From the Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine; and the Institute of NanoBiotechnology, The Johns Hopkins University.
Plast Reconstr Surg. 2019 Jul;144(1):48e-57e. doi: 10.1097/PRS.0000000000005715.
The purpose of this study was to assess the efficacy of biodegradable, electrospun poly(ε-caprolactone) nanofiber nerve conduits in improving nerve regeneration.
The authors used a rat forelimb chronic denervation model to assess the effects of poly(ε-caprolactone) conduits on improving nerve regeneration and upper extremity function. Three groups of rats were examined: (1) negative-control animals (n = 5), which underwent 8 weeks of median nerve chronic denervation injury followed by repair with no conduit; (2) experimental animals (n = 5), which underwent 8 weeks of median nerve chronic denervation followed by repair and poly(ε-caprolactone) nerve conduit wrapping of the nerve coaptation site; and (3) positive-control animals (n = 5), which were naive controls. All animals underwent compound muscle action potential and functional testing. At 14 weeks after repair, the median nerve and flexor muscles were harvested for histologic analysis.
Histomorphometric analysis of regenerating median nerves demonstrated augmented axonal regeneration in experimental versus negative control animals (total axon count, 1769 ± 672 versus 1072 ± 123.80; p = 0.0468). With regard to functional recovery, experimental and negative-control animals (1.67 ± 0.04 versus 0.97 ± 0.39; p = 0.036) had regained 34.9 percent and 25.4 percent, respectively, of baseline hand grip strength at 14 weeks after repair. Lastly, less collagen deposition at the nerve coaptation site of experimental animals was found when compared to control animals (p < 0.05).
Biodegradable, poly(ε-caprolactone) nanofiber nerve conduits can improve nerve regeneration and subsequent physiologic extremity function in the setting of delayed nerve repair by decreasing the scar burden at nerve coaptation sites.
本研究旨在评估可生物降解的电纺聚己内酯纳米纤维神经导管在改善神经再生方面的疗效。
作者使用大鼠前肢慢性去神经模型来评估聚己内酯导管对改善神经再生和上肢功能的影响。三组大鼠接受了检查：（1）阴性对照动物（n = 5），接受 8 周正中神经慢性去神经损伤，然后在无导管的情况下进行修复；（2）实验组动物（n = 5），接受 8 周正中神经慢性去神经损伤，然后修复并包裹聚己内酯神经导管以贴合神经；（3）阳性对照动物（n = 5），为未处理对照。所有动物均进行复合肌肉动作电位和功能测试。修复后 14 周，收获正中神经和屈肌进行组织学分析。
再生正中神经的组织形态计量学分析显示，实验组与阴性对照组相比，轴突再生增加（总轴突计数，1769 ± 672 对 1072 ± 123.80；p = 0.0468）。就功能恢复而言，实验组和阴性对照组（1.67 ± 0.04 对 0.97 ± 0.39；p = 0.036）分别在修复后 14 周恢复了基线手抓握强度的 34.9%和 25.4%。最后，实验组动物神经吻合部位的胶原沉积较对照组减少（p < 0.05）。
可生物降解的聚己内酯纳米纤维神经导管可通过减少神经吻合部位的瘢痕负担，改善延迟神经修复后的神经再生和随后的肢体生理功能。
