Kang Weibo, Yan Jiazhi, Chen Yongjie, Li Chenxi, Sang Dacheng
Department of Orthopaedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 May 15;37(5):622-628. doi: 10.7507/1002-1892.202212081.
To investigate the effect of folic acid coated-crosslinked urethane-doped polyester elastomer (fCUPE) nerve conduit in repairing long distance peripheral nerve injury.
Thirty-six 3-month-old male Sprague Dawley rats weighing 180-220 g were randomly assigned to 3 groups, each consisting of 12 rats: CUPE nerve conduit transplantation group (group A), fCUPE nerve conduit transplantation group (group B), and autologous nerve transplantation group (group C), the contralateral healthy limb of group C served as the control group (group D). A 20-mm-long sciatic nerve defect model was established in rats, and corresponding materials were used to repair the nerve defect according to the group. The sciatic function index (SFI) of groups A-C was calculated using the Bain formula at 1, 2, and 3 months after operation. The nerve conduction velocity (NCV) of the affected side in groups A-D was assessed using neuroelectrophysiological techniques. At 3 months after operation, the regenerated nerve tissue was collected from groups A-C for S-100 immunohistochemical staining and Schwann cell count in groups A and B to compare the level of nerve repair and regeneration in each group.
At 3 months after operation, the nerve conduits in all groups partially degraded. There was no significant adhesion between the nerve and the conduit and the surrounding tissues, the conduit was well connected with the distal and proximal nerves, and the nerve-like tissues in the conduit could be observed when the nerve conduit stents were cut off. SFI in group A was significantly higher than that in group C at each time point after operation and was significantly higher than that in group B at 2 and 3 months after operation ( <0.05). There was no significant difference in SFI between groups B and C at each time point after operation ( >0.05). NCV in group A was significantly slower than that in the other 3 groups at each time point after operation ( <0.05). The NCV of groups B and C were slower than that of group D, but the difference was significant only at 1 month after operation ( <0.05). There was no significant difference between groups B and C at each time point after operation ( >0.05). Immunohistochemical staining showed that the nerve tissue of group A had an abnormal cavo-like structure, light tissue staining, and many non-Schwann cells. In group B, a large quantity of normal neural structures was observed, the staining was deeper than that in group A, and the distribution of dedifferentiated Schwann cells was obvious. In group C, the nerve bundles were arranged neatly, and the tissue staining was the deepest. The number of Schwann cells in group B was (727.50±57.60) cells/mm , which was significantly more than that in group A [(298.33±153.12) cells/mm ] ( =6.139, <0.001).
The fCUPE nerve conduit is effective in repairing long-distance sciatic nerve defects and is comparable to autologous nerve grafts. It has the potential to be used as a substitute material for peripheral nerve defect transplantation.
探讨叶酸包被交联聚氨酯掺杂聚酯弹性体(fCUPE)神经导管修复长距离周围神经损伤的效果。
将36只3月龄、体重180 - 220 g的雄性Sprague Dawley大鼠随机分为3组,每组12只:CUPE神经导管移植组(A组)、fCUPE神经导管移植组(B组)和自体神经移植组(C组),C组对侧健康肢体作为对照组(D组)。建立大鼠20 mm长的坐骨神经缺损模型,按组分别用相应材料修复神经缺损。术后1、2、3个月采用Bain公式计算A - C组的坐骨神经功能指数(SFI)。采用神经电生理技术评估A - D组患侧的神经传导速度(NCV)。术后3个月,收集A - C组再生神经组织进行S - 100免疫组织化学染色,并对A、B组进行雪旺细胞计数,比较各组神经修复和再生水平。
术后3个月,各组神经导管均有部分降解。神经与导管及周围组织无明显粘连,导管与远近端神经连接良好,切断神经导管支架时可观察到导管内有类神经组织。术后各时间点A组SFI均显著高于C组,术后2、3个月显著高于B组(P<0.05)。术后各时间点B组与C组SFI差异无统计学意义(P>0.05)。术后各时间点A组NCV均显著慢于其他3组(P<0.05)。B、C组NCV慢于D组,但仅术后1个月差异有统计学意义(P<0.05)。术后各时间点B组与C组差异无统计学意义(P>0.05)。免疫组织化学染色显示,A组神经组织有空泡样结构异常,组织染色浅,非雪旺细胞多。B组可见大量正常神经结构,染色较A组深,去分化雪旺细胞分布明显。C组神经束排列整齐,组织染色最深。B组雪旺细胞数为(727.50±57.60)个/mm,显著多于A组[(298.33±153.12)个/mm](t = 6.139,P<0.001)。
fCUPE神经导管可有效修复长距离坐骨神经缺损,与自体神经移植效果相当,有潜力作为周围神经缺损移植替代材料。