In utero repair of an experimental neural tube defect in a chronic sheep model using biomatrices
In utero repair of an experimental neural tube defect in a chronic sheep model using biomatrices
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DOI：
10.1159/000086808
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发表时间：
2005-01-01
影响因子：
2.2
通讯作者：
van den Berg, PP
中科院分区：
文献类型：
--
作者：
Eggink, AJ;Roelofs, LAJ;van den Berg, PP
目的：在脊髓脊膜膨出的情况下，未受保护的脊髓持续暴露于羊水和子宫壁可能会导致神经组织进行性损伤（二次打击假说）。本研究的目的是评估在子宫内修复胎羔实验性神经管缺陷是否可以保护神经组织免受继发性损伤并在出生后保存神经功能。方法：在 19 只羔羊中，在妊娠 79 天时产生神经管缺陷。在 12 只羔羊中，缺陷被一种新型的、分子定义的基于胶原蛋白的生物相容性和可生物降解基质 (UMC) 或小肠粘膜下层 (SIS) 生物基质 (Cook (R)) 覆盖，或者通过闭合缺陷处的皮肤来覆盖。结果：与缺陷未覆盖的羔羊相比，所有缺陷被覆盖的羔羊都没有表现出或轻微的神经系统发病，而在这些羔羊中，出现了严重的神经系统发病。结论：这些结果表明，开放的脊髓长期暴露于宫内环境会导致神经组织损伤，从而导致神经功能丧失，而覆盖缺损可以带来更好的神经系统结果。此外，我们可以证明 UMC 生物基质和 SIS 生物基质对于在我们的模型中手术创建的神经管缺陷的子宫内覆盖非常有用。 Copyright (c) 2005 S. Karger AG, Basel.
Objective: Persistent exposure of the unprotected spinal cord to amniotic fluid and the uterine wall can lead to progressive damage of neural tissue in case of a myelomeningocele (two-hit hypothesis). The aim of this study was to evaluate whether in utero repair of an experimental neural tube defect in a fetal lamb could protect neural tissue from secondary injury and save neurologic functions after birth. Methods: In 19fetal lambs, a neural tube defect was created at 79 days' gestation. In 12 lambs the defect was covered either with a novel, molecular defined collagen-based biocompatible and biodegradable matrix (UMC) or with a small intestinal submucosa (SIS) biomatrix (Cook (R)) or by closing the skin over the defect. Results: All lambs with the defect covered showed no or minor neurologic morbidity in contrast to the lambs with the defect uncovered in which major neurologic morbidity was seen. Conclusions: These results demonstrate that long-term exposure of the open spinal cord to the intrauterine environment can lead to damage of neural tissue and, consequently loss of neurologic functions and that coverage of the defect can lead to a better neurologic outcome. Furthermore, we could show that a UMC biomatrix and an SIS biomatrix are useful for in utero coverage of a surgically created neural tube defect in our model. Copyright (c) 2005 S. Karger AG, Basel.