Contralateral C7 transfer combined with acellular nerve allografts seeded with differentiated adipose stem cells for repairing upper brachial plexus injury in rats
Contralateral C7 transfer combined with acellular nerve allografts seeded with differentiated adipose stem cells for repairing upper brachial plexus injury in rats
复制标题
对侧C7移植联合分化脂肪干细胞移植的脱细胞同种神经修复大鼠上臂丛神经损伤
DOI：
10.4103/1673-5374.259626
复制
发表时间：
2019-11-01
影响因子：
6.1
通讯作者：
Gu, Li-Qiang
中科院分区：
文献类型：
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作者：
Yang, Jian-Tao;Fang, Jin-Tao;Gu, Li-Qiang
当对侧C7神经根转移治疗臂丛神经损伤时，神经移植一直是必要的。无细胞神经同种异体移植物是治疗神经缺陷的一种有前途的替代方案，并且通过充满分化的脂肪干细胞的移植物改善了结果。然而，尚未有使用这些组织工程神经移植物治疗臂丛神经损伤的报道。本研究的目的是评估移植分化脂肪干细胞的同种异体脱细胞神经移植物的效果，以改善大鼠模型的神经再生，其中对侧 C7 神经被转移以修复上臂丛神经损伤。从 Sprague-Dawley 大鼠中获得分化的脂肪干细胞，并转分化为雪旺细胞样表型。从大鼠坐骨神经双侧 15 毫米切片制备脱细胞神经同种异体移植物。将大鼠随机分为三组：脱细胞同种异体神经移植组、脱细胞同种异体神经移植+分化脂肪干细胞组和自体移植组。采用微型止血钳远离椎间孔牵引建立上臂丛神经损伤模型。使用带或不带种子细胞的脱细胞同种异体神经移植物来桥接对侧 C7 神经根和 C5-6 神经之间的间隙。术后16周采用组织学染色、电生理学和神经功能测试评价神经修复效果。结果显示，自体神经移植组出现明显的功能恢复较早，其次是同种脱细胞神经移植+分化脂肪干细胞组，最后是同种脱细胞神经移植组。此外，自体神经移植组和无细胞同种异体神经移植组之间存在显着差异。与脱细胞同种神经移植组相比，自体移植组和脱细胞同种神经移植+分化脂肪干细胞组的复合肌肉动作电位、运动传导速度、神经丝和S100阳性率、再生轴突直径、髓鞘厚度和有髓纤维密度均显着增加。这些研究结果证实，接种分化脂肪干细胞的同种脱细胞神经移植物有效促进臂丛神经损伤后的神经修复，且效果优于单独的脱细胞神经修复。本研究于2016年6月获得中山大学附属第一医院动物伦理委员会批准（批准号：2016-150）。
Nerve grafting has always been necessary when the contralateral C7 nerve root is transferred to treat brachial plexus injury. Acellular nerve allograft is a promising alternative for the treatment of nerve defects, and results were improved by grafts laden with differentiated adipose stem cells. However, use of these tissue-engineered nerve grafts has not been reported for the treatment of brachial plexus injury. The aim of the present study was to evaluate the outcome of acellular nerve allografts seeded with differentiated adipose stem cells to improve nerve regeneration in a rat model in which the contralateral C7 nerve was transferred to repair an upper brachial plexus injury. Differentiated adipose stem cells were obtained from Sprague-Dawley rats and transdifferentiated into a Schwann cell-like phenotype. Acellular nerve allografts were prepared from 15-mm bilateral sections of rat sciatic nerves. Rats were randomly divided into three groups: acellular nerve allograft, acellular nerve allograft + differentiated adipose stem cells, and autograft. The upper brachial plexus injury model was established by traction applied away from the intervertebral foramen with micro-hemostat forceps. Acellular nerve allografts with or without seeded cells were used to bridge the gap between the contralateral C7 nerve root and C5–6 nerve. Histological staining, electrophysiology, and neurological function tests were used to evaluate the effect of nerve repair 16 weeks after surgery. Results showed that the onset of discernible functional recovery occurred earlier in the autograft group first, followed by the acellular nerve allograft + differentiated adipose stem cells group, and then the acellular nerve allograft group; moreover, there was a significant difference between autograft and acellular nerve allograft groups. Compared with the acellular nerve allograft group, compound muscle action potential, motor conduction velocity, positivity for neurofilament and S100, diameter of regenerating axons, myelin sheath thickness, and density of myelinated fibers were remarkably increased in autograft and acellular nerve allograft + differentiated adipose stem cells groups. These findings confirm that acellular nerve allografts seeded with differentiated adipose stem cells effectively promoted nerve repair after brachial plexus injuries, and the effect was better than that of acellular nerve repair alone. This study was approved by the Animal Ethics Committee of the First Affiliated Hospital of Sun Yat-sen University of China (approval No. 2016-150) in June 2016.