Yilmaz Ali, Topcu Abdullah, Erdogan Cagdas, Sahin Barbaros, Abban Gulcin, Coskun Erdal, Ozkul Ayca
Adnan Menderes University, Neurosurgery Department, Aydın, Turkey.
Pamukkale University, Neurology Department, Denizli, Turkey.
Open Access Maced J Med Sci. 2018 Oct 29;6(11):1946-1952. doi: 10.3889/oamjms.2018.417. eCollection 2018 Nov 25.
There are many trials concerning peripheral nerve damage causes and treatment options. Unfortunately, nerve damage is still a major problem regarding health, social and economic issues. On this study, we used vascular graft and human cord blood derived stem cells to find an alternative treatment solution to this problem.
We used 21 female Wistar rats on our study. They were anesthetized with ketamine and we studied right hind limbs. On Group 1, we did a full layer cut on the right sciatic nerve. On Group 2, we did a full layer cut on the right sciatic nerve, and we covered synthetic vascular graft on cut area. On Group 3, we did a full layer cut on right sciatic nerve, and we covered the area with stem cell applied vascular graft.
At the end of postoperative 8. weeks, we performed EMG on the rats. When we compared healthy and degenerated areas as a result of EMG, we found significant amplitude differences between the groups on healthy areas whereas there was no significant difference on degenerated areas between the groups. Then we re-opened the operated area again to reveal the sciatic nerve cut area, and we performed electron microscope evaluation. On the stem cell group, we observed that both the axon and the myelin sheet prevented degeneration.
This study is a first on using synthetic vascular graft and cord blood derived CD34+ cells in peripheral nerve degeneration. On the tissues that were examined with electron microscope, we observed that CD34+ cells prevented both axonal and myelin sheath degeneration. Nerve tissue showed similar results to the control group, and the damage was minimal.
有许多关于周围神经损伤原因及治疗方案的试验。遗憾的是，神经损伤在健康、社会和经济问题方面仍然是一个主要问题。在本研究中，我们使用血管移植物和人脐带血来源的干细胞来寻找该问题的替代治疗方案。
我们在研究中使用了21只雌性Wistar大鼠。用氯胺酮对它们进行麻醉，我们研究右后肢。在第1组中，我们对右侧坐骨神经进行全层切断。在第2组中，我们对右侧坐骨神经进行全层切断，并在切断区域覆盖合成血管移植物。在第3组中，我们对右侧坐骨神经进行全层切断，并用应用了干细胞的血管移植物覆盖该区域。
术后8周结束时，我们对大鼠进行了肌电图检查。当我们通过肌电图比较健康区域和退变区域时，我们发现各实验组在健康区域存在显著的振幅差异，而在退变区域各实验组之间没有显著差异。然后我们再次打开手术区域以暴露坐骨神经切断区域，并进行电子显微镜评估。在干细胞组中，我们观察到轴突和髓鞘均阻止了退变。
本研究首次在周围神经退变中使用合成血管移植物和脐带血来源的CD34+细胞。在通过电子显微镜检查的组织中，我们观察到CD34+细胞阻止了轴突和髓鞘的退变。神经组织显示出与对照组相似的结果，且损伤最小。
