82:951–956
  25. Abukawa H , Shin M , Williams WB , Vacanti JP , Kaban LB , Troulis MJ . Reconstruction of mandibular defects with autolo-gous tissue-engineered bone . J Oral Maxillofac Surg . 2004;62:601–606
  26. Ambrose CG, Clyburn TA, Louden K, Joseph J, Wright J, Gulati P, et al  Effective treatment of osteomyelitis with biodegradable microspheres in a rabbit model . Clin Orthop Relat Res . 2004;421:293–299
  27. von Arx T , Cochran DL , Hermann JS , Schenk RK , Buser D . Lateral ridge augmentation using different bone fillers and barrier membrane application: a histologic and histomorpho-metric pilot study in the canine mandible . Clin Oral Implants . 2001;12:260–269
  28. Kovacs K , Velich N , Huszar T , Fenyves B , Suba Z , Szabo G . Histomorphometric and densitometric evaluation of the effects of platelet-rich plasma on the remodeling of beta-tricalcium phosphate in beagle dogs . J Craniofac Surg . 2005;16:150–154
  29. Fellah BH , Josselin N , Chappard D , Weiss P , Lavrolle P . Inflammatory reaction in rats muscle after implantation of bipha-sic calcium phosphate micro particles . J Mater Sci Mater Med . 2007;18:287–294
  30. Curran JM , Gallagher JA , Hunt JA . The inflammatory potential of biphasic calcium phosphate granules in osteoblast/macrophage co-culture . Biomaterials . 2005;26:5313–5320
  31. Lu J , Tang T , Ding H , Dai K . Micro-particles of bioceramics could cause cell and tissue damage . Sheng Wu Yi Xue Gong Cheng Xue Za Zhi . 2006;23:85–89
  32. De Kok IJ , Drapeau SJ , Young R , Cooper LF . Evaluation of mesenchymal stem cells following implantation in alveolar sockets: a canine safety study . Int Oral Maxillofac Implants . 2005;20:511–518
  33. Komatsu F , Yoshida S . Utility and quality of autologous fresh frozen plasma and autologous fibrin glue for surgical patients . Transfus Sci . 1999;21:105–109
  34. Malicev E , Radosavljevic D , Velikonja NK . Fibrin gel improved the spatial uniformity and phenotype of human chondrocytes seeded on collagen scaffolds . Biotechnol Bioeng . 2007;96:364–370
  35. Fang H , Peng S , Chen A , Li F , Ren K , Hu N . Biocompatibility studies on fibrin glue cultured with bone marrow mesenchymal stem cells in vitro . J Huazhong Univ Sci Technol Med Sci . 2004;24:272–274
  36. Erkan AN , Cakmak O , Kocer NE , Yilmaz I . Effects of fibrin glue on nasal septal tissues . Laryngoscope . 2007;117:491–496
  37. Gosk J , Knakiewicz M , Wiacek R , Reichert P . The use of fibrin glue in peripheral nerve reconstructions . Polim Med . 2006;36:11–15
  38. Ivanovski S , Gronthos S , Shi S , Bartold PM . Stem cells in the periodontal ligament . Oral Dis . 2006;12:358–363
  39. Le Nihouannen D, Goyenvalle E, Aguado E, Pilet P, Bilban M, Daculsi G, et al. Hybrid composites of calcium phosphate granules, fibrin glue, and bone marrow for skeletal repair . J Biomed Mater Res A . 2007;81:399–408
  40. Lee MY, Chiou TJ, Bai LY, Hsiao LT, Hung GY, Chang CY, et al. Intravenous busulfan as preparative regimen in pediatric patients receiving hematopoietic stem cell transplantation: the preliminary experience in Taiwan . J Chin Med Assoc . 2004;67:117–122
  41. Hung GY , Chiou TJ , Lin CY , Hsiao LT , Chen PM , Hwang B . Transplantation of related histocompatible marrow and peripheral blood stem cells in a patient with severe combined immunodeficiency and disseminated BCG infection . J Chin Med Assoc . 2003;66:72–75
  42. Chung KM , Chuang SS , Hwang WS , Lee PS , Li CY . High dose chemotherapy and allogenic peripheral blood stem cell transplantation for multiple myeloma evolving from intra-abdominal plasmacytoma . J Chin Med Assoc . 2002;65:557–560
  43. Chen YC , Hsueh EJ , Ho CL , Kao WY , Wan HL , Chao TY . Autologous peripheral blood stem cell transplantation for patients with malignancies: the Tri-Service General Hospital experience . J Chin Med Assoc . 2001;64:395–402
  44. Hwang WL , Tsai CS , Jour JH , Kuo LH , Chang YM . Autologous peripheral blood stem cell transplantation using simplified procedures for collection and freezing . J Chin Med Assoc . 1999;62:529–535

PII: S1726-4901(08)70077-7

doi:10.1016/S1726-4901(08)70077-7

Journal of the Chinese Medical Association
Volume 71, Issue 2 , Pages 66-73, February 2008

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