Development of new minimally invasive meniscal repair treatment using bone marrow-derived mesenchymal stem cells and platelet-rich plasma

• Project/Area Number: 16K10845
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Orthopaedic surgery
• Research Institution: University of Tsukuba
• Principal Investigator: Yoshioka Tomokazu 筑波大学, 医学医療系, 准教授 (80649822)
• Research Collaborator: Arai Norihito
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000); Fiscal Year 2018: ¥130,000 (Direct Cost: ¥100,000、Indirect Cost: ¥30,000); Fiscal Year 2017: ¥2,600,000 (Direct Cost: ¥2,000,000、Indirect Cost: ¥600,000); Fiscal Year 2016: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
• Keywords: 多血小板血漿 / 半月板損傷 / 動物モデル / 半月板修復 / 移植・再生医療 / 再生医学 / 動物 / 外科 / 細胞・組織

Outline of Final Research Achievements

Experiment 1：The purpose of this experiment was to investigate the effect of leukocyte-poor (LR) platelet-rich plasma (PRP) on potential healing of avascular zone of longitudinal medial meniscus tears in rabbit model. 0.5 mL of LR-PRP membrane from each rabbit’s whole blood was prepared and put into longitudinal tears with suture. We found that there were no significant differences of quantitative macroscopic and histologic scoring between LR-PRP group and control group at 12 weeks after surgery.
Experiment 2：Based on the results of experiment 1, we changed the injury model from longitudinal tears to 1.5-mm circular defects, and formulation of PRP form membrane to clot. The results are currently being analyzed, and the results are expected to be published in the next year.

Academic Significance and Societal Importance of the Research Achievements

半月板損傷は将来的に不可逆的な変形性膝関節症へと進行し、それに伴う疼痛や膝関節機能低下によって日常生活動作の制限が生じることが明らかとなっているため、可能な限り損傷した半月板を修復、温存することが重要である。従来の半月板縫合術の臨床成績は安定しておらず新たな治療方法の開発が必要である。
末梢血から簡便に調製可能で組織修復に必要な因子の一つである成長因子を有する多血小板血漿の投与により半月板の組織修復促進が得られれば一期的手術が可能な新しい低侵襲半月板治癒促進治療となり、それは半月板縫合術の適応を拡大させ、変形性膝関節症への進行を抑制することで、健康寿命の延伸が期待できる。