CN106362213A - 一种prp负载缓释抗菌素‑间充质干细胞凝胶系统及其制备方法 - Google Patents

一种prp负载缓释抗菌素‑间充质干细胞凝胶系统及其制备方法 Download PDF

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CN106362213A
CN106362213A CN201610944046.8A CN201610944046A CN106362213A CN 106362213 A CN106362213 A CN 106362213A CN 201610944046 A CN201610944046 A CN 201610944046A CN 106362213 A CN106362213 A CN 106362213A
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antibiotics
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费军
余洪俊
韩玉卓
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Third Affiliated Hospital of TMMU
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Abstract

本发明公开了一种PRP负载缓释抗菌素‑间充质干细胞凝胶系统及其制备方法,在PRP加入凝血酶和钙离子,形成50~200μm的不规则微观三维立体网格结构,在此网格结构上负载细菌敏感的抗菌素和干细胞。本发明具有明显防治开放性骨折、骨关节感染、皮肤、皮下组织及肌肉组织感染,四肢、脊柱内植物相关感染及人工关节假体周围感染和降低相关感染发生率的作用。该技术在一定时间内自内而外的释放抗菌素,直接杀灭内植物周围的细菌,抑制及破坏细菌生物膜的形成,并解决了抗菌素在体内缓释的同时和促进骨关节与软组织愈合的技术难题。

Description

一种PRP负载缓释抗菌素-间充质干细胞凝胶系统及其制备 方法
技术领域
本发明属于外科医疗技术领域,具体的说,涉及一种PRP负载缓释抗菌素~间充质干细胞凝胶系统及其制备方法。
背景技术
一直以来,骨与肌肉组织感染始终是困扰骨科临床的最常见而严重的并发症之一,2010年英国报道,骨与肌肉组织感染有细菌生物膜的形成并参与进展,生物膜中细菌的高度耐药性,业已导致临床面临无药可用的严峻局面。由此可见,软组织骨感染不仅消耗巨大的社会财富,同时,还会导致包括由于反复长期应用抗菌素所致细菌耐药、脏器功能损害;住院时间延长、截肢甚至死亡等严重后果。究其原因,细菌与植入物材料粘附以形成完整的生物膜是软组织骨感染的主要病理基础。目前针对细菌生物膜,通过抑制其多糖基质合成及促进其分解、干扰密度感应系统、加用单抗和改进植入物的表面理化特性以降低细菌与材料的粘附及抗菌素涂层等方法,证实在一定程度上可以降低软组织骨感染发生率,但均不能彻底地解决生物膜的形成和由此导致的持续感染。因此,软组织骨感染的早期诊治与生物膜早期防治技术业已成为骨关节临床研究焦点之一。
近二十年来,富血小板血浆(PRP)是一个新的方向正越来越多地用于临床治疗。骨愈合的并发症,如感染,骨不连的治疗。但其抑菌作用一般为24小时内,同时抑菌种类有限。受将PRP可以形成自体富血小板凝胶的启发,我们采用在PRP-间充质干细胞中加入凝血酶和钙离子,调整相关参数
以形成一定直径范围微观网格结构。体外扫描电镜实验证实:三维微孔结构直径通过调整凝血酶与钙离子和钠离子浓度可以调整在50~200μm的不规则微观三维立体网格结构。在此基础上,根据前期细菌培养与药敏结果,负载细菌敏感抗菌素,以局部应用缓释抗菌素。课题组前期在体内外实验已经证实,PRP负载的抗菌素在软组织骨感染局部可超过静脉应用抗菌素MIC的500~30000倍,并延长释放抗菌素长达3~4周窗口期。从而,有望开展PRP联合缓释抗菌素局部应用治疗软组织骨感染,使细菌生物膜受到清除与破坏的同时,结合内植物种类、材质与几何形态、感染病程、细菌种类与生物膜成熟程度等相关因素总结相应外科治疗策略,从根本上改变传统抗菌素的全身或局部使用方式,代之自内而外早期抗菌及直接抑制生物膜的形成与发展,以进一步提高防治软组织骨感染的疗效,该技术的探索成功将对提高软组织与骨关节感染的救治成功率,降低残疾率和死亡率具有重大临床意义。
发明内容
本发明的目的之一在于提供一种强力抗感染和抑制细菌生物膜形成的载缓释抗菌素载体,同时又极大促进骨关节与肌肉组织、皮肤、皮下组织再生。
本发明的目的之二在于提供一种强力抗感染和抑制细菌生物膜形成的载缓释抗菌素载体的制备方法。
一种PRP负载缓释抗菌素-间充质干细胞凝胶系统,其特征在于:在PRP加入凝血酶和钙离子,形成50~200μm的不规则微观三维立体网格结构,在此网格结构上负载细菌敏感的抗菌素。
上述网格结构上还负载干细胞。
受将PRP可以形成自体富血小板凝胶的启发,我们采用在PRP加入各种凝血酶和钙离子,调整相关参数以形成50~200μm的不规则微观三维立体网格结构,在此基础上,根据药敏结果,负载细菌敏感抗菌素,以局部应用缓释抗菌素。课题组前期在体内外实验已经证实,PRP负载的抗菌素在软组织骨感染局部可超过静脉应用抗菌素MIC的500~30000倍,并释放抗菌素长达3~4周窗口期。从而,有望开展PRP联合缓释抗菌素局部应用治疗软组织骨感染,使细菌生物膜受到清除与破坏的同时,结合感染病程、细菌种类与生物膜成熟程度等相关因素总结相应外科治疗策略,从根本上改变传统抗菌素的全身或局部使用方式,代之自内而外早期抗菌及直接抑制生物膜的形成与发展,以进一步提高防治软组织骨感染的疗效,该技术的探索成功将对提高软组织骨感染的救治成功率,降低残疾率和死亡率具有重大临床意义。
上述抗菌素为青霉素类或氯霉素类或四环素类或头孢菌素类或β内酰胺类或克林霉素和林可霉素类或大环内酯类或氨基糖甙类或喹诺酮类或糖肽类或碳氢霉烯类或恶唑烷酮类或抗结核药物和抗菌肽类。
一种PRP负载缓释抗菌素-间充质干细胞凝胶系统的制备方法,其特征在于:按如下步骤进行:
(1)PRP~间充质干细胞的制备:首先将2~10ml枸橼酸钠抗凝剂与10~45ml血液混合,在严格无菌条件下制备PRP,将混有抗凝剂的血液放入离心机中,以500~3500r/min,离心8~12分钟后,取出离心管,试管中分为三层,上层为贫血小板血浆即PPP,中间层为PRP,最底层为红细胞,抽出底层红细胞,剩余3~5ml红细胞,血液为血库所取人血。实施二次离心,离心转数为1000~3000r/min。离心10min后。抽出上清液1/2~3/4,即PPP,剩余约8~10mlPRP,
间充质干细胞系骨髓,水平离心机20℃条件下500g(2000r/min)离心25~30分钟,计数约1×105~1×106/ml,取1~3ml与PRP混合均匀,形成PRP~间充质干细胞;
(2)配置PRP负载缓释抗菌素-间充质干细胞凝胶系统。
这里分为两种方法
第一种上述步骤(2)配置PRP负载缓释抗菌素-间充质干细胞凝胶系统:是将500~2000u普通凝血酶溶于0.5~2ml10%氯化钙或葡萄糖酸钙等钙离子溶液中,另将敏感抗菌素0.3~5g均匀混入PRP中,以100~500r/min搅拌后,利用三腔管将凝血酶及钙离子与PRP混合形成凝胶。
第二种上述步骤(2)配置PRP负载缓释抗菌素-间充质干细胞凝胶系统:是将抗菌素0.3~5g溶解在0.5~2ml0.9%氯化钠中,利用三腔管将500~2000u普通凝血酶及0.5~2ml10%氯化钙或葡萄糖酸钙等钙离子溶液与PRP混合物喷洒在溶有抗菌素的盐水中形成凝胶。凝胶形成后均匀植入开放性骨折、骨关节感染、皮肤皮下及肌肉组织感染;四肢、脊柱内植物相关感染及人工关节假体周围感染等防治部位。
上述抗菌素为青霉素类或氯霉素类或四环素类或头孢菌素类或β内酰胺类或克林霉素和林可霉素类或大环内酯类或氨基糖甙类或喹诺酮类或糖肽类或碳氢霉烯类或恶唑烷酮类或抗结核药物和抗菌肽类。
凝胶形成后均匀植入开放性骨折、骨关节感染、皮肤皮下及肌肉组织感染;四肢、脊柱内植物相关感染及人工关节假体周围感染等防治部位。
实验证明,上述抗菌素包括青霉素类或氯霉素类或四环素类或头孢菌素类或β内酰胺类或克林霉素和林可霉素类或大环内酯类或氨基糖甙类或喹诺酮类或糖肽类或碳氢霉烯类或恶唑烷酮类或抗结核药物和抗菌肽类。这些各类抗菌素都可以与PRP混合。本发明富血小板血浆(PRP)负载缓释抗菌素凝胶系统的构建经体内(新西兰白兔)及体外药物动力学检测证实,具有明显降低导管相关感染的作用。
我们采用专利技术以PRP负载抗菌素以局部缓释治疗软组织骨感染,其体内外实验及软组织骨感染的防治均未见报道。课题组在此基础上,首次在四肢闭合及开放性骨折术后、脊柱骨折术后葡萄球菌软组织骨感染翻修治疗中局部应用PRP联合缓释抗菌素治疗3例,2例成功保留内植物,1例取出内植物后有效控制了软组织骨感染。
有益效果:本发明具有明显防治开放性骨折、骨关节感染、皮肤、皮下组织及肌肉组织感染,四肢、脊柱内植物相关感染及人工关节假体周围感染和降低相关感染发生率的作用。该技术在一定时间内自内而外的释放抗菌素,直接杀灭内植物周围的细菌,抑制及破坏细菌生物膜的形成,并解决了抗菌素在体内缓释的同时和促进骨关节与软组织愈合的技术难题。
具体实施方式
实施例1:
下面对一种PRP负载缓释抗菌素-间充质干细胞凝胶系统及其制备方法作出详细说明:
一种PRP负载缓释抗菌素-间充质干细胞凝胶系统,在PRP加入凝血酶和钙离子,形成50~200μm的不规则微观三维立体网格结构,在此网格结构上负载细菌敏感的抗菌素。网格结构上还负载干细胞。
一种PRP负载缓释抗菌素-间充质干细胞凝胶系统的制备方法,其特征在于:按如下步骤进行:
(1)PRP~间充质干细胞的制备:首先将2~10ml枸橼酸钠抗凝剂与10~45ml血液混合,在严格无菌条件下制备PRP,将混有抗凝剂的血液放入离心机中,以500~3500r/min,离心8~12分钟后,取出离心管,试管中分为三层,上层为贫血小板血浆即PPP,中间层为PRP,最底层为红细胞,抽出底层红细胞,剩余3~5ml红细胞,血液为血库所取人血。实施二次离心,离心转数为1000~3000r/min。离心10min后。抽出上清液1/2~3/4,即PPP,剩余约8~10mlPRP,
间充质干细胞系骨髓,水平离心机20℃条件下500g(2000r/min)离心25~30分钟,计数约1×105~1×106/ml,取1ml与PRP混合均匀,形成PRP-间充质干细胞;
(2)配置PRP负载缓释抗菌素-间充质干细胞凝胶系统。
步骤(2)配置PRP负载缓释抗菌素-间充质干细胞凝胶系统:是将500~2000u普通凝血酶溶于0.5~2ml10%氯化钙或葡萄糖酸钙等钙离子溶液中,另将敏感抗菌素0.3~5g均匀混入PRP中,以100~500r/min搅拌后,利用三腔管将凝血酶及钙离子与PRP混合形成凝胶。
实施例2:
下面对一种PRP负载缓释抗菌素-间充质干细胞凝胶系统及其制备方法作出详细说明:
一种PRP负载缓释抗菌素-间充质干细胞凝胶系统,在PRP加入凝血酶和钙离子,形成50~200μm的不规则微观三维立体网格结构,在此网格结构上负载细菌敏感的抗菌素。网格结构上还负载干细胞。
一种PRP负载缓释抗菌素-间充质干细胞凝胶系统的制备方法,其特征在于:按如下步骤进行:
(1)PRP-间充质干细胞的制备:首先将2~10ml枸橼酸钠抗凝剂与10~45ml血液混合,在严格无菌条件下制备PRP,将混有抗凝剂的血液放入离心机中,以500~3500r/min,离心8~12分钟后,取出离心管,试管中分为三层,上层为贫血小板血浆即PPP,中间层为PRP,最底层为红细胞,抽出底层红细胞,剩余3~5ml红细胞,血液为血库所取人血。实施二次离心,离心转数为1000~3000r/min。离心10min后。抽出上清液1/2~3/4,即PPP,剩余约8~10mlPRP,
间充质干细胞系骨髓,水平离心机20℃条件下500g(2000r/min)离心25~30分钟,计数约1×105~1×106/ml,取1ml与PRP混合均匀,形成PRP~间充质干细胞;
(2)配置PRP负载缓释抗菌素-间充质干细胞凝胶系统。
步骤(2)配置PRP负载缓释抗菌素-间充质干细胞凝胶系统:是将抗菌素0.3~5g溶解在0.5~2ml0.9%氯化钠中,利用三腔管将500~2000u普通凝血酶及0.5~2ml10%氯化钙或葡萄糖酸钙等钙离子溶液与PRP混合物喷洒在溶有抗菌素的盐水中形成凝胶。
实施3与实施1相同所不同的是所用抗菌素为抗菌肽类。
实施4与实施2相同所不同的是所用抗菌素为喹诺酮类。
实施5与实施1相同所不同的是所用抗菌素为磺胺类。
实施6与实施2相同所不同的是所用抗菌素为青霉素类。
实施7与实施1相同所不同的是所用抗菌素为头孢菌素类。
实施8与实施2相同所不同的是所用抗菌素为β内酰胺类。
实施9与实施1相同所不同的是所用抗菌素为克林霉素类。
实施10与实施2相同所不同的是所用抗菌素为大环内酯类。
实施11与实施1相同所不同的是所用抗菌素为抗结核药物。
实施12与实施2相同所不同的是所用抗菌素为碳氢霉烯类。
实施13与实施1相同所不同的是所用抗菌素为恶唑烷酮类。
实施14与实施2相同所不同的是所用抗菌素为林可霉素类。
实施15与实施1相同所不同的是所用抗菌素为氯霉素类。
实施16与实施2相同所不同的是所用抗菌素为四环素类。
最后说明的是,以上优选实施例仅用以说明本方明的技术方案而非限制,尽管通过上述优选实施例已经对本发明进行了详细的描述,但本领域技术人员应当理解,可以在形式上和细节上对其作出各种各样的改变,而不偏离本发明权利要求所限定的范围。

Claims (7)

1.一种PRP负载缓释抗菌素-间充质干细胞凝胶系统,其特征在于:在PRP加入凝血酶和钙离子,形成50~200μm的不规则微观三维立体网格结构,在此网格结构上负载细菌敏感的抗菌素。
2.根据要求1所述一种PRP负载缓释抗菌生素-间充质干细胞凝胶系统,其特征在于:所述网格结构上还负载干细胞。
3.根据权利要求1或2所述一种PRP负载缓释抗菌素-间充质干细胞凝胶系统,其特征在于:所述抗菌素为青霉素类或氯霉素类或四环素类或头孢菌素类或β内酰胺类或克林霉素和林可霉素类或大环内酯类或氨基糖甙类或喹诺酮类或糖肽类或碳氢霉烯类或恶唑烷酮类或抗结核药物和抗菌肽类。
4.一种如权利1所述PRP负载缓释抗菌素-间充质干细胞凝胶系统的制备方法,按如下步骤进行:
(1)PRP-间充质干细胞的制备:首先将2~10ml枸橼酸钠抗凝剂与10~45ml血液混合,在严格无菌条件下制备PRP,将混有抗凝剂的血液放入离心机中,以500~3500r/min,离心8~12分钟后,取出离心管,试管中分为三层,上层为贫血小板血浆即PPP,中间层为PRP,最底层为红细胞,抽出底层红细胞,剩余3~5ml红细胞,实施二次离心,离心转数为1000~3000r/min,离心10min后,抽出上清液1/2~3/4,即PPP,剩余约8~10mlPRP;
间充质干细胞系骨髓,水平离心机20℃条件下500g(2000r/min)离心25~30分钟,计数约1×105~1×106/ml,取1~3ml与PRP混合均匀,形成PRP-间充质干细胞;
(2)再加入抗菌素,配置PRP负载缓释抗菌素-间充质干细胞凝胶系统。
5.根据权利要求1所述PRP负载缓释抗菌素-间充质干细胞凝胶系统的制备方法,其特征在于:所述步骤(2)配置PRP负载缓释抗菌素-间充质干细胞凝胶系统:是将500~2000u普通凝血酶溶于0.5~2ml10%氯化钙或葡萄糖酸钙等钙离子溶液中,另将敏感抗菌素0.3~5g均匀混入PRP中,以100~500r/min搅拌后,利用三腔管将凝血酶及钙离子与PRP混合形成凝胶。
6.根据权利要求1所述PRP负载缓释抗菌素-间充质干细胞凝胶系统的制备方法,其特征在于:所述步骤(2)配置PRP负载缓释抗菌素-间充质干细胞凝胶系统:是将抗菌素0.3~5g溶解在0.5~2ml0.9%氯化钠中,利用三腔管将500~2000u普通凝血酶及0.5~2ml10%氯化钙或葡萄糖酸钙等钙离子溶液与PRP混合物喷洒在溶有抗菌素的盐水中形成凝胶。
7.根据权利要求1所述PRP负载缓释抗菌素-间充质干细胞凝胶系统的制备方法,其特征在于:所述抗菌素为青霉素类或氯霉素类或四环素类或头孢菌素类或β内酰胺类或克林霉素和林可霉素类或大环内酯类或氨基糖甙类或喹诺酮类或糖肽类或碳氢霉烯类或恶唑烷酮类或抗结核药物和抗菌肽类。
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