组织工程化人工神经修复长段神经缺损实验的初步报告

目的 研究组织化人工神经修复大鼠2．5cm长坐骨神经缺损的效果。方法 90只2个月月龄的Lewis1W雌性大鼠，按手术先后顺序随机分成3个神经移植组，每组30只。A组：用种植同源雪旺细胞并具有内部支架结构的胶原神经管桥接，即组织工程化人工神经组。B组：用无雪旺细胞但具有内部支架结构的胶原神经管桥接，即对照组。C组：自体神经移植组。术后6月，进行神经电生理监测，神经肌肉组织学观察；用S－100和神经微丝蛋白免疫组化染色后，行轴突计数等检测。结果 完成对21只大鼠（每组7只）的实验评估。从A组和C组的胫前肌中均能诱发出波幅明显的神经肌肉复合动作电位（CMAP），再生轴突已通过移植段神经全长，远端肌肉轻度萎缩。B组中则没有或仅记录到波幅很低的CMAP，移植神经远端结缔纤维组织增生，再生轴突罕见，所支配肌肉明显萎缩。结论 组织工程化人工神经可用来修复大鼠长段神经缺损。

Repair of a long nerve defect with a tissue - engineered bioartificial nerve graft: a preliminary report

Objective To evaluate the effectiveness of a tissue engineered artificial nerve on bridging sciatic nerve defect 2.5 cm in length in rats. Methods 90 female Lewis 1W rats aged 2 months were randomly divided into three groups, with 30 in each. Three types of materials were used as graft: group A, collagen nerve tubes with an intrinsic framework seeded with syngeneic Schwann cells, which were referred as tissue engineered artificial nerves; group B, collagen nerve tubes filled with an intrinsic framework without Schwann cells; and group C, nerve autografts. Six months later, a series of examinations were performed as follows: electrophysiological testing, hisotological staining of nerves and muscles, S 100 and neurofilament immunostaining as well as axon counts.Results Until now, the assessment has been finished in 21 rats (7 rats in each group). A significant compound muscle action potential (CMAP) was evoked in anterior tibial muscle in group A and C. Regenerated axons were observed in the whole length of nerve grafts, with mild atrophy of their innervating muscles. On the contrary, nothing or only a tiny CMAP was recorded in group B. The distal parts of nerve grafts were filled with fibrotic tissue, while regenerated axons were rarely seen. There was a significant atrophy of the related muscles. Conclusions Our preliminary results demonstrated that the tissue engineered artificial nerve could effectively repair a long nerve defect in rats.