Early peripheral nerve healing in collagen and silicone tube implants: Myofibroblasts and the cellular response
Early peripheral nerve healing in collagen and silicone tube implants: Myofibroblasts and the cellular response
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DOI：
10.1016/s0142-9612(98)00018-0
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发表时间：
1998-08-01
期刊：
影响因子：
14
通讯作者：
Spector, M
中科院分区：
文献类型：
--
作者：
Chamberlain, LJ;Yannas, IV;Spector, M
支配肢体的周围神经损伤会导致瘫痪，并可能需要截肢。神经不能自发再生和自体移植手术的局限性导致了神经末端插入假体管状装置的治疗发展。先前的研究表明，与空硅胶管相比，神经末段在含有特定多孔、可吸收的胶原- gag （CG）共聚物的硅胶管中“膨胀”，作为细胞外基质的类似物，可以改善再生。然而，长期使用硅胶管治疗会产生收缩，导致再生轴突的部分降解；由于这样或那样的原因，实施不可降解的管子可能需要第二次手术切除。在本研究中，硅胶管被多孔和非多孔胶原蛋白管取代，以生产完全可降解的装置。在大鼠坐骨神经的10mm间隙内植入cg填充的胶原管和对照组（cg填充的硅胶管和空的胶原和硅胶管），每组3只大鼠。六周后，利用数字化和分析的神经横截面光镜图像评估再生情况。生成轴突直径的直方图并进行比较。对植入生物材料的细胞反应进行组织学评估，并使用α -平滑肌肌动蛋白抗体进行免疫组化，以确定肌成纤维细胞（收缩细胞）的存在。在多孔胶原蛋白、非多孔胶原蛋白和填充CG基质的硅胶管中，轴突再生是相似的。这些结果支持可降解胶原蛋白管代替硅胶装置的实施。证实了早期的工作，与空管相比，CG共聚物增强了硅酮和胶原蛋白管的再生能力。一个值得注意的发现是，在所有六个硅胶管假体的表面上都有一层连续的肌成纤维细胞，但在六个胶原管中只有一个的内表面(Fisher的精确测试；P < 0.01)，这是关于硅胶管周围可收缩胶囊的首次报道，支持了可降解胶原管在周围神经再生中的应用，在硅胶管和胶原管的周围都发现了巨噬细胞，在胶原管的情况下，巨噬细胞似乎参与了管的调节。1998爱思唯尔科学有限公司版权所有
Injuries to peripheral nerves innervating a limb cause paralysis, and can necessitate amputation. The inability of the nerves to regenerate spontaneously and the limitations of autograft procedures led to the development of treatments involving insertion of the nerve ends into prosthetic tubular devices. Previous work showed that 'entubulation' of the nerve ends in a silicone tube containing a specific porous, resorbable collagen-GAG (CG) copolymer, serving as an analog of extracellular matrix, improved regeneration compared to an empty silicone tube. However, long-term treatment with silicone tubes produced constriction that caused partial degradation of the regenerated axons; for this and other reasons, implementation of a nondegradable tube may require a second surgical procedure for removal. In this study the silicone tube was replaced with porous and non-porous collagen tubes in order to produce fully degradable devices. CG-filled collagen tubes and controls (CG-filled silicone tubes and empty collagen and silicone tubes) were implanted in a 10-mm gap in the rat sciatic nerve, with three rats in each group. The regeneration was evaluated after six weeks using light microscope images of cross sections of the nerve that were digitized and analyzed. Histograms of the diameters of the axons were generated and compared. The cellular response to the implanted biomaterials was assessed histologically, and immunohistochemistry was performed using an antibody to alpha-smooth muscle actin in order to determine the presence of myofibroblasts (contractile cells). Axonal regrowth was comparable in porous collagen, non-porous collagen, and silicone tubes filled with a CG matrix. These results support the implementation of a degradable collagen tube in place of a silicone device. Confirming earlier work, regeneration through the silicone and collagen tubes was enhanced by the CG copolymer, compared to empty tubes. A notable finding was a continuous layer of myofibroblasts on the surfaces of all of the six silicone tube prostheses, but on the inner surface of only one of six collagen tubes (Fisher's exact tests; P < 0.01), This is the first report of contractile capsules around silicone tubes, and supports the use of degradable collagen tubes in peripheral nerve regeneration, Macrophages were found bordering both the silicone and collagen tubes, and in the case of the collagen tubes, appeared to be participating in the regulation of the tubes. (C) 1998 Elsevier Science Ltd. All rights reserved