Department of Orthopaedic Surgery, Columbia University, New York, NY, USA.
Microsurgery. 2013 Jul;33(5):367-75. doi: 10.1002/micr.22101. Epub 2013 May 7.
Adipose tissue-derived stem cells and insulin-like growth factor-1 (IGF-1) have shown potential to enhance peripheral nerve regeneration. The purpose of this study was to investigate the effect of an in vivo biologic scaffold, consisting of white adipose tissue flap (WATF) and/or IGF-1 on nerve regeneration in a crush injury model. Forty rats all underwent a sciatic nerve crush injury and then received: a pedicled WATF, a controlled local release of IGF-1, both treatments, or no treatment at the injury site. Outcomes were the normalized maximum isometric tetanic force (ITF) of the tibialis anterior muscle and histomorphometric measurements. At 4 weeks, groups with WATF had a statistically significant improvement in maximum ITF recovery, as compared to those without (P < 0.05), and there was an increase in myelin thickness and total axon count in the WATF-only group versus control (P < 0.01). Functional and histomorphometric data suggest that IGF-1 suppressed the effect of the WATF. Use of a pedicled WATF improved the functional and histomorphometrical results after axonotmesis in a rat model. IGF-1 does not appear to enhance nerve regeneration in this model. Utilizing the WATF may have a beneficial therapeutic role in peripheral nerve injuries.
脂肪组织来源的干细胞和胰岛素样生长因子-1（IGF-1）已显示出增强周围神经再生的潜力。本研究的目的是研究由白色脂肪组织瓣（WATF）和/或 IGF-1 组成的体内生物支架对挤压伤模型中神经再生的影响。所有 40 只大鼠均接受坐骨神经挤压伤，然后接受以下治疗：带蒂 WATF、IGF-1 的局部控制释放、两种治疗或在损伤部位不治疗。结果是比目鱼肌的归一化最大等长强直力（ITF）和组织形态计量学测量。在 4 周时，与无 WATF 的组相比，具有 WATF 的组的最大 ITF 恢复具有统计学意义上的改善（P < 0.05），并且 WATF 组的髓鞘厚度和总轴突计数与对照组相比增加（P < 0.01）。功能和组织形态计量学数据表明 IGF-1 抑制了 WATF 的作用。在大鼠模型中，使用带蒂 WATF 可改善轴突切断后的功能和组织形态计量学结果。IGF-1 似乎并未增强该模型中的神经再生。利用 WATF 在外周神经损伤中可能具有有益的治疗作用。
