WO2011048803A1 - 硬組織再生誘導用材料 - Google Patents
硬組織再生誘導用材料 Download PDFInfo
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- WO2011048803A1 WO2011048803A1 PCT/JP2010/006203 JP2010006203W WO2011048803A1 WO 2011048803 A1 WO2011048803 A1 WO 2011048803A1 JP 2010006203 W JP2010006203 W JP 2010006203W WO 2011048803 A1 WO2011048803 A1 WO 2011048803A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3604—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the human or animal origin of the biological material, e.g. hair, fascia, fish scales, silk, shellac, pericardium, pleura, renal tissue, amniotic membrane, parenchymal tissue, fetal tissue, muscle tissue, fat tissue, enamel
- A61L27/3616—Blood, e.g. platelet-rich plasma
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3641—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the site of application in the body
- A61L27/3645—Connective tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/40—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material
- A61L27/44—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix
- A61L27/46—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix with phosphorus-containing inorganic fillers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L27/56—Porous materials, e.g. foams or sponges
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P19/00—Drugs for skeletal disorders
- A61P19/04—Drugs for skeletal disorders for non-specific disorders of the connective tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P19/00—Drugs for skeletal disorders
- A61P19/08—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/02—Materials or treatment for tissue regeneration for reconstruction of bones; weight-bearing implants
Definitions
- the present invention relates to a material for inducing regeneration of hard tissue such as bone and cartilage, which comprises platelet-rich plasma and gelatin ⁇ -TCP sponge.
- autologous bone grafting has been performed in which bone is collected from its own healthy part and transplanted to the bone defect site for reconstruction of the bone defect site such as bone union at the fracture site or removal of a benign bone tumor.
- the bone defect site such as bone union at the fracture site or removal of a benign bone tumor.
- complications such as infection at the bone collection site, residual pain and nerve damage around the bone extraction area occur at a high rate of about 30%.
- a large amount of autologous bone is required, so there may be a clinical problem of a defect in the autologous bone collection part.
- Non-patent Document 1 a method has been developed in which autologous bone marrow mesenchymal stem cells are cultured and combined with an artificial bone and transplanted to a bone defect site, and a clinical application example has been reported (Non-patent Document 1).
- the need for specialized facilities such as a clean room (cell processing center) capable of cell culture makes it virtually difficult to carry out in a city hospital, and it is also possible to obtain cancerous cells of multipotent mesenchymal cells.
- There are various problems such as the risk and the fact that differentiation induction is not always perfect, and the versatility is low.
- BMP-2 bone morphogenetic protein-2
- Non-patent Documents 2 and 3 reports that inflammatory reaction was observed in the lumbar perivertebral tissue, and in cases where cervical spine fixation was performed, dyspnea due to laryngeal edema, dysphagia and abnormal swelling of the neck itself There have been reports that serious complications such as were observed (Non-patent Documents 2 and 3). As a cause of these, by administering a large amount of artificially produced growth factor, the growth factor diffuses from the administration site to the surrounding tissue, and as a result of inducing an antigen-antibody reaction, edema in soft tissues and important organs is caused. It is conceivable that a change has occurred. Furthermore, BMP-2 is expensive, and in addition to the cost of surgery, it costs several hundred thousand yen per person, which places a large financial burden on patients.
- Platelet rich plasma (also referred to as Platelet Rich Plasma (PRP)) is platelet-rich plasma obtained by low speed centrifugation of peripheral blood to remove red blood cells.
- PRP contains many growth factors such as platelet-derived growth factor (PDGF), transforming growth factor ⁇ (TGF- ⁇ ), fibroblast growth factor (FGF), and insulin-like growth factor (IGF) contained in platelets. It is known that these synergistic effects have effects such as promoting angiogenesis, osteogenesis, and wound healing. It has also been confirmed that an osteogenic effect is exhibited in a long bone or skull defect model by using PRP together with a suitable drug delivery system material such as gelatin hydrogel (Patent Document 1, Non-patent Document 4 and 5).
- PDGF platelet-derived growth factor
- TGF- ⁇ transforming growth factor ⁇
- FGF fibroblast growth factor
- IGF insulin-like growth factor
- a scaffold with a three-dimensional structure to promote cell differentiation and induction is essential.
- the object of the present invention is to provide a novel safety and practicable novel bone / cartilage and other hard tissue regeneration having a sustained release effect of platelet-rich plasma-derived growth factor and a good scaffold function of tissue regeneration. To provide various materials.
- the inventors processed the gelatin which is excellent as a material for a growth factor drug delivery system and ⁇ -TCP granules which are bioabsorbable ceramics into a sponge shape, A gelatin- ⁇ -TCP sponge was used to prepare a material for inducing regeneration of hard tissue comprising Platelet Rich Plasma (PRP) purified from the patient's autologous blood. Then, it was verified that this material dramatically promotes bone formation using a rat spinal fixation model.
- PRP Platelet Rich Plasma
- the present invention has been made based on the above-mentioned findings, and provides a material for inducing hard tissue regeneration, which comprises platelet-rich plasma and gelatin ⁇ -TCP sponge.
- Hard tissues targeted by the material of the present invention are bone / cartilage tissues and the like that require a scaffold for regeneration, and also include dental areas such as alveolar bone.
- the material for inducing hard tissue regeneration of the present invention promotes osteogenesis and chondrogenesis.
- the material for inducing hard tissue regeneration of the present invention also promotes angiogenesis.
- the material for inducing regeneration of hard tissue of the present invention is suitably used for regeneration of hard tissues such as bones and cartilage requiring a scaffold since gelatin ⁇ -TCP sponge functions as a good cell scaffold for tissue regeneration.
- the application site is not limited to hard tissues, but may be soft tissues in contact with hard tissues such as bone and cartilage.
- soft tissues such as bone and cartilage.
- tendon and ligament regeneration is induced by its angiogenesis promoting action. Therefore, the use for inducing regeneration of soft tissue in contact with such hard tissue is also included in the present invention.
- the platelet-rich plasma used in the present invention is preferably derived from a subject to which the material for inducing hard tissue regeneration is applied.
- the subject to which the material for inducing hard tissue regeneration of the present invention is applied is not limited to human but includes mammals in general.
- the pore diameter of the gelatin ⁇ -TCP sponge used in the present invention is preferably about 10 to 500 ⁇ m, and the gelatin in the gelatin ⁇ -TCP sponge is preferably crosslinked.
- the cross-linking is prepared by subjecting a composition containing ⁇ -TCP and gelatin to cross-linking and lyophilization, but either cross-linking or lyophilization may precede it, and the cross-linked composition may be lyophilized.
- the freeze-dried composition may be crosslinked.
- the PRP used in the present invention can be easily collected from the subject's own blood to which the material for inducing hard tissue regeneration is applied, there are no therapeutic ethical problems, and there are no viral infections associated with the use of blood products or It has the advantage of avoiding risks such as immune mismatches. Furthermore, the gelatin ⁇ -TCP sponge used in the present invention allows sustained release of components such as growth factors contained in PRP to promote osteogenesis, chondrogenesis, angiogenesis and a good cell scaffold for tissue regeneration. By acting as a bone, it enables remarkable bone regeneration.
- FIG. 1 is a view schematically showing implantation between the 4 and 5 transverse processes in a rat spinal posterior lateral fixation model.
- FIG. 2 is a sagittal reconstructed image of left and right 4, 5 lateral projections.
- FIG. 3 is a graph showing bone mass between transverse processes.
- FIG. 4 is a graph showing the results of a three-point bending test.
- FIG. 5 shows a histologic image between the 4 and 5 lateral projections of the PRP sponge model. Intrachondral ossification-like changes are observed between the lateral processes.
- FIG. 5 shows a histologic image between the 4 and 5 lateral projections of the PRP sponge model. Intrachondral ossification-like changes are observed between the lateral processes.
- FIG. 5 shows a histologic image between the 4 and 5 lateral projections of the PRP sponge model. Intrachondral ossification-like changes are observed between the lateral processes.
- FIG. 5 shows a
- the present invention relates to a material for inducing hard tissue regeneration, comprising platelet-rich plasma (PRP) and gelatin beta-TCP sponge.
- PRP platelet rich plasma
- the “Platelet Rich Plasma (PRP)” according to the present invention is platelet-rich plasma obtained by low speed centrifugation of peripheral blood to remove erythrocytes.
- PRP contains many growth factors such as platelet-derived growth factor (PDGF), transforming growth factor ⁇ (TGF- ⁇ ), stem cell-derived factor (SDF) -1 and insulin-like growth factor (IGF) contained in platelets.
- PDGF platelet-derived growth factor
- TGF- ⁇ transforming growth factor ⁇
- SDF stem cell-derived factor
- IGF insulin-like growth factor
- the number of rotations and the time for efficiently removing blood cell components can be appropriately selected according to the type of centrifugal separator used. If necessary, platelets may be concentrated by removing the blood cell components and centrifuging again. Alternatively, PRP can also be prepared by a membrane-based blood separation device.
- the PRP used in the present invention is preferably derived from the autologous blood of the subject in need of administration of the material for inducing hard tissue regeneration of the present invention.
- platelet-rich plasma purified from allogeneic blood may be used in subjects with severe anemia or underlying diseases in which blood collection is difficult.
- the gelatin ⁇ -TCP sponge used in the present invention is a porous spongy structure consisting of gelatin and ⁇ -TCP granules.
- the gelatin used in the present invention is used as collagen or collagen which can be collected from any part of the body such as skin, bones and tendons of various animal species including cattle, pigs, fish etc.
- the substance can be obtained by being denatured by various treatments such as alkaline hydrolysis, acid hydrolysis and enzymatic degradation.
- the properties of gelatin vary depending on the material used and the processing method, but gelatin having any of the properties can be utilized as the gelatin ⁇ -TCP sponge material of the present invention.
- isoelectric point, molecular weight, zeta potential and the like can be used as a scale indicating the properties of gelatin.
- commercially available gelatins include Type A gelatin manufactured by Sigma and gelatin manufactured by Wako, and the zeta potential in an aqueous solution is as follows: Sigma type A gelatin: about 0 to about 5 mV Wako gelatin: about -5 to about -2mV
- the zeta potential is a measure representing the degree of electrostatic charge of a substance (gelatin).
- Particularly preferred gelatins used in the present invention have the following physical properties: An acidic gelatin obtained by alkaline hydrolysis treatment from collagen, The molecular weight is about 100,000 to about 200,000 daltons under non-reducing conditions of SDS-PAGE, The gelatin potential in aqueous solution is about -15 to about -20 mV.
- acidic gelatin prepared by alkali treatment of bovine bone-derived type I collagen can be used, and it can also be obtained as a sample isoelectric point (IEP) 5.0 of Nitta Gelatin Co., Ltd.
- the basic gelatin prepared by acid treatment can also be obtained as Sample IEP 9.0 of Nitta Gelatin Co., Ltd., but the zeta potential is largely different as follows.
- the ⁇ -TCP (tricalcium phosphate) used in the present invention is a biodegradable ceramic which has conventionally been widely used as an artificial bone material.
- the compressive strength of porous ⁇ -TCP is about 3 M pascal, which is weaker than that of living bone (about 7 M pascal in cancellous bone), but it can be said to be a strength sufficient for clinical use.
- ⁇ -TCP is gradually decomposed in the living body to release calcium ions and phosphate ions, thereby realizing an environment in which osteoblasts can easily synthesize hydroxyapatite, which is a component of bone.
- ⁇ -TCP not only serves as a carrier for a drug delivery system or as a scaffold for bone formation, but itself has a function of actively promoting osteogenesis, chondrogenesis, angiogenesis and the like.
- ⁇ -TCP enhances the mechanical strength of the gelatin sponge obtained by mixing it with gelatin, and itself actively promotes osteogenesis, chondrogenesis, angiogenesis and the like to form a good scaffold material. It becomes.
- the ⁇ -TCP used in the present invention may have any size, porosity, pore size and the like, and all types of ⁇ -TCP granules can be used.
- commercially available ⁇ -TCP-100 (ground product): manufactured by Taihei Kagaku Sangyo Co., Ltd., Osferin (registered trademark): manufactured by Olympus, etc. can be used.
- the ratio of gelatin to ⁇ -TCP in the gelatin ⁇ -TCP sponge of the present invention is 10: 1 to 1:10, preferably 5: 1 to 1: 5 by dry weight. .
- the gelatin ⁇ -TCP sponge according to the present invention is in the form of a sponge having a large number of fine pores having an average pore size of 10 to 500 ⁇ m.
- a structure having a large number of micropores when transplanted, surrounding cells can easily penetrate into the sponge and can play a role as a scaffold for tissue regeneration. Become. Furthermore, it becomes possible to supply sufficient nutrition and oxygen to the adhered cells, and the cells can be proliferated and differentiated normally.
- the lower limit of the average pore diameter of the micro pores of the gelatin ⁇ -TCP sponge according to the present invention is 10 ⁇ m, and the upper limit is 500 ⁇ m. If it is less than 10 ⁇ m, cells can not enter into the inside of the support for regenerative medicine, cell adhesion is extremely poor, or adherent cells can not extend three-dimensionally, or if it exceeds 500 ⁇ m, the density of cells Is low and the tissue or organ can not be regenerated.
- the preferred lower limit is 50 ⁇ m, and the preferred upper limit is 200 ⁇ m.
- gelatin is cross-linked.
- the moisture content is an index for evaluating the degree of crosslinking (crosslinking degree).
- the moisture content is the weight percent of water in the sponge to the weight of the swollen gelatin beta-TCP sponge. The higher the water content, the lower the degree of crosslinking of the gelatin ⁇ -TCP sponge, and the more easily it is degraded. That is, the in vivo enzymatic degradability of the gelatin ⁇ -TCP sponge changes depending on the water content, and the value of the water content influences the sustained release (slow release) of PRP.
- the gelatin ⁇ -TCP sponge of the present invention preferably has a water content of 90% to 99.8%. If the water content is less than 90%, in addition to the loss of flexibility suitable for transplantation, it takes a long time to biodegrade even if it is transplanted in vivo, and the physiologically active substance is not sustained-released and remains in the support. There are times when If it exceeds 99.8%, the support may not maintain its strength in the culture solution or buffer, or the bioactive substance may be released only for a short period of 1 to 3 days. A more preferable lower limit is 95%, and a more preferable upper limit is 98%.
- the gelatin ⁇ -TCP sponge used in the present invention is obtained by subjecting a composition containing gelatin and ⁇ -TCP to crosslinking and lyophilization.
- ⁇ -TCP is blended with gelatin.
- the gelatin is then crosslinked.
- the crosslinking method is not particularly limited, and examples thereof include vacuum thermal dehydration method, dry heat method, ⁇ -ray irradiation method, ultraviolet irradiation method, electron beam irradiation method, X-ray irradiation method, and a method using a crosslinking agent.
- a method of using a crosslinking agent is preferable because crosslinking can be performed so as to obtain a uniform degree of crosslinking even in the case of crosslinking gelatin in a state of being once formed into a sponge shape as described later.
- the crosslinking agent used is not particularly limited.
- glutaraldehyde for example, water-soluble carbodiimides such as EDC, for example, propylene oxide, diepoxy compounds, hydroxyl group, carboxyl group, amino group, thiol group, imidazole group, etc. form a chemical bond Condensing agents (ethylene glycol diglycidyl ether, polyethylene glycol diglycidyl ether, polyglycerol polyglycidyl ether, glycerol polyglycidyl ether, hexamethylene diisocyanate, etc.) can be used.
- Preferred is glutaraldehyde.
- Crosslinking may be performed before lyophilization or after lyophilization. Specifically, for example, a gelatin aqueous solution containing .beta.-TCP is vigorously stirred and foamed by a homogenizer or the like, subjected to a crosslinking reaction, cast on a mold, frozen and then freeze-dried.
- a sponge-like molded body is obtained, or a gelatin aqueous solution mixed with ⁇ -TCP is vigorously stirred and foamed by a homogenizer or the like, cast on a mold, frozen and then freeze-dried to form a sponge-like sponge A body is obtained, and the sponge-like molded body is crosslinked by immersion in a glutaraldehyde solution of an appropriate concentration for a certain period of time (see JP-A-2005-21147).
- a sponge structure important as a scaffold material is formed by foaming with stirring and a lyophilization process. That is, innumerable ice crystals grown by the freezing step become pores upon lyophilization to give a porous sponge structure having desired porosity and pore diameter.
- a thermal crosslinking treatment or the like may be performed before the treatment for the purpose of avoiding the swelling of the sponge-like structure at the initial stage of the treatment.
- a crosslinking agent it is preferable to treat the reaction end to remove the toxicity.
- the reaction end can be inactivated to remove toxicity by washing with a glycine aqueous solution or the like.
- the gelatin ⁇ -TCP sponge may be formed into any shape, for example, cylindrical, prismatic, sheet, disc, sphere, particles and the like.
- Columnar, prismatic, sheet-like or disc-like ones are usually used as the embedded pieces in many cases, or they can be finely crushed into particles.
- spherical and particulate ones can also be administered by injection.
- gelatin ⁇ -TCP sponge As the gelatin ⁇ -TCP sponge, a commercially available product (for example, ⁇ -TCP fortified gelatin sponge MedGel® Scaffold or MedGel® SP (Medgel)) may be used.
- ⁇ -TCP fortified gelatin sponge MedGel® Scaffold or MedGel® SP Medgel
- the material for inducing hard tissue regeneration of the present invention means a tissue having a hard intercellular substance including bone, cartilage and teeth.
- the material for inducing hard tissue regeneration according to the present invention induces hard tissue regeneration by including PRP having an effect of promoting regeneration such as osteogenesis, chondrogenesis, angiogenesis and the like and gelatin ⁇ -TCP sponge excellent as a scaffold for tissue regeneration. It is used as a material. In particular, it is suitably used as a material for inducing regeneration of bone / cartilage tissue defects.
- the material for inducing regeneration of hard tissue according to the present invention is suitably used as a material for inducing regeneration of bone / cartilage defects requiring a cell scaffold, but the application site is not limited to hard tissue, and bone -It may be soft tissue in contact with hard tissue such as cartilage. Specifically, even in the transplantation of soft tissue such as tendon and ligament in contact with bone and cartilage, regeneration of tendon and ligament is induced by PRP's angiogenesis promoting action. Therefore, the use for inducing regeneration of soft tissue in contact with such hard tissue is also included in the present invention.
- the material for inducing regeneration of hard tissue of the present invention is widely usable in the medical and veterinary fields including orthopedics and dental areas, and the subject to which the application is applied is not limited to human but includes mammals in general.
- the material for inducing regeneration of hard tissue of the present invention is prepared by blending PRP with the above-mentioned gelatin ⁇ -TCP sponge.
- PRP-containing gelatin ⁇ -TCP sponge can be obtained, for example, by dropping PRP onto the above-described freeze-dried gelatin ⁇ -TCP sponge, or immersing gelatin ⁇ -TCP sponge in PRP to impregnate PRP in the sponge. You can get it.
- This impregnation operation is usually completed in 15 minutes to 1 hour at 4-37 ° C., preferably 15-30 minutes at 4-25 ° C., during which the sponge swells with PRP and is contained in PRP.
- PRP is immobilized in the gelatin ⁇ -TCP sponge by physical interaction by the growth factor etc.
- the weight ratio of PRP to gelatin beta-TCP sponge (dry weight) is preferably in the range of about 1-fold to about 10000-fold. More preferably, the weight ratio of PRP to gelatin ⁇ -TCP sponge is about 2 times to about 5000 times, more preferably about 10 times to about 1000 times.
- the gelatin ⁇ -TCP sponge may be formed into a desired shape such as a cylindrical shape, a prismatic shape, a sheet shape, a disk shape, a spherical shape, or a particle shape in accordance with the application site.
- the dose of PRP in the material for inducing regeneration of hard tissue of the present invention can be appropriately adjusted according to the severity of the disease, the age of the subject, the weight of the subject, etc.
- the dose is selected from the range of ⁇ 500 ml, preferably in the range of about 1 ⁇ 50 ml, which can be injected into the affected area or its surrounding area.
- the material for inducing regeneration of hard tissue of the present invention may optionally contain other agents and pharmacologically acceptable carriers as appropriate.
- agents and carriers include agents that promote angiogenesis and bone regeneration, osteoblasts activation or osteoclast inhibitors, scaffold carriers that promote cell proliferation and differentiation, or combinations thereof. .
- the material for inducing hard tissue regeneration of the present invention has various effects included in PRP, since it has both the sustained release effect and the stabilizing effect of PRP. A small amount of function such as factor can be exerted for a long time. Therefore, in the locally administered site, the angiogenesis promoting function and the osteogenesis / chondrogenic function such as these growth factors are effectively exhibited.
- the mechanism of this sustained release is based on the fact that various growth factors and the like contained in PRP are physically immobilized on gelatin ⁇ -TCP in the sponge.
- the present inventors have attempted to control release using bioabsorbable polymer hydrogels such as growth factors, cytokines, monokines, lymphokines, and other physiologically active substances so far, and this allows physiology that can not be achieved with other materials.
- the growth factors and the like contained in PRP are slowly released from gelatin ⁇ -TCP by the same mechanism. When immobilized on gelatin ⁇ -TCP, growth factors and the like are not released from the sponge.
- the gelatin ⁇ -TCP sponge As the gelatin ⁇ -TCP sponge is degraded in vivo, the gelatin ⁇ -TCP molecule becomes water soluble, and along with it, the growth factors etc. immobilized on the gelatin ⁇ -TCP molecule become released. That is, the sustained release of growth factors and the like can be controlled by the degradation of gelatin ⁇ -TCP sponge.
- the degradability of gelatin ⁇ -TCP sponge can be changed by adjusting the degree of crosslinking at the time of preparation of gelatin ⁇ -TCP sponge.
- various growth factors and the like contained in PRP interact with gelatin ⁇ -TCP to improve their stability in the living body, for example, resistance to enzymatic degradation.
- the gelatin ⁇ -TCP sponge disappears with the slow release of growth factors and the like, it has a feature that it does not physically inhibit the bone regeneration process by cell proliferation and differentiation.
- blended with the material for induction of hard tissue regeneration of this invention contains various growth factors etc.
- the inventors confirmed that the material for inducing hard tissue regeneration of the present invention has a remarkable bone regeneration effect.
- involvement of angiogenesis has also been reported, and the tissue regeneration at the defect site is not only the effect of promoting osteogenesis and chondrogenesis but also various effects of PRP such as the effect of promoting angiogenesis. Promoted, good bone regeneration is achieved.
- the material for inducing regeneration of hard tissue of the present invention is mainly composed of cross-linked gelatin ⁇ -TCP sponge, and is composed of a substrate having a large number of fine pores of a fixed pore size. It can be easily infiltrated and can serve as a scaffold for regeneration.
- the PRP component is electrostatically bonded to the surface of the base material and released slowly in accordance with the decomposition of the base material, it is possible to keep the PRP component acting on cells over a long period of time, bone The formation effect can be dramatically increased.
- the sustained release rate can be adjusted by adjusting the degree of crosslinking of the gelatin. That is, the material for inducing regeneration of hard tissue of the present invention can simultaneously play two roles of a scaffold material for regeneration and a regeneration promoter.
- Example 1 Preparation of platelet-rich plasma (PRP) Preparation SD rats (male, 8 weeks old, 240 to 290 g, Shimizu experimental material, Kyoto), 250 ⁇ L of pentobarbital was injected intraperitoneally for general anesthesia. The chest was opened, and 5 CC blood was collected from the heart using a 21 G needle. The blood was transferred to a 15 cc centrifuge tube in which 2 cc of ACD-A solution (W / V%: citric acid 0.85, trisodium citrate 2.32, glucose 2.59) had been placed. The centrifuge tube was centrifuged at 1500 rpm for 10 minutes using a centrifuge (KN-70, manufactured by Kubota Seisakusho).
- KN-70 manufactured by Kubota Seisakusho
- the clear serum portion in the upper layer was aspirated using a 14 G perfusion needle and transferred to another centrifuge tube. Furthermore, it centrifuged at 3000 rotations for 10 minutes. The upper serum portion was aspirated with 200 ⁇ L remaining using a 14 G perfusion needle, and the remaining solution was agitated to obtain 200 ⁇ L of platelet-rich plasma (PRP).
- PRP platelet-rich plasma
- the resulting 200 ⁇ L of PRP is impregnated into a total of 20 mg of gelatin ⁇ -TCP sponge ( ⁇ -TCP reinforced gelatin sponge MedGel® Scaffold (Medgel)) cut into 2 mm cubes and left overnight at 4 ° C. did.
- PBS Phosphate buffer saline
- Rat spinal posterior lateral fixation model SD rats male, 8 weeks old, 240 to 290 g, Shimizu experimental material, Kyoto
- a 40 mm longitudinal incision was made in the back midline skin.
- a 25 mm longitudinal incision was made in the paraspinal muscle at a position of 5 mm from the middle to the left and right to expose the lateral processes of the fourth and fifth lumbar vertebrae (hereinafter referred to as 4.5 lateral processes).
- PRP-impregnated gelatin ⁇ -TCP sponge hereinafter PRP sponge
- PBS phosphate buffer saline
- MedGel® Scaffold Medgel
- 3 PRP alone
- 4 Autologous iliac, with no grafting group, a total of 5 groups were studied.
- PRP single model of 3 only 200 ⁇ L of PRP was dispersed between the lateral projections.
- the autologous ilium of 4 was collected at a size of 5 ⁇ 2 ⁇ 2 mm at the iliac tip on the same side as the planned implantation site.
- FIG. 1 schematically shows implantation between the 4 and 5 lateral processes in the rat spinal posterior lateral fixation model.
- a three-point bending test of the lumbar spine was performed using a three-point bending tester (Tokyo Testing Machine, LSC-200 / 30-2). Place the lumbar spine on top of the jig with a width of 40 mm, and use a 5 mm diameter cylindrical jig at a speed of 10 mm / min in front of the 4th / 5 lumbar disc I applied pressure. The loads at a displacement distance of 10 mm were compared in each group. Next, tissue fixation was performed at 4 ° C. for 1 week with 4% paraformaldehyde.
- Results Figure 2 shows the results of sagittal reconstructed images of the left and right 4, 5 lateral projections.
- PRP sponge model and the autologous iliac model, there was a tendency of union between the left and right lateral processes.
- PRP sponge model a marked increase in the anterior-posterior diameter was observed as compared to the autologous iliac model.
- PBS sponge PRP alone and no placement model, there was no increase between transverse processes, and no tendency to bone union was observed.
- FIG. 3 shows the bone mass between the left and right 4, 5 lateral projections. Significant increase in bone mass was observed in the PRP sponge model compared to the other models.
- FIG. 4 shows the results of the three-point bending test.
- an average strength of 59.6 times was observed compared to the other groups.
- FIG. 5 shows a tissue image between the 4 and 5 horizontal protrusions of the PRP sponge model.
- an image in which bone matrix and hyaline cartilage components were mixed was shown, and a phenomenon similar to endochondral ossification had occurred.
- Safranin O staining revealed that a part of the hyaline cartilage had a red staining image, which proved to be a cartilage matrix.
- the histology (8 weeks after surgery) between the 4 and 5 horizontal processes of the non-installation group is shown.
- FIG. 5 although a ligament component is observed between the lateral processes, no bone and cartilage components are recognized.
- the acid-treated gelatin was dissolved in distilled water to prepare a 3 wt% gelatin aqueous solution.
- aqueous gelatin solution thus obtained, 1.8 g of ⁇ -TCP was added, 0.4 mL of 0.16 wt% aqueous glutaraldehyde aqueous solution was added, and the mixture was foamed by stirring with a homogenizer at 5000 rpm for 3 minutes.
- the foamed gelatin ⁇ -TCP aqueous solution is cast in a mold of 12 cm ⁇ 12 cm, allowed to stand at 4 ° C for 12 hours for crosslinking reaction, frozen at -40 ° C and then freeze-dried to give a sponge body I got
- the obtained sponge body was washed 3 times with a 0.1 N aqueous glycine solution for 1 hour, further washed with water, and again freeze-dried to obtain a gelatin ⁇ -TCP sponge.
- the platelet-rich plasma used in the present invention can be purified only by centrifuging the subject's own blood to which the material for inducing hard tissue regeneration is applied, so that it can be carried out at multiple facilities without the need for special facilities or equipment. It is.
- platelet-rich plasma derived from autologous blood is used, the possibility of occurrence of side effects is extremely low as compared with recombinant growth factor.
- the gelatin ⁇ -TCP sponge uses only materials used in clinical practice and is highly safe for the human body, the material for inducing hard tissue regeneration of the present invention can be expected to have extremely rapid clinical application.
- the spread of the present invention not only dramatically reduces the need for autologous bone collection that has conventionally been generally performed, but also enables early loading and early rehabilitation by the osteogenic ability promoting action. The benefits are immeasurable.
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Abstract
Description
1.多血小板血漿(PRP)
本発明に係る「多血小板血漿(Platelet Rich Plasma:PRP)」とは、末梢血を低速で遠心分離して赤血球を除くことにより得られる濃厚血小板血漿である。PRPには、血小板中に含まれる血小板由来成長因子(PDGF)、トランスホーミング成長因子β(TGF-β)、幹細胞由来因子(SDF)-1、インスリン様成長因子(IGF)などの成長因子が多く含まれており、これらの相乗的作用により血管新生、骨新生、軟骨新生、創傷治癒の促進等の効果を有することが知られている。
本発明で使用されるゼラチンβ-TCPスポンジとは、ゼラチンとβ-TCP顆粒からなる多孔質のスポンジ状構造物のことである。
2.1 ゼラチン
本発明で使用されるゼラチンは、牛、豚、魚類などを始めとする各種の動物種の皮膚、骨、腱などの身体のあらゆる部位から採取できるコラーゲン、あるいはコラーゲンとして用いられている物質から、アルカリ加水分解、酸加水分解、及び酵素分解等の種々の処理によって変性させて得ることができる。ゼラチンの性質は、用いる材料及び処理方法により様々であるが、そのいずれの性質をもつゼラチンも本発明のゼラチンβ-TCPスポンジ材料として利用することができる。
シグマ社製タイプAゼラチン:約0~約5mV
和光社製ゼラチン:約-5~約-2mV
ジータ電位は、物質(ゼラチン)の静電的な荷電の程度を表す尺度である。
コラーゲンからのアルカリ加水分解処理によって得られる、酸性ゼラチンであり、
分子量が、SDS-PAGEの非還元条件下で約10~約20万ダルトンであり、
水溶液中のジータ電位が、約-15~約-20mVである
を有するゼラチンである。
酸性ゼラチン (新田ゼラチン社試料IEP 5.0):約-15~約-20mV
塩基性ゼラチン (新田ゼラチン社試料IEP 9.0):約+12~約+15mV
本発明で用いられるβ-TCP(リン酸三カルシウム)は、従来より人工骨材料として汎用されている生分解性セラミックスである。多孔性β-TCPの圧縮強度は3M パスカル程度で、生体骨(海綿骨で7Mパスカル程度)よりは弱いものの、臨床使用には十分な強度といえる。さらに、β-TCPは生体内で徐々に分解してカルシウムイオンとリン酸イオンを放出し、骨芽細胞による、骨の構成成分であるハイドロキシアパタイト合成が容易な環境を実現する。つまり、β-TCPはドラッグデリバリーシステムの担体や骨形成の足場としてだけでなく、それ自体が骨新生、軟骨新生、血管新生等を積極的に促進させる機能を有する。かくして、β-TCPは、ゼラチンと混合されることで得られるゼラチンスポンジの力学強度を高めるとともに、それ自体も骨新生、軟骨新生、血管新生等を積極的に促進することで、良好な足場材料となる。本発明で用いられるβ-TCPは、そのサイズ、気孔率、孔サイズなどはどのようなものであってもよく、全ての種類のβ-TCP顆粒を用いることができる。例えば、市販のβ-TCP-100(粉砕品):太平化学産業株式会社製、オスフェリン(登録商標):オリンパス製等を用いることができる。
本発明のゼラチンβ-TCPスポンジにおけるゼラチンとβ-TCPの比率は、乾燥重量で10:1~1:10、好ましくは5:1~1:5である。
本発明で使用されるゼラチンβ-TCPスポンジは、ゼラチンとβ-TCPを含む組成物に、架橋と凍結乾燥を施して得られる。
本発明にかかる「硬組織」とは、骨、軟骨、歯を含む硬い細胞間物質を持つ組織を意味する。本発明の硬組織再生誘導用材料は、骨新生や軟骨新生、血管新生等の再生促進効果をもつPRPと、組織再生の足場として優れたゼラチンβ-TCPスポンジを含むことで、硬組織再生誘導用材料として用いられる。とくに、骨・軟骨組織欠損部の再生誘導用材料として好適に用いられる。
4.1 PRP徐放性効果
本発明の硬組織再生誘導用材料は、PRPの徐放性効果と安定化効果を併せ持つため、PRPに含まれる各種成長因子等の機能を少量で長時間にわたって発揮し得る。そのため、局所投与した部位において、これらの成長因子等の血管新生促進機能及び骨新生・軟骨新生機能が効果的に発揮される。
本発明の硬組織再生誘導用材料に配合されるPRPは、各種成長因子等を含み、血管新生促進効果、骨新生促進効果、軟骨新生促進効果、創傷治癒促進効果、皮膚潰瘍治療効果等のさまざまな効果を有する(前掲)。
本発明の硬組織再生誘導用材料は、架橋されたゼラチンβ-TCPスポンジを主体とし、一定の孔径の多数の微細小孔を有する基材からなることにより細胞が容易に浸入することができ、再生の足場材料としての役割を果たすことができる。また、基材の表面にはPRP成分が静電結合しており基材の分解に合わせて徐放されることから、長期間に渡って細胞に該PRP成分を作用させ続けることができ、骨形成効果を飛躍的に増大させることができる。この徐放速度は、ゼラチンの架橋度を調整することにより調節することが可能である。即ち、本発明の硬組織再生誘導用材料は、再生のための足場材料と再生促進剤の2つの役割を同時に果たし得るものである。
1.多血小板血漿の(PRP)調製
SDラット(雄性、8週齢、240~290g、清水実験材料、京都)、250μLのペントバルビタールを腹腔内注射し全身麻酔を行った。開胸し、21G針を用いて心臓から5CCの採血を行った。あらかじめACD-A液(W/V%: クエン酸0.85、クエン酸三ナトリウム2.32、グルコース2.59)を2CC入れておいた15 cc遠心チューブに、血液を移した。遠心チューブを、遠心分離機(KN-70、久保田製作所製)を用いて1500回転で10分間遠心分離した。遠心分離後、上層にある透明な血清部分を、14Gサーフロー針を用いて吸引し、別の遠心チューブに移した。さらに、3000回転で10分間遠心分離した。上層の血清部分を、14Gサーフロー針を用いて、200μL残して吸引し、残った溶液を撹拌し、多血小板血漿(PRP)200μLを得た。得られた200μLのPRPを、一片2mmの立方体に切断したゼラチンβ-TCPスポンジ(β-TCP強化型ゼラチンスポンジ MedGel(登録商標) Scaffold(メドジェル))計20mgに含浸させ、4℃で一晩放置した。対照として、Phosphate buffer saline(以下、PBS)200μLを同形同量のゼラチンβ-TCPスポンジに含浸させ、4℃で一晩放置した。
SDラット(雄性、8週齢、240~290g、清水実験材料、京都)に、250μLのペントバルビタールを腹腔内注射し全身麻酔を行った。背部正中の皮膚に40mmの縦切開を加えた。正中から左右5mmの位置で、傍脊柱筋に25mmの縦切開を加え、第4及び5腰椎の横突起(以下、4・5横突起)を両側露出させた。先端が直径0.5mmのスチールバー (オサダサクセス-40M、OS-40MV、長田電機工業社製)を用いて、横突起の背側皮質骨を、骨髄からの出血が確認できるまで掘削した。左右の4・5横突起間に以下に示すマテリアルを移植し、切開した傍脊柱筋と皮膚を3-0 ナイロン糸(社製で)縫合した。移植するマテリアルは1: PRP含浸ゼラチンβ-TCPスポンジ(以下PRPスポンジ)、2: PBS (phosphate buffer saline)含浸ゼラチンβ-TCPスポンジ(MedGel(登録商標) Scaffold(メドジェル):以下、PBSスポンジ)、3: PRP単独、4: 自家腸骨とし、何も移植しない群と合わせて、計5群で検討を行った。3のPRP単独モデルでは、200μLのPRP のみを横突起間に散布した。4の自家腸骨は移植予定部と同側の腸骨先端を5×2×2mmの大きさで採取した。図1に、ラット脊椎後側方固定モデルにおける4・5横突起間への移植を模式的に示す。
手術後8週間でペントバルビタールの大量投与で安楽死させ、腰椎を摘出した。μCT(マイクロフォーカス2D/3D X線CT装置、ScanXmate-E090S40、コムスキャンテクノ社製)を用いて4・5横突起の矢状断再構成画像を作成し、横突起間の癒合の有無を評価した。また、得られた画像を元に、画像解析ソフト(FanCT ver1.3 コムスキャンテクノ社製)を用いて横突起間のみを抽出し、骨量を計測した。その後、3点曲げ試験機(東京試験機、LSC-200/30-2)を用い腰椎の3点曲げ試験を行った。幅40mmの間隔をあけた治具の上に、腰椎を前方が上に向くように設置し、直径5mmの円柱治具を用いて、10mm/minの早さで第4/5腰椎椎間板前方に圧迫力をかけた。変位距離が10mmの時点での荷重を各群で比較した。次に、4%パラホルムアルデヒドで、1週間、4℃で組織固定を行った。0.5MEDTA(ethylenediaminetetraacetic acid)液で、2週間、脱灰を行った後、20%スクロースに2日間浸漬させた。4・5横突起間断面の凍結組織切片(厚さ12μm)を作製し、ヘマトキシリン・エオジン染色およびサフラニンO染色(軟骨基質を赤染)を行った。
図2に、左右4・5横突起の矢状断再構成画像の結果を示す。PRPスポンジモデル及び自家腸骨モデルでは左右横突起間の癒合傾向が認められた。また、PRPスポンジモデルでは、自家腸骨モデルに比べて、著しい横突起前後径の増大が認められた。PBSスポンジ、PRP単独及び無設置モデルでは横突起間の増大はなく、骨癒合傾向は認められなかった。
以上の結果から、PRPとゼラチンβ-TCPスポンジを組み合わせることにより、自家骨移植を上回る、極めて高い骨・軟骨形成能が達成され、癒合部位における力学的強度が著明に増強することが証明された。
ゼラチンとしては、新田ゼラチン社製の酸処理品(酸処理ゼラチン)を用いた。また、β-TCPとしては、β-TCP-100(粉砕品)(太平化学産業株式会社)を用いたが、オスフェリンを用いてもよい。
Claims (8)
- 多血小板血漿及びゼラチンβ-TCPスポンジを含む、硬組織再生誘導用材料。
- 硬組織が骨・軟骨組織である、請求項1に記載の材料。
- 骨新生又は軟骨新生を促進するためのものである、請求項1又は2に記載の材料。
- 血管新生を促進するためのものである、請求項1又は2に記載の材料。
- 多血小板血漿が硬組織再生誘導用材料の適用を受ける対象由来のものである、請求項1~4のいずれか1項に記載の材料。
- ゼラチンβ-TCPスポンジの孔径が10~500μmである、請求項1~5のいずれか1項に記載の材料。
- ゼラチンβ-TCPスポンジ中のゼラチンが架橋されたものである、請求項1~6のいずれか1項に記載の材料。
- ゼラチンβ-TCPスポンジが、β-TCPとゼラチンを含む組成物に、架橋と凍結乾燥を施して作製されたものである、請求項1~7のいずれか1項に記載の材料。
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JP2013202213A (ja) * | 2012-03-28 | 2013-10-07 | Fujifilm Corp | 硬組織再生用材料 |
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WO2023002817A1 (ja) * | 2021-07-21 | 2023-01-26 | 公立大学法人公立諏訪東京理科大学 | 骨の治療装置及び骨の治療・診断装置 |
WO2023140312A1 (ja) * | 2022-01-21 | 2023-07-27 | 学校法人大阪歯科大学 | 複合体及びその製造方法並びに骨再生用材料 |
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JP2013202213A (ja) * | 2012-03-28 | 2013-10-07 | Fujifilm Corp | 硬組織再生用材料 |
JP2014124416A (ja) * | 2012-12-27 | 2014-07-07 | Gunze Ltd | 骨再生材料キット、ペースト状骨再生材料、骨再生材料及び骨接合材 |
JP2018165248A (ja) * | 2017-03-28 | 2018-10-25 | 国立大学法人京都工芸繊維大学 | 持効性/徐放性骨破壊阻止剤 |
WO2019151205A1 (ja) * | 2018-01-30 | 2019-08-08 | 富士フイルム株式会社 | フィブリン組成物、再生医療用基材、フィブリン組成物の製造方法およびキット |
JPWO2019151205A1 (ja) * | 2018-01-30 | 2021-01-14 | 富士フイルム株式会社 | フィブリン組成物、再生医療用基材、フィブリン組成物の製造方法およびキット |
JP7036839B2 (ja) | 2018-01-30 | 2022-03-15 | 富士フイルム株式会社 | フィブリン組成物、再生医療用基材、フィブリン組成物の製造方法およびキット |
JP2021518203A (ja) * | 2018-03-20 | 2021-08-02 | ユニバーシティ オブ ピッツバーグ − オブ ザ コモンウェルス システム オブ ハイヤー エデュケイション | 活力のある歯髄の再生 |
JP7406809B2 (ja) | 2018-03-20 | 2023-12-28 | ユニバーシティ オブ ピッツバーグ - オブ ザ コモンウェルス システム オブ ハイヤー エデュケイション | 活力のある歯髄の再生 |
WO2023002817A1 (ja) * | 2021-07-21 | 2023-01-26 | 公立大学法人公立諏訪東京理科大学 | 骨の治療装置及び骨の治療・診断装置 |
WO2023140312A1 (ja) * | 2022-01-21 | 2023-07-27 | 学校法人大阪歯科大学 | 複合体及びその製造方法並びに骨再生用材料 |
Also Published As
Publication number | Publication date |
---|---|
EP2491958A4 (en) | 2014-07-16 |
US9040070B2 (en) | 2015-05-26 |
US20120237586A1 (en) | 2012-09-20 |
EP2491958A1 (en) | 2012-08-29 |
KR20120092632A (ko) | 2012-08-21 |
JPWO2011048803A1 (ja) | 2013-03-07 |
CN102665775A (zh) | 2012-09-12 |
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