TY - JOUR A1 - Bothe, Friederike A1 - Deubel, Anne-Kathrin A1 - Hesse, Eliane A1 - Lotz, Benedict A1 - Groll, Jürgen A1 - Werner, Carsten A1 - Richter, Wiltrud A1 - Hagmann, Sebastien T1 - Treatment of focal cartilage defects in minipigs with zonal chondrocyte/mesenchymal progenitor cell constructs JF - International Journal of Molecular Sciences N2 - Despite advances in cartilage repair strategies, treatment of focal chondral lesions remains an important challenge to prevent osteoarthritis. Articular cartilage is organized into several layers and lack of zonal organization of current grafts is held responsible for insufficient biomechanical and biochemical quality of repair-tissue. The aim was to develop a zonal approach for cartilage regeneration to determine whether the outcome can be improved compared to a non-zonal strategy. Hydrogel-filled polycaprolactone (PCL)-constructs with a chondrocyte-seeded upper-layer deemed to induce hyaline cartilage and a mesenchymal stromal cell (MSC)-containing bottom-layer deemed to induce calcified cartilage were compared to chondrocyte-based non-zonal grafts in a minipig model. Grafts showed comparable hardness at implantation and did not cause visible signs of inflammation. After 6 months, X-ray microtomography (µCT)-analysis revealed significant bone-loss in both treatment groups compared to empty controls. PCL-enforcement and some hydrogel-remnants were retained in all defects, but most implants were pressed into the subchondral bone. Despite important heterogeneities, both treatments reached a significantly lower modified O’Driscoll-score compared to empty controls. Thus, PCL may have induced bone-erosion during joint loading and misplacement of grafts in vivo precluding adequate permanent orientation of zones compared to surrounding native cartilage. KW - cartilage repair KW - osteochondral defect KW - tissue engineering KW - starPEG hydrogel KW - chondrocyte KW - MSC KW - zonal construct KW - minipig Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-285118 SN - 1422-0067 VL - 20 IS - 3 ER - TY - THES A1 - Hafen, Bettina T1 - Physical contact between mesenchymal stem cells and endothelial precursors induces distinct signatures with relevance to tissue regeneration and engineering T1 - Physischer Kontakt zwischen mesenchymalen Stammzellen und endothelialen Vorläuferzellen indiziert eine bestimmte Signatur mit Relevanz für die Geweberegeneration und Tissue Engineering N2 - The goal of the project VascuBone is to develop a tool box for bone regeneration, which on one hand fulfills basic requirements (e.g. biocompatibility, properties of the surface, strength of the biomaterials) and on the other hand is freely combinable with what is needed in the respective patient's situation. The tool box will include a variation of biocompatible biomaterials and cell types, FDA-approved growth factors, material modification technologies, simulation and analytical tools like molecular imaging-based in vivo diagnostics, which can be combined for the specific medical need. This tool box will be used to develop translational approaches for regenerative therapies of different types of bone defects. This project receives funding from the European Union's Seventh Framework Program (VascuBone 2010). The present study is embedded into this EU project. The intention of this study is to assess the changes of the global gene expression patterns of endothelial progenitor cells (EPCs) and mesenchymal stem cells (MSCs) after direct cell-cell contact as well as the influence of conditioned medium gained from MSCs on EPCs and vice versa. EPCs play an important role in postnatal vasculogenesis. An intact blood vessel system is crucial for all tissues, including bone. Latest findings in the field of bone fracture healing and repair by the use of tissue engineering constructs seeded with MSCs raised the idea of combining MSCs and EPCs to enhance vascularization and therefore support survival of the newly built bone tissue. RNA samples from both experimental set ups were hybridized on Affymetrix GeneChips® HG-U133 Plus 2.0 and analyzed by microarray technology. Bioinformatic analysis was applied to the microarray data and verified by RT-PCR. This study gives detailed information on how EPCs and MSCs communicate with each other and therefore gives insights into the signaling pathways of the musculoskeletal system. These insights will be the base for further functional studies on protein level for the purpose of tissue regeneration. A better understanding of the cell communication of MSCs and EPCs and subsequently the targeting of relevant factors opens a variety of new opportunities, especially in the field of tissue engineering. The second part of the present work was to develop an ELISA (enzyme-linked immunosorbent assay) for a target protein from the lists of differentially expressed genes revealed by the microarray analysis. This project was in cooperation with Immundiagnostik AG, Bensheim, Germany. The development of the ELISA aimed to have an in vitro diagnostic tool to monitor e.g. the quality of cell seeded tissue engineering constructs. The target protein chosen from the lists was klotho. Klotho seemed to be a very promising candidate since it is described in the literature as anti-aging protein. Furthermore, studies with klotho knock-out mice showed that these animals suffered from several age-related diseases e.g. osteoporosis and atherosclerosis. As a co-receptor for FGF23, klotho plays an important role in bone metabolism. The present study will be the first one to show that klotho is up-regulated in EPCs after direct cell-cell contact with MSCs. The development of an assay with a high sensitivity on one hand and the capacity to differentiate between secreted and shedded klotho on the other hand will allow further functional studies of this protein and offers a new opportunity in medical diagnostics especially in the field of metabolic bone disease. N2 - Das Ziel des durch die europäische Union geförderten Projekts VascuBone ist die Entwicklung einer tool box zur Knochenregeneration, die einerseits sämtliche Grundanforderungen erfüllt, beispielsweise an die Biokompatibilität, Oberflächenbeschaffenheit und Robustheit der Biomaterialien, und andererseits frei an den Bedarf der individuellen Patientensituation angepasst werden kann. Sie beinhaltet unterschiedlichste biokompatible Materialien und Zelltypen, FDA-zugelassene Wachstumsfaktoren, materialmodifizierende Technologien sowie Simulations- und analytische Werkzeuge, wie die auf molekularer Bildgebung basierende in-vivo-Diagnostik (MRI und PET/CT), die für den spezifischen medizinischen Bedarf kombiniert werden können. Die tool box wird für die Entwicklung translationaler Ansätze in der regenerativen Medizin für unterschiedliche Arten von Knochendefekten verwendet (VascuBone 2010). Eingebettet in dieses EU-Projekt sollten in der vorliegenden Arbeit die molekularen Grundlagen und Änderungen der globalen Genexpressionsmuster von endothelialen Vorläuferzellen (EPCs) und mesenchymalen Stammzellen (MSCs) nach direktem Zell-Zell-Kontakt sowie nach Gabe von konditioniertem Medium untersucht werden. EPCs spielen eine wichtige Rolle in der postnatalen Vaskulogenese. Ein intaktes Blutgefäßsystem ist überlebensnotwendig für alle Gewebe, einschließlich Knochen. Neueste Erkenntnisse in der Knochenheilung und -regeneration durch die Nutzung von Tissue-Engineering-Konstrukten, die mit MSCs besiedelt wurden, förderten die Idee, MSCs und EPCs zu kombinieren, um die Vaskularisierung – und somit das Überleben – des neu gebildeten Knochengewebes zu begünstigen. Die RNA-Proben aus beiden Versuchsansätzen wurden für die Microarray-Analysen auf Affymetrix GeneChips® HG-U133 Plus 2.0 hybridisiert. Die Array-Daten wurden bioinformatisch ausgewertet und mittels RT-PCR verifiziert. Die vorliegende Arbeit gibt detailliert Aufschluss darüber, wie MSCs und EPCs miteinander kommunizieren, und erlaubt somit wichtige Einblicke in Signalwege des muskuloskelettalen Systems. Dies wiederum ermöglicht weitere funktionelle Studien auf Proteinebene zum Zwecke der Geweberegeneration. Das bessere Verständnis der Zellkommunikation zwischen MSCs und EPCs und somit die gezielte Adressierung von relevanten Faktoren eröffnet völlig neue Möglichkeiten in der klinischen Anwendung, insbesondere im Bereich Tissue Engineering. Im zweiten Teil dieser Arbeit sollte in Kooperation mit der Firma Immundiagnostik AG, Bensheim, ein ELISA (enzyme-linked immunosorbent assay) aufgebaut werden. Ziel war es, für ein geeignetes Protein aus den zu erwartenden Listen regulierter Gene ein in-vitro-diagnostisches Nachweisverfahren zu entwickeln, das ggf. später als Qualitätsnachweis für erfolgreich besiedelte Tissue-Engineering-Konstrukte herangezogen werden könnte. Als geeigneter Kandidat wurde Klotho ausgewählt. Klotho gilt als anti-aging-Protein, da Klotho-knock-out-Mäuse alle alterstypischen Erkrankungen wie Osteoporose oder Arteriosklerose zeigen. Als Co-Rezeptor für FGF23 spielt Klotho außerdem eine wichtige Rolle im Knochenstoffwechsel. Diese Studie ist die erste, die zeigt, dass in EPCs nach direktem Zell-Zell-Kontakt mit MSCs Klotho hochreguliert wird. Die Entwicklung eines sensitiven und differenzierten Nachweises von sezerniertem Klotho sowie der von der Membran proteolytisch abgespaltenen Form von Klotho, eröffnet völlig neue Möglichkeiten in der klinischen Diagnostik, insbesondere im Bereich der Knochenstoffwechselerkrankungen KW - MSC KW - EPC KW - bone regeneration KW - microarray KW - Vorläuferzelle KW - Endothel KW - Mesenchymzelle KW - Knochenregeneration Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-119417 ER - TY - JOUR A1 - Herrmann, Marietta A1 - Hildebrand, Maria A1 - Menzel, Ursula A1 - Fahy, Niamh A1 - Alini, Mauro A1 - Lang, Siegmund A1 - Benneker, Lorin A1 - Verrier, Sophie A1 - Stoddart, Martin J. A1 - Bara, Jennifer J. T1 - Phenotypic characterization of bone marrow mononuclear cells and derived stromal cell populations from human iliac crest, vertebral body and femoral head JF - International Journal of Molecular Sciences N2 - (1) In vitro, bone marrow-derived stromal cells (BMSCs) demonstrate inter-donor phenotypic variability, which presents challenges for the development of regenerative therapies. Here, we investigated whether the frequency of putative BMSC sub-populations within the freshly isolated mononuclear cell fraction of bone marrow is phenotypically predictive for the in vitro derived stromal cell culture. (2) Vertebral body, iliac crest, and femoral head bone marrow were acquired from 33 patients (10 female and 23 male, age range 14–91). BMSC sub-populations were identified within freshly isolated mononuclear cell fractions based on cell-surface marker profiles. Stromal cells were expanded in monolayer on tissue culture plastic. Phenotypic assessment of in vitro derived cell cultures was performed by examining growth kinetics, chondrogenic, osteogenic, and adipogenic differentiation. (3) Gender, donor age, and anatomical site were neither predictive for the total yield nor the population doubling time of in vitro derived BMSC cultures. The abundance of freshly isolated progenitor sub-populations (CD45−CD34−CD73+, CD45−CD34−CD146+, NG2+CD146+) was not phenotypically predictive of derived stromal cell cultures in terms of growth kinetics nor plasticity. BMSCs derived from iliac crest and vertebral body bone marrow were more responsive to chondrogenic induction, forming superior cartilaginous tissue in vitro, compared to those isolated from femoral head. (4) The identification of discrete progenitor populations in bone marrow by current cell-surface marker profiling is not predictive for subsequently derived in vitro BMSC cultures. Overall, the iliac crest and the vertebral body offer a more reliable tissue source of stromal progenitor cells for cartilage repair strategies compared to femoral head. KW - bone marrow stromal cells KW - MSC KW - pericytes KW - femoral head KW - vertebral body KW - iliac crest KW - chondrogenesis Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-285054 SN - 1422-0067 VL - 20 IS - 14 ER - TY - JOUR A1 - Herrmann, Marietta A1 - Diederichs, Solvig A1 - Melnik, Svitlana A1 - Riegger, Jana A1 - Trivanović, Drenka A1 - Li, Shushan A1 - Jenei-Lanzl, Zsuzsa A1 - Brenner, Rolf E. A1 - Huber-Lang, Markus A1 - Zaucke, Frank A1 - Schildberg, Frank A. A1 - Grässel, Susanne T1 - Extracellular Vesicles in Musculoskeletal Pathologies and Regeneration JF - Frontiers in Bioengineering and Biotechnology N2 - The incidence of musculoskeletal diseases is steadily increasing with aging of the population. In the past years, extracellular vesicles (EVs) have gained attention in musculoskeletal research. EVs have been associated with various musculoskeletal pathologies as well as suggested as treatment option. EVs play a pivotal role in communication between cells and their environment. Thereby, the EV cargo is highly dependent on their cellular origin. In this review, we summarize putative mechanisms by which EVs can contribute to musculoskeletal tissue homeostasis, regeneration and disease, in particular matrix remodeling and mineralization, pro-angiogenic effects and immunomodulatory activities. Mesenchymal stromal cells (MSCs) present the most frequently used cell source for EV generation for musculoskeletal applications, and herein we discuss how the MSC phenotype can influence the cargo and thus the regenerative potential of EVs. Induced pluripotent stem cell-derived mesenchymal progenitor cells (iMPs) may overcome current limitations of MSCs, and iMP-derived EVs are discussed as an alternative strategy. In the last part of the article, we focus on therapeutic applications of EVs and discuss both practical considerations for EV production and the current state of EV-based therapies. KW - extracellular vesicles KW - exosomes KW - musculoskeletal diseases KW - MSC KW - iMP KW - cell-free therapeutics Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-222882 SN - 2296-4185 VL - 8 ER - TY - JOUR A1 - Schwab, Andrea A1 - Buss, Alexa A1 - Pullig, Oliver A1 - Ehlicke, Franziska T1 - Ex vivo osteochondral test system with control over cartilage defect depth – A pilot study to investigate the effect of oxygen tension and chondrocyte based treatments in chondral and full thickness defects in an organ model JF - Osteoarthritis and Cartilage Open N2 - Objective Cartilage defect treatment strategies are dependent on the lesion size and severity. Osteochondral explant models are a platform to test cartilage repair strategies ex vivo. Current models lack in mimicking the variety of clinically relevant defect scenarios. In this controlled laboratory study, an automated device (artificial tissue cutter, ARTcut®) was implemented to reproducibly create cartilage defects with controlled depth. In a pilot study, the effect of cartilage defect depth and oxygen tension on cartilage repair was investigated. Design Osteochondral explants were isolated from porcine condyles. 4 ​mm chondral and full thickness defects were treated with either porcine chondrocytes (CHON) or co-culture of 20% CHON and 80% MSCs (MIX) embedded in collagen hydrogel. Explants were cultured with tissue specific media (without TGF-β) under normoxia (20% O\(_2\)) and physiological hypoxia (2% O\(_2\)). After 28 days, immune-histological stainings (collagen II and X, aggrecan) were scored (modified Bern score, 3 independent scorer) to quantitatively compare treatment outcome. Results ARTcut® represents a software-controlled device for creation of uniform cartilage defects. Comparing the scoring results of the MIX and the CHON treatment, a positive relation between oxygen tension and defect depth was observed. Low oxygen tension stimulated cartilaginous matrix deposition in MIX group in chondral defects and CHON treatment in full thickness defects. Conclusion ARTcut® has proved a powerful tool to create cartilage defects and thus opens a wide range of novel applications of the osteochondral model, including the relation between oxygen tension and defect depth on cartilage repair. KW - cartilage defectex vivo model KW - cartilage test system KW - chondrocytes KW - MSC KW - collagen type I hydrogel Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-260511 VL - 3 IS - 2 ER - TY - JOUR A1 - Schmidt, Stefanie A1 - Abinzano, Florencia A1 - Mensinga, Anneloes A1 - Teßmar, Jörg A1 - Groll, Jürgen A1 - Malda, Jos A1 - Levato, Riccardo A1 - Blunk, Torsten T1 - Differential production of cartilage ECM in 3D agarose constructs by equine articular cartilage progenitor cells and mesenchymal stromal cells JF - International Journal of Molecular Sciences N2 - Identification of articular cartilage progenitor cells (ACPCs) has opened up new opportunities for cartilage repair. These cells may be used as alternatives for or in combination with mesenchymal stromal cells (MSCs) in cartilage engineering. However, their potential needs to be further investigated, since only a few studies have compared ACPCs and MSCs when cultured in hydrogels. Therefore, in this study, we compared chondrogenic differentiation of equine ACPCs and MSCs in agarose constructs as monocultures and as zonally layered co-cultures under both normoxic and hypoxic conditions. ACPCs and MSCs exhibited distinctly differential production of the cartilaginous extracellular matrix (ECM). For ACPC constructs, markedly higher glycosaminoglycan (GAG) contents were determined by histological and quantitative biochemical evaluation, both in normoxia and hypoxia. Differential GAG production was also reflected in layered co-culture constructs. For both cell types, similar staining for type II collagen was detected. However, distinctly weaker staining for undesired type I collagen was observed in the ACPC constructs. For ACPCs, only very low alkaline phosphatase (ALP) activity, a marker of terminal differentiation, was determined, in stark contrast to what was found for MSCs. This study underscores the potential of ACPCs as a promising cell source for cartilage engineering. KW - ACPC KW - chondroprogenitors KW - tissue engineering KW - MSC KW - agarose KW - hypoxia KW - ECM KW - co-culture KW - zonal KW - cartilage Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-236180 SN - 1422-0067 VL - 21 IS - 19 ER - TY - THES A1 - Haddad-Weber, Meike T1 - Development of stem cell-based ACL- and tendon reconstruction T1 - Entwicklung Stammzell-basierter Konstrukte für den Kreuzband- und Sehnenersatz N2 - Ruptures of the anterior cruciate ligament (ACL) and defects of the rotator cuff represent the most common ligament and tendon injuries in knee and shoulder. Both injuries represent significant implications for the patients. After an injury, the ACL and the rotator cuff both exhibit poor intrinsic healing capacities. In order to prevent further defects such as arthritis of the knee and fatty infiltration of the rotator cuff, surgical interaction is essential. In both cases, the currently used surgical techniques are far from optimal because even after the therapy many patients report problems ranging from pain and reduced mobility to complete dysfunction of the involved joint and muscles. Tissue engineering may be a possible solution. It is a promising field of regenerative medicine and might be an advantageous alternative for the treatment of musculoskeletal injuries and diseases in the near future. In this thesis, different tissue engineering based approaches were investigated. For the reconstruction of damaged or diseased ligaments and tendons, the use of MSCs and gene therapy with growth factors is especially suitable and possesses a great therapeutic potential. Therefore, the first method studied and tested in this thesis was the development of a biomaterial based construct for the repair of a ruptured ACL. The second approach represents a cell based strategy for the treatment of the fatty infiltration in the rotator cuff. The third approach was a combined cell, biomaterial, and growth factor based strategy for ACL ruptures. Biomaterial based ACL construct The implant is currently tested in a preclinical in vivo study in mini pigs. This proof-of-principle study is performed to validate the functional capability of the collagen fiber based implant under load in vivo and its population with fibroblasts which produce a ligamentogenic matrix. Cell based treatment of the fatty infiltration in the rotator cuff Regarding the treatment of the fatty infiltration of the rotator cuff in a rabbit model, the in vivo results are also promising. The group treated with autologous MSCs (+MSC group) showed a lower fat content than the untreated group (–MSC group) 6 weeks after the treatment. Furthermore, the SSP muscle of the MSC-treated animals revealed macroscopically and microscopically only few differences compared to the healthy control group. The exact underlying mechanisms leading to the positive results of the treatment are not yet fully understood and have therefore to be further investigated in the future. Cell, biomaterial, and growth factor based treatment of ACL ruptures Studies described in current literature show that collagen hydrogel scaffolds are not ideal for a complete ligament or tendon reconstruction, because of their insufficient mechanical stability. Introduced as an alternative and superior therapy, the combined strategy used in this thesis proves that the cultivation of BMP-12, -13, and IGF-1 transduced MSCs and ACL fibroblasts in a collagen hydrogel is successful. The results of the performed in vitro study reveal that the cells exhibit a fibroblastic appearance and produce a ligamentogenic matrix after 3 weeks. Furthermore, the adenoviral transduction of MSCs and ACL fibroblasts showed no negative effects on proliferation or viability of the cells nor was apoptosis caused. Therefore, the application of these cells represents a possible future therapy for a partial ligament and tendon rupture where the mechanical stability of the remaining ligament or tendon is sufficient and the healing can be improved substantially by this therapy. In general, prospective randomized clinical trials still have to prove the postulated positive effect of MSCs for the treatment of various musculoskeletal diseases, but the results obtained here are already very promising. Ideally, the treatment with MSCs is superior compared to the standard surgical procedures. Because of current safety issues the use of genetically modified cells cannot be expected to be applied clinically in the near future. In summary, the different tissue engineering approaches for novel therapies for musculoskeletal injuries and diseases invested in this thesis showed very promising results and will be further developed and tested in preclinical and clinical trials. N2 - 7.2 Zusammenfassung Kreuzbandrupturen und Defekte im Bereich der Rotatorenmanschette stellen die häufigsten Band- und Sehnenverletzungen im Kniegelenk bzw. in der Schulter dar. Beide Verletzungen haben erhebliche Auswirkungen für den Patienten. Sowohl das Kreuzband als auch die Rotatorenmanschette weisen ein sehr schlechtes Heilungspotential nach einer Verletzung auf. Um weiteren Schäden wie einer Kniegelenksarthrose oder einer Verfettung der Rotatorenmanschette vorzubeugen, ist ein operativer Eingriff erforderlich. In beiden Fällen sind die zurzeit verwendeten Behandlungsstandards nicht optimal, da auch nach einer Therapie viele Patienten über Beschwerden klagen, die von Schmerzen und einer eingeschränkten Mobilität bis hin zu einer kompletten Dysfunktion des betroffenen Gelenks und Muskels reichen. Tissue Engineering ist ein zukunftsträchtiges Feld der Regenerativen Medizin und kann ein möglicher Lösungsansatz sein. Vor allem bei der Behandlung von muskuloskelettalen Verletzungen und Erkrankungen kann es zukünftig eine vorteilhafte Behandlungsalternative darstellen. In dieser Doktorarbeit wurden verschiedene Tissue Engineering-basierte Lösungsansätze untersucht. Zur Rekonstruktion von defektem Band- und Sehnengewebe sind sowohl der Einsatz von mesenchymalen Stammzellen (MSZ) als auch die Gentherapie mit Wachstumsfaktoren besonders geeignet und weisen ein großes therapeutisches Potential auf. Deswegen wurde in der vorliegenden Doktorarbeit als erster innovativer Therapieansatz ein Biomaterial-basiertes Konstrukt für den Ersatz eines gerissenen Kreuzbandes entwickelt und getestet. Der zweite Lösungsansatz stellt eine Zell-basierte Therapie zur Behandlung einer fettigen Atrophie der Rotatorenmanschette dar. Die dritte Methode kombiniert Zellen, Biomaterialien und Wachstumsfaktoren zur Therapie von Kreuzbandrupturen. Biomaterial-basiertes Kreuzbandkonstrukt Das Implantat wird zurzeit in einer präklinischen in vivo Studie am Mini Pig getestet. Diese Proof-of-Principle Studie wird durchgeführt, um die Funktionsfähigkeit der Kollagenfaser-basierten Implantate unter Belastung in vivo zu validieren und ihre Besiedelung mit Fibroblasten, die eine ligamentäre Matrix ausbilden, zu beobachten. Zell-basierte Behandlung der fettig-infiltrieten Rotatorenmanschette Auch bei der Behandlung der fettigen Infiltration der Rotatorenmanschette im Kaninchenmodel, wurden in vivo sehr viel versprechende Ergebnisse erzielt. Die mit autologen MSZ (+MSZ-Gruppe) behandelte Gruppe zeigte nach 6 Wochen einen deutlich geringeren Fettanteil als die unbehandelte Gruppe (-MSZ-Gruppe). Des Weiteren wies der SSP-Muskel aller MSZ-behandelten Tiere sowohl makroskopisch als auch mikroskopisch nur geringe Unterschiede im Vergleich zur gesunden Kontrollgruppe auf. Der genaue zugrunde liegende Mechanismus dieser erfolgreichen Behandlung konnte bisher noch nicht genau geklärt werden und muss in zukünftigen Studien weiter untersucht werden. Zell-, Biomaterial- und Wachstumsfaktor-basierte Behandlung von Kreuzbandrupturen In der aktuellen Literatur beschriebenen Studien zeigen, dass Kollagenhydrogel-konstrukte aufgrund der fehlenden biomechanischen Stabilität nicht geeignet sind für den kompletten Band- bzw. Sehnenersatz. Als vorteilhafte Behandlungsalternative wurde in der vorliegenden Arbeit eine kombinierte Strategie entwickelt und erfolgreich in vitro getestet: Die Kultivierung von BMP-12-, -13- bzw. IGF-1-transduzierten MSZ und Kreuzbandfibroblasten in einem Kollagenhydrogel verlief sehr viel versprechend und ergab, dass die Zellen nach 3 Wochen im Kollagenhydrogel eine fibroblastäre Morphologie aufweisen und eine ligamentäre Matrix ausbilden. Des Weiteren führte die adenovirale Transduktion der Zellen weder zu negativen Auswirkungen auf das Proliferationsverhalten noch auf die Vitalität der Zellen und löste auch keine Apoptose bei den transduzierten Zellen aus. Zukünftig kann der Einsatz dieser Zellen deswegen ein möglicher Ansatz zur Behandlung von Teilrupturen bei Bändern und Sehnen darstellen, bei denen die biomechanische Stabilität ausreichend ist und die Heilung durch die Therapie wesentlich verbessert wird. Im Allgemeinen müssen prospektive randomisierte klinische Studien zeigen, ob sich der positive Effekt der MSZ bei der Behandlung von Erkrankungen des muskuloskelettalen Systems in der Orthopädie und Unfallchirurgie bewährt, wobei die in der vorliegenden Arbeit erzielten Ergebnisse sehr Erfolg versprechend sind. Idealerweise erweist sich die Behandlung mit MSZ als deutlich vorteilhaft gegenüber den bisher etablierten chirurgischen Standardverfahren. Aufgrund der bestehenden Sicherheitsrichtlinien für den Einsatz von gentherapeutischen modifizierten Zellen ist mit deren Verwendung zur Behandlung von Band- und Sehnenerkrankungen in naher Zukunft nicht zu rechnen. Zusammenfassend führte die Untersuchung der unterschiedlichen Tissue Engineering Ansätze, die in dieser Doktorarbeit als neue Therapien zur Behandlung von muskuloskelettalen Verletzungen und Erkrankungen evaluiert wurden, zu sehr viel versprechende Ergebnisse. Diese Therapieansätze sollen weiterentwickelt und in präklinischen und klinischen Studien getestet werden. KW - Kreuzband KW - Sehne KW - Tissue Engineering KW - Mesenchymale Stammzellen KW - Gentherpie KW - Zell-basierte Therapie KW - ACL KW - tendon KW - MSC KW - genetherapy KW - cell-based therapy Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-66796 ER -