Department of Plastic Surgery, Reconstructive and Hand Surgery, Burn Center, University Hospital RWTH Aachen, Aachen, Germany.
Department of Hand-Plastic and Reconstructive Surgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.
J Tissue Eng Regen Med. 2018 Nov;12(11):2125-2137. doi: 10.1002/term.2731. Epub 2018 Sep 12.
The reconstruction of peripheral nerve injuries is clinically challenging, and today, the autologous nerve transplantation is still considered as the only gold standard remedy for nerve lesions where a direct nerve coaptation is not possible. Nevertheless, the functional merits of many biomaterials have been tested as potential substitutes for the autologous nerve transplant. One of the strategies that have been pursued is the combination of bioengineered nerve guides with cellular enrichment. In this present study, we combined the previously evaluated collagen-based and microstructured nerve guide Perimaix with olfactory ensheathing cell enrichment. Rat sciatic nerve defects of 20 mm were either bridged by a cell-seeded or nonseeded nerve guide or an autologous nerve transplant. Animals were monitored for 12 weeks for structural and functional parameters. Seeded cells survived on Perimaix, and following implantation aligned along the microstructured Perimaix framework. Axonal densities within the cell-seeded nerve guides were higher than in the nonseeded nerve guides and were comparable to the autograft. Additionally, cell-seeding had local beneficial effects on myelination within the nerve guide, as myelin sheath thickness was enhanced when compared with the empty scaffold. Nevertheless, for bridging the nerve gap of 20 mm, both the cell-seeded as well as nonseeded scaffolds were equally efficient regarding the functional outcome, which did not differ between the autograft, seeded or nonseeded groups. Our data demonstrate that olfactory ensheathing cell enrichment has local effects on nerve regeneration in combination with the Perimaix nerve guide. Surprisingly, for traversing the lesion gap, additional cell-seeding is not crucial.
外周神经损伤的重建在临床上具有挑战性，目前自体神经移植仍然被认为是治疗无法直接进行神经吻合的神经损伤的唯一金标准方法。然而，许多生物材料的功能优势已被测试为自体神经移植的潜在替代品。其中一种策略是将生物工程神经导管与细胞富集相结合。在本研究中，我们将之前评估过的基于胶原蛋白和微结构神经导管 Perimaix 与嗅鞘细胞富集相结合。大鼠坐骨神经缺损 20mm 分别用细胞接种或非接种神经导管或自体神经移植桥接。动物在 12 周内监测结构和功能参数。接种的细胞在 Perimaix 上存活，并在植入后沿微结构 Perimaix 支架排列。细胞接种神经导管内的轴突密度高于非接种神经导管，与自体移植物相当。此外，细胞接种对神经导管内的髓鞘形成有局部有益影响，与空支架相比，髓鞘厚度增强。然而，对于桥接 20mm 的神经间隙，细胞接种和非接种支架在功能结果方面同样有效，与自体移植物、接种或非接种组之间没有差异。我们的数据表明，嗅鞘细胞富集与 Perimaix 神经导管结合具有局部促进神经再生的作用。令人惊讶的是，对于穿过病变间隙，额外的细胞接种并不是至关重要的。
