Kasuya Taisuke, Nishimoto Shunsuke, Iwahashi Toru, Sayanagi Junichi, Hirai Yukio, Shimada Toshiki, Yoshimura Yoshiaki, Konishi Katsuyuki, Konishi Mai, Shiode Ryoya, Miyamura Satoshi, Oka Kunihiro, Murase Tsuyoshi, Okada Seiji, Tanaka Hiroyuki
Department of Orthopaedic Surgery, Graduate School of Medicine, The University of Osaka, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Department of Sports Medical Science, Graduate School of Medicine, The University of Osaka, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Regen Ther. 2025 Jul 29;30:446-455. doi: 10.1016/j.reth.2025.07.011. eCollection 2025 Dec.
The gold standard treatment for peripheral nerve gap injury is nerve autograft transplantation. Although various nerve guidance conduits (NGCs) have been developed as alternatives to autografting, few reports have evaluated the effects of the internal structure of NGCs on nerve regeneration. We investigated how the internal structure of NGCs affects nerve regeneration.
In 30 male Wistar rats, a 5 mm segment of the left sciatic nerve was resected, creating a gap. The animals were then randomly divided into two groups. A 7 mm polyglycolic acid (PGA) conduit, with (PGA-c group) or without a collagen filling (PGA group), was used to bridge the gap (n = 15 for each group). At 2 and 4 weeks postoperatively, longitudinal sciatic nerve slices were fluorescently immunostained with RECA-1 for endothelial cells, S100 for Schwann cells, and TUJ1 for axons. The fluorescence-positive areas were quantitatively evaluated. Next, 32 male Wistar rats underwent resection of a 10 mm segment of the left sciatic nerve. The animals were then assigned into four groups: sham group, autograft group, PGA-c group (transplantation of 12-mm PGA-c), and hollow PGA group (transplantation of 12 mm hollow PGA) (n = 8 for each group). At 12 weeks postoperatively, morphological evaluations and neurofunctional analyses were performed.
In longitudinal sciatic nerve slices, the PGA-c group had significantly larger RECA-1-positive areas proximally and distally at 2 weeks, larger S100-positive areas proximally at 2 weeks, and larger TUJ1-positive areas proximally at 4 weeks postoperatively than the PGA group. In the 10 mm nerve defect model, the PGA-c group had a significantly higher percentage of myelinated axons, isometric tetanic force, and tibialis anterior muscle wet weight than the PGA group.
The internal filling structure of the NGCs may promote nerve regeneration by providing a scaffold for cells involved in nerve regeneration and may restore motor function. These findings provide new insights into the further structural development of NGCs suitable for peripheral nerve regeneration.
周围神经间隙损伤的金标准治疗方法是自体神经移植。尽管已经开发出各种神经引导导管（NGC）作为自体移植的替代方法，但很少有报告评估NGC内部结构对神经再生的影响。我们研究了NGC的内部结构如何影响神经再生。
在30只雄性Wistar大鼠中，切除左侧坐骨神经5mm节段，造成间隙。然后将动物随机分为两组。使用7mm聚乙醇酸（PGA）导管，有（PGA-c组）或没有胶原蛋白填充（PGA组），来桥接间隙（每组n = 15）。术后2周和4周，对坐骨神经纵向切片进行荧光免疫染色，分别用RECA-1标记内皮细胞、S100标记雪旺细胞、TUJ1标记轴突。对荧光阳性区域进行定量评估。接下来，32只雄性Wistar大鼠接受左侧坐骨神经10mm节段切除。然后将动物分为四组：假手术组、自体移植组、PGA-c组（移植12mm PGA-c）和中空PGA组（移植12mm中空PGA）（每组n = 8）。术后12周，进行形态学评估和神经功能分析。
在坐骨神经纵向切片中，与PGA组相比，PGA-c组在术后2周近端和远端的RECA-1阳性区域明显更大，在术后2周近端的S100阳性区域更大，在术后4周近端的TUJ1阳性区域更大。在10mm神经缺损模型中，与PGA组相比，PGA-c组有髓轴突的百分比、等长强直力和胫前肌湿重明显更高。
NGC的内部填充结构可能通过为参与神经再生的细胞提供支架来促进神经再生，并可能恢复运动功能。这些发现为适合周围神经再生的NGC的进一步结构开发提供了新的见解。
