Department of Plastic Surgery, Reconstructive Surgery, Hand Surgery and Burn Injuries, RWTH-Aachen University Hospital, Aachen, Germany.
Institute of Neuroanatomy, Hannover Medical School, and Center for Systems Neuroscience (ZSN), Hannover, Germany.
J Tissue Eng Regen Med. 2017 Dec;11(12):3349-3361. doi: 10.1002/term.2248. Epub 2016 Dec 16.
Progress in material development has enabled the production of nerve guides that increasingly resemble the characteristics of an autologous nerve graft. In the present study, 20 mm adult rat sciatic nerve defects were bridged with the collagen-based, two-component nerve guide 'Neuromaix', the commercially available NeuraGen® nerve tube or an autologous nerve graft. Neuromaix was able to support structural as well as functional regeneration across this gap. The majority of the axons grew across the scaffold into the distal nerve segment and retrograde tracing confirmed that these axons were of somatosensory and motor origin. Histomorphology revealed that axons regenerating through Neuromaix exhibited reduced myelin sheath thickness, whereas axon diameter and axon density were comparable to those of the autograft. Neuromaix implantation resulted in reinnervation of the gastrocnemius muscle to a level that was not significantly different from that supported by the autograft, as demonstrated by electrophysiology. Our findings show that the use of the Neuromaix scaffold not only allowed axonal regeneration across large nerve gaps, but that the regenerating axons were also able to functionally reinnervate the muscles. These data provide a promising perspective for the first in human application of the materials. Copyright © 2016 John Wiley & Sons, Ltd.
材料的发展进步使得能够生产出越来越类似于自体神经移植物特征的神经导管。在本研究中,使用基于胶原蛋白的双组分神经导管“Neuromaix”、市售的 NeuraGen®神经管或自体神经移植物桥接 20mm 成年大鼠坐骨神经缺损。Neuromaix 能够支持结构和功能再生穿过这个间隙。大多数轴突穿过支架进入远端神经段,逆行追踪证实这些轴突来自感觉和运动起源。组织形态学显示,通过 Neuromaix 再生的轴突髓鞘厚度减少,而轴突直径和轴突密度与自体移植物相当。Neuromaix 的植入导致比格犬腓肠肌的重新神经支配,其水平与自体移植物支持的水平没有显著差异,如电生理学所示。我们的研究结果表明,使用 Neuromaix 支架不仅允许轴突穿过大的神经间隙再生,而且再生的轴突也能够对肌肉进行功能性再神经支配。这些数据为这些材料的首次人体应用提供了一个有前途的视角。版权所有©2016 约翰威立父子公司