一种活体组织工程构建的神经导管与在大鼠中进行的实验研究

Background:Several types of nerve conduits have been used for peripheral nerve gap bridging. This study investigated the in vivo engineering of a biological nerve conduit and its suitability for nerve gap bridging.  Material and Methods:A 19-mm long polyvinyl chloride (PVC) tube was implanted parallely to the sciatic nerve. After implantation, a connective tissue cover developed around the PVC-tube, the so-called biogenic conduit. Histological cross-sections were performed after 1, 2, 3, and 4weeks. Wall thicknesses were measured and all vessels per cross-section were counted. The biogenic conduit filled with fibrin was used to bridge a 15-mm long nerve gap in the sciatic lesion model of the rat (n=8). The results of nerve repair with the conduit were compared to the autologous nerve graft (n=8). Sciatic functional index (SFI), nerve area, axon count, myelination index, and ratio of total myelinated fiber area/nerve area (N-ratio) were analyzed after 4weeks.  Results:The wall thickness of biogenic conduits increased over the 4weeks implantation time. Biogenic conduits revealed highest number of vessels per cross-section after 4weeks. The results of SFI analysis did not show significant difference between the repairs with biogenic conduit and autologous nerve graft. Nerve area and axon count in the biogenic conduit group were significantly lower than in the autologous nerve group (P<0.001). The biogenic conduit group showed significant higher myelination values, but lower N-ratio when compared to the nerve graft group (P<0.001). Conclusions:The in vivo engineered conduits allow nerve gap bridging of 15mm. However, quality of regeneration after 4weeks observation time is not comparable to autologous nerve grafts. Whether biogenic conduits might be a suitable alternative to artificial and biological conduits for gap bridging will have to be evaluated in further studies (Fig 1).  Figure 1: (a) Implanted PVC tube; (b) 4weeks after implantation, tube-like fibrous tissue (biogenic conduit). [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.] (Reprinted from Penna V, Munder B, Stark G-B, et al. An in vivo engineered nerve conduit–fabrication and experimental study in rats. Microsurgery. 2011;31:395-400, with permission from Wiley-Liss, Inc.)

学科代码：外科学　　　关键词：活体组织工程构建
来源： Eclips