Regeneration of injured articular cartilage using the recombinant human amelogenin protein

Author:

Helwa-Shalom Omer1ORCID,Saba Faris2ORCID,Spitzer Elad3ORCID,Hanhan Salem2ORCID,Goren Koby2ORCID,Markowitz Shany I.1ORCID,Shilo Dekel2ORCID,Khaimov Nissim3ORCID,Gellman Yechiel N.3ORCID,Deutsch Dan2ORCID,Blumenfeld Anat24ORCID,Nevo Hani34ORCID,Haze Amir345ORCID

Affiliation:

1. The inter-faculty Biotechnology Program, The Hebrew University of Jerusalem, Jerusalem, Israel

2. Faculty of Dental Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel

3. Orthopedic Surgery Department, Hadassah University Medical Center, Jerusalem, Israel

4. The Wohl Institute for Translational Medicine, Hadassah University Medical Center, Jerusalem, Israel

5. Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel

Abstract

AimsCartilage injuries rarely heal spontaneously and often require surgical intervention, leading to the formation of biomechanically inferior fibrous tissue. This study aimed to evaluate the possible effect of amelogenin on the healing process of a large osteochondral injury (OCI) in a rat model.MethodsA reproducible large OCI was created in the right leg femoral trochlea of 93 rats. The OCIs were treated with 0.1, 0.5, 1.0, 2.5, or 5.0 μg/μl recombinant human amelogenin protein (rHAM+) dissolved in propylene glycol alginate (PGA) carrier, or with PGA carrier alone. The degree of healing was evaluated 12 weeks after treatment by morphometric analysis and histological evaluation. Cell recruitment to the site of injury as well as the origin of the migrating cells were assessed four days after treatment with 0.5 μg/μl rHAM+ using immunohistochemistry and immunofluorescence.ResultsA total of 12 weeks after treatment, 0.5 μg/μl rHAM+ brought about significant repair of the subchondral bone and cartilage. Increased expression of proteoglycan and type II collagen and decreased expression of type I collagen were revealed at the surface of the defect, and an elevated level of type X collagen at the newly developed tide mark region. Conversely, the control group showed osteoarthritic alterations. Recruitment of cells expressing the mesenchymal stem cell (MSC) markers CD105 and STRO-1, from adjacent bone marrow toward the OCI, was noted four days after treatment.ConclusionWe found that 0.5 μg/μl rHAM+ induced in vivo healing of injured articular cartilage and subchondral bone in a rat model, preventing the destructive post-traumatic osteoarthritic changes seen in control OCIs, through paracrine recruitment of cells a few days after treatment.Cite this article: Bone Joint Res 2023;12(10):615–623.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Orthopedics and Sports Medicine,Surgery

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