Ghoreishian Mehdi, Rezaei Majid, Beni Batoul Hashemi, Javanmard Shaghayegh Haghjooy, Attar Bijan Movahedian, Zalzali Haidar
Department of Oral and Maxillofacial Surgery and Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
J Oral Maxillofac Surg. 2013 Mar;71(3):577-87. doi: 10.1016/j.joms.2012.05.025. Epub 2012 Aug 4.
Synthetic conduits have been considered a viable option in nerve reconstructive procedures. They address the goal of entubulization and eliminate the disadvantages of autografts. However, despite all successful reports, none has contained regeneration characteristics, such as growth factors or essential cells, for nerve repair. The authors evaluated the capability of adipose-derived stem cells in Gore-Tex tubes to enhance facial nerve repair.
Undifferentiated mesenchymal stem cells were extracted from the autogenous adipose tissues of 7 mongrel dogs. The frontal branch of the facial nerve was transected. A gap size of 7 mm was repaired with an expanded polytetrafluoroethylene tube filled with undifferentiated adipose-derived stem cells encapsulated in alginate hydrogel. The control sides were repaired with the tube and alginate alone. The healing phase was 12 weeks.
Except in 2 control sides, an organized neural tissue was formed within the tubes. Compared with the normal nerve diameter, there was a decreased ratio of 29% and 39% in the experimental and control groups, respectively. Neurofilament-positive axon counts were 67% of normal values in the 2 groups. There was no significant difference between groups in histomorphometric parameters. Nerve conduction velocity in the experimental group (28.5 ± 3.5 m/s) was significantly greater than in the control group (16.2 ± 7 m/s). The experimental group also exhibited a greater maximal amplitude of action potential (1.86 ± 0.24 mV) than the control group (1.45 ± 0.49 mV).
Addition of stem cells in the Gore-Tex tube enhanced the neural repair from a functional standpoint. However, for better functional and histologic results, differentiated Schwann cells and other mediators may be warranted.
合成导管已被视为神经重建手术中的一种可行选择。它们实现了神经导管化的目标，并消除了自体移植的缺点。然而，尽管有所有成功的报道，但均未包含用于神经修复的再生特性，如生长因子或关键细胞。作者评估了戈尔（Gore-Tex）管中脂肪来源干细胞促进面神经修复的能力。
从7只杂种犬的自体脂肪组织中提取未分化的间充质干细胞。切断面神经的额支。用填充有包裹在海藻酸水凝胶中的未分化脂肪来源干细胞的膨体聚四氟乙烯管修复7毫米的间隙。对照组仅用该管和海藻酸进行修复。愈合期为12周。
除2个对照侧外，管内形成了有组织的神经组织。与正常神经直径相比，实验组和对照组的直径减少比例分别为29%和39%。两组中神经丝阳性轴突计数均为正常值的67%。组织形态计量学参数在两组之间无显著差异。实验组的神经传导速度（28.5±3.5米/秒）显著高于对照组（16.2±7米/秒）。实验组的动作电位最大振幅（1.86±0.24毫伏）也高于对照组（1.45±0.49毫伏）。
在戈尔管中添加干细胞从功能角度增强了神经修复。然而，为了获得更好的功能和组织学结果，可能需要分化的施万细胞和其他介质。
