- 學位論文
溫感水膠複合物於骨組織再生之應用
Application of Thermogel Composite for Bone Tissue Regeneration
本文將於2027/12/31開放下載。若您希望在開放下載時收到通知，可將文章加入收藏。
摘要
溫感性水膠為一種可注射的流體，使用微創手術的方式，可將水膠注入體內至所需的組織或器官進行治療。此外，溫感性水膠具有許多優點，例如藉由溫度的改變，不需要有機溶劑的參予，可將水膠由固態改變成液態，並且，形成原位凝膠狀態。於藥物傳輸和生物醫學的應用面，溫感性水膠藉由水膠型態的轉變，可做為藥物、生物活性因子的優良載體，並應用於組織工程的研究。 論文的研究主題是針對水膠進行骨組織修復進行討論。第一部分研究的主題是使用骨頭生長因子(BMP-2)與水膠進行結合，用於治療股骨頭缺血性壞死（AVN）。由大鼠的動物實驗結果得知，水膠中BMP-2(1μg/ mL)的劑量治療4週後，可有效降低股骨頭缺血性壞死引起的股骨損傷，治療8週後，股骨頭和股骨下生長板下方更多的骨小梁的生成。由上述結果可以得知，水膠混摻BMP-2生長因子的系統，對於股骨頭缺血性壞死的病症的具有不錯的修復潛力。 另一項研究是使用溫感性水膠系統混摻BMP-2生長因子，用於治療骨缺損。藉由相同濃度的BMP-2於不同濃度水膠系統釋放曲線決定出25wt%為最合適的水膠濃度。在動物實驗中，用25wt%的水膠混摻BMP-2進行骨缺損的治療，發現水膠含生長因子的系統，於12週的實驗結果發現骨缺損的部位已有顯著的骨癒合效果。若在12周治療過程中發現，將BMP-2的濃度提高會有更好的骨癒合效果外，若BMP-2的濃度達到20μg/mL時，由臨床的實驗結果得知，骨癒合效果與自體移植組相當。
並列摘要
Thermo-sensitive hydrogels are injectable fluids that can be introduced into the body in a minimally invasive manner prior to solidifying or gelling with the desired tissue or organ. Additionally, the thermos sensitive hydrogels own many advantages, such as it does not require organic solvents and can be an in-situ forming gel. Because of the simplicity of pharmaceutical and biomedical uses of the water-based sol-gel transition that can be used as drug delivery-control systems, bioactive compounds delivery, and tissue engineering. In this study we aimed the bone tissue repair. The first part was focused on avascular necrosis (AVN) treat with thermogel blend with BMP-2.From results showed that AVN surgery plus MP treatment has successfully reduced the damage of femoral head 4 weeks after treatment. A dosage of BMP-2 (1μg/mL) in hydrogel has effectively reduced the femoral damage induced by AVN surgery plus MP treatment by preserving more epiphysis of the femoral head and more trabeculae below the growth plate of the femoral head 8 weeks after treatment. Furthermore, BMP-2 in hydrogel attenuated the femoral head damage after AVN surgery plus MP treatment at doses of 1 and 2μg/mL. These findings strongly suggest that BMP-2 in the hydrogel has a great potential for treating patients suffering from avascular necrosis or other conditions characterized by the osteonecrosis of bones. The other study was to develop a suitable biodegradable thermosensitive hydrogel system as a carrier for bone morphogenetic protein (BMP)-2 delivery in the treatment of critical-sized femoral defects. The BMP-2 release from BOX hydrogel exhibited a near-linear release profile in vitro. In animal experiments, treatment of critical-sized bony defects with 25 wt% BOX hydrogel carrying BMP-2 effectively promoted fracture healing during the 12-week trial period and higher concentrations of BMP-2 treatment correlated with better bone quality. Most importantly, clinical outcome and bone healing in the BOX-hydrogel group with 20 μg/mL BMP-2 were nearly equivalent to those in the autograft group in a 12-week treatment course.
參考文獻
[1] Mont M.A, Hungerford D.S. Non-traumatic avascular necrosis of the femoral head. J. Bone Joint Surg. Am. 77, 459-474, (1995)
[2] Babis G.C, Sakellariou V, Parvizi J, Soucacos P. Osteonecrosis of the Femoral Head. Orthopedics 34, 39-48, (2011)
[3] Bhandari M, Guyatt G.H, Swiontkowski M.F, Schemitsch E.H. Treatment of open fractures of the shaft of the tibia. J Bone Joint Surg Br. 83, 62-68, (2001)
[4] Arrington E.D, Smith WJ, Chambers H.G, Bucknell A.L, Davino N.A. Complications of iliac crest bone graft harvesting. Clin Orthop Relat Res. 329, 300-309, (1996)
[5] Ahlmann E, Patzakis M, Roidis N, Shepherd L, Holtom P. Comparison of anterior and posterior iliac crest bone grafts in terms of harvest-site morbidity and functional outcomes. J Bone Joint Surg Am. 84,716-7220, (2002)