Value of a Novel PGA-Collagen Tube on Recurrent Laryngeal Nerve Regeneration in a Rat Model
Value of a Novel PGA-Collagen Tube on Recurrent Laryngeal Nerve Regeneration in a Rat Model
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DOI：
10.1002/lary.25750
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发表时间：
2016-07-01
期刊：
影响因子：
2.6
通讯作者：
Shiotani, Akihiro
中科院分区：
文献类型：
--
作者：
Suzuki, Hiroshi;Araki, Koji;Shiotani, Akihiro
目的/假设：Nerbridge(日本大阪丰田株式会社)是一种新型的聚乙醇酸(PGA)管，填充了胶原纤维，促进了神经纤维的扩张和血管的生长。它具有生物兼容性和商业用途，并已获得政府批准在日本实际使用。我们推测PGA胶原管可以促进喉返神经的再生。这一假说在大鼠喉返神经切断模型中得到验证。研究设计：前瞻性动物研究。方法：切断成年SD大鼠左侧喉返神经建立神经切断模型。神经的断端用Nerbridge(丰田汽车公司)桥接。缝合间隙1 mm(插管治疗组)或直接缝合(缝合对照组)。结果：治疗15周后，两组均大体观察到神经纤维连接，管状治疗组较缝合对照组有更清晰的有髓神经纤维，且能更好地预防喉肌萎缩。但两组均未观察到声带运动恢复，喉返神经传导速度两组间无差异。结论：插管治疗组神经再生较好。分子或基因联合治疗可能是改善声带运动的有效策略。PGA-胶原管具有促进喉返神经再生的潜力，在这些联合疗法中可作为给药的支架。
Objectives/Hypothesis: Nerbridge (Toyobo Co., Ltd., Osaka, Japan) is a novel polyglycolic acid (PGA) tube that is filled with collagen fibers and that facilitates nerve fiber expansion and blood vessel growth. It is biocompatible and commercially available, with governmental approval for practical use in Japan. We hypothesized that the PGA-collagen tube would promote regeneration of the recurrent laryngeal nerve (RLN). This hypothesis was examined in a rat axotomy model of the RLN.Study Design: Prospective animal study.Methods: The axotomy model was established by transection of the left RLN in adult Sprague-Dawley rats. The cut ends of the nerve were bridged using Nerbridge (Toyobo Co., Ltd.) with a 1-mm gap (tube-treatment group) or direct sutures (sutured-control group). Left vocal fold mobility, nerve conduction velocity, morphology, and histology were assessed after 15 weeks.Results: Fifteen weeks after treatment, nerve fiber connections were observed macroscopically in both groups, and more clear myelinated fibers and better prevention of laryngeal muscle atrophy were observed in the tube-treatment group compared with the sutured-control group. However, vocal fold movement recovery was not observed in either group, and the conduction velocity of the RLN did not differ between the two groups.Conclusions: Better nerve regeneration was observed in the tube-treatment group. The combination therapy with molecular or gene therapy might be an effective strategy to improve vocal fold movement. The PGA-collagen tube has the potential to promote regeneration of the RLN and to be a scaffold for drug administration in these combination therapies.