Objective The effects of umbilical blood mononuclear cells (UCB-MNCs) on the biomechanical properties, histological characteristics and molecular mechanism of partial rotator cuff tear healing in rabbits were systematically evaluated to provide an experimental basis for clinical transformation. Methods Thirty New Zealand male rabbits were randomly divided into four groups: blank group (no intervention), cell injection group (UCB-MNCs local injection), control group (modeling + normal saline injection) and experimental group (modeling +UCB-MNCs injection). At 8 and 12 weeks after surgery, the repair effect was analyzed by gross observation, biomechanical tests (maximum tensile load, elastic modulus), histopathological staining (HE, Masson, saffranine solid green), and immunohistochemistry (type I/III collagen), and the safety of UCB-MNCs was evaluated. Results After 8 weeks, scar area of the experimental group was reduced by 42% (P<0.01), and biomechanical strength was significantly increased (82.83±8.22N vs 64.26±2.46 N, P=0.002). At 12 weeks after surgery, the arrangement regularity of collagen fibers in the experimental group reached 78% of normal tendons, and the proportion of type I collagen increased from 35% to 62% (P<0.05), and there was no statistical difference in the biomechanical properties between the experimental group and the blank group (P=0.213). Histology showed that UCB-MNCs significantly inhibited the expression of inflammatory factors such as tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and promoted the regeneration of fibrocartilage interface. Conclusion UCB-MNCs significantly improved the healing quality of partial rotator cuff tears by inhibiting inflammatory microenvironment and promoting extracellular matrix remodeling, providing experimental basis for non-surgical treatment.
Key words
partial tear of rotator cuff /
umbilical blood mononuclear cells /
biomechanics /
tissue remodeling /
inflammation regulation
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] SHER JS, URIBE JW, POSADA A, et al.Abnormal findings on magnetic resonance images of asymptomatic shoulders[J]. J Bone Joint Surg Am, 1995, 77(1): 10-15.
[2] MILGROM C, SCHAFFLER M, GILBERT S, et al.Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender[J]. J Bone Joint Surg Br, 1995, 77(2): 296-298.
[3] CHANG IY, POLSTER JM.Pathomechanics and Magnetic Resonance Imaging of the Thrower's Shoulder[J]. Radiol Clin North Am, 2016, 54(5): 801-815.
[4] FINNAN RP, CROSBY LA.Partial-thickness rotator cuff tears[J]. J Shoulder Elbow Surg, 2010, 19(4): 609-616.
[5] CONNOR PM, BANKS DM, TYSON AB, et al.Magnetic resonance imaging of the asymptomatic shoulder of overhead athletes: a 5-year follow-up study[J]. Am J Sports Med, 2003, 31(5): 724-727.
[6] SNYDER SJ, PACHELLI AF, DEL PIZZO W, et al.Partial thickness rotator cuff tears: results of arthroscopic treatment[J]. Arthroscopy, 1991, 7(1):1-7.
[7] KIM YS, LEE HJ, KIM JH, et al.When Should We Repair Partial-Thickness Rotator Cuff Tears? Outcome Comparison Between Immediate Surgical Repair Versus Delayed Repair After 6-Month Period of Nonsurgical Treatment[J]. Am J Sports Med, 2018, 46(5): 1091-1096.
[8] B SHAFFER, HUTTMAN D. Rotator cuff tears in the throwing athlete[J]. Sports Med Arthrosc Rev, 2014, 22(2): 101-109.
[9] BEITZEL K, SOLOVYOVA O, COTE MP, et al.The future role of mesenchymal stem cells in the management of shoulder disorders[J]. Arthroscopy, 2013, 29(10): 1702-1711.
[10] FU Y, ZHANG C, YANG Y, et al.Effect of umbilical cord blood-mononuclear cells on knee osteoarthritis in rabbits[J]. J Orthop Surg, 2024, 19(1): 323.
[11] LEOR J, GUETTA E, CHOURAQUI P, et al.Human umbilical cord blood cells: a new alternative for myocardial repair?[J]. Cytotherapy, 2005, 7(3): 251-257.
[12] PARK GY, KWON DR, LEE SC.Regeneration of Full-Thickness Rotator Cuff Tendon Tear After Ultrasound-Guided Injection With Umbilical Cord Blood-Derived Mesenchymal Stem Cells in a Rabbit Model[J]. Stem Cells Transl Med, 2015, 4(11): 1344-1351.
[13] BIAZAR E.Use of umbilical cord and cord blood-derived stem cells for tissue repair and regeneration[J]. Expert Opin Biol Ther, 2014, 14(3): 301-310.
[14] SNEDEKER JG, PELLED G, ZILBERMAN Y, ET AL.An analytical model for elucidating tendon tissue structure and biomechanical function from in vivo cellular confocal microscopy images[J]. Cells Tissues Organs, 2009, 190(2): 111-119.
[15] GOTOH M, MITSUI Y, SHIBATA H, et al.Increased matrix metalloprotease-3 gene expression in ruptured rotator cuff tendons is associated with postoperative tendon retear[J]. Knee Surg Sports Traumatol Arthrosc, 2013, 21(8): 1807-1812.
[16] LO IK, MARCHUK LL, HOLLINSHEAD R, et al.Matrix metalloproteinase and tissue inhibitor of matrix metalloproteinase mRNA levels are specifically altered in torn rotator cuff tendons[J]. Am J Sports Med, 2004, 32(5): 1223-1229.
[17] CHEN Y, XU Y, DAI G, SHI Q, et al.Enhanced Repaired Enthesis Using Tenogenically Differentiated Adipose-Derived Stem Cells in a Murine Rotator Cuff Injury Model[J]. Stem Cells Int, 2022, 2022: 1309684
[18] HYMAN SA, WU IT, VASQUEZ-BOLANOS LS, et al.Supraspinatus muscle architecture and physiology in a rabbit model of tenotomy and repair[J]. J Appl Physiol (1985), 2021, 131(6):1708-1717.
[19] XIA P, SHI Y, WANG X, LI X.Advances in the application of low-intensity pulsed ultrasound to mesenchymal stem cells[J]. Stem Cell Res Ther, 2022, 13(1): 214.
[20] SUN TJ, TAO R, HAN YQ, et al.Therapeutic potential of umbilical cord mesenchymal stem cells with Wnt/β-catenin signaling pathway pre-activated for the treatment of diabetic wounds[J]. Eur Rev Med Pharmacol Sci. 2014, 18(17): 2460-2464.
PDF(4294 KB)
