Fansa H, Keilhoff G, Wolf G, Schneider W
Department of Plastic, Reconstructive, and Hand Surgery, Institute of Medical Neurobiology, University of Magdeburg, Germany.
Plast Reconstr Surg. 2001 Feb;107(2):485-94; discussion 495-6. doi: 10.1097/00006534-200102000-00026.
Bioengineering is considered to be the laboratory-based alternative to human autografts and allografts. It ought to provide "custom-made organs" cultured from patient's material. Venous grafts and acellular muscle grafts support axonal regeneration only to a certain extent because of the lack of viable Schwann cells in the graft. We created a biologic nerve graft in the rat sciatic nerve model by implanting cultured Schwann cells into veins and acellular gracilis muscles, respectively. Autologous nerve grafts and veins and acellular muscle grafts without Schwann cells served as controls. After 6 and 12 weeks, regeneration was assessed clinically, histologically, and morphometrically. The polymerase chain reaction analvsis showed that the implanted Schwann cells remained within all the grafts. The best regeneration was seen in the control; after 12 weeks the number of axons was increased significantly compared with the other grafts. A good regeneration was noted in the muscle-Schwann cell group, whereas regeneration in both of the venous grafts and the muscle grafts without Schwann cells was impaired. The muscle-Schwann cell graft showed a systematic and organized regeneration including a proper orientation of regenerated fibers. The venous grafts with Schwann cells showed less fibrous tissue and disorganization than the veins without Schwann cells, but failed to show an excellent regeneration. This might be attributed to the lack of endoneural-tube-like components serving as scaffold for the sprouting axon. Although the conventional nerve graft remains the gold standard, the implantation of Schwann cells into an acellular muscle provides a biologic graft with basal lamina tubes as pathways for regenerating axons and the positive effects of Schwann cells producing neurotrophic and neurotropic factors, and thus, supporting axonal regeneration.
生物工程被认为是基于实验室的人类自体移植和异体移植的替代方法。它应该能提供从患者材料培养而来的“定制器官”。静脉移植物和脱细胞肌肉移植物仅在一定程度上支持轴突再生，因为移植物中缺乏有活力的施万细胞。我们通过将培养的施万细胞分别植入静脉和脱细胞股薄肌中，在大鼠坐骨神经模型中创建了一种生物神经移植物。自体神经移植物以及没有施万细胞的静脉和脱细胞肌肉移植物作为对照。6周和12周后，从临床、组织学和形态学方面评估再生情况。聚合酶链反应分析表明，植入的施万细胞保留在所有移植物中。对照组的再生效果最佳；12周后，与其他移植物相比，轴突数量显著增加。肌肉 - 施万细胞组观察到良好的再生，而没有施万细胞的静脉移植物和肌肉移植物的再生均受到损害。肌肉 - 施万细胞移植物显示出系统性和有组织的再生，包括再生纤维的正确定向。含有施万细胞的静脉移植物与不含施万细胞的静脉相比，纤维组织更少且结构更规整，但未显示出优异的再生效果。这可能归因于缺乏作为发芽轴突支架的类神经内膜管成分。尽管传统神经移植物仍然是金标准，但将施万细胞植入脱细胞肌肉中可提供一种生物移植物，其基底膜管作为再生轴突的通道，并且施万细胞产生神经营养和神经营向因子具有积极作用，从而支持轴突再生。
