Schwann Cell Delivery Via a Novel 3-D Collagen Matrix Conduit Improves Outcomes in Critical Length Nerve Gap Repairs. (16th November 2020)

• Record Type: Journal Article
• Authors: Diaz, Anthony; Burks, Shelby; Haggerty, Agnes; Munoz, Natalia D; Midha, Rajiv; Levi, Allan D
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_596
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: The current clinical standard for the repair of a long segmental peripheral nerve injury (PNI) requires extensive harvest of nerve autograft. This approach has several limitations including donor morbidity, size mismatch, and duration of surgery. An alternative therapy that employs a guidance channel to bridge long segmental gaps offers several potential advantages, including the ability to add support cells that aid in promoting axonal regeneration. METHODS: The authors studied the use of a Neuragen ® 3D conduit in combination with autologous SCs (100, 000 cells/μl) to promote axonal regeneration across a critical size defect (13 mm) in the sciatic nerve of male Fischer rats. SCs were loaded inside of a 1 cc syringe by applying negative pressure to the chamber with a syringe plumber. Reversed sciatic nerve autografts were used as positive controls and conduits filled with serum only as negative controls (20 animals per group; total of n = 60). Behavioral analysis and electrophysiology assessments were made in vivo. Animals were sacrificed at either 4 or 16 weeks post-injury, dry muscle weights were measured, and grafts underwent immunohistochemical and morphometric analysis. RESULTS: SC survival, post-transplantation, was confirmed by the presence of green fluorescence protein (GFP) labeled positive SCs within regenerated fibers. Regeneration and elongation of myelinated axons in all three segments of the graft were significantly enhanced at 16 weeks in the conduit with SCs as compared to the conduit alone and statistically similar to autograft. Nerves repaired with SC-filled conduits exhibited onset latencies and nerve conduction amplitudes similar to contralateral controls and autograft ( P < .05). Adding SCs to the conduit also significantly reduced the presence of muscle atrophy as compared to conduit alone ( P < .0001). CONCLUSION: Repair of long segmental PNI of rat sciatic nerve is significantly enhanced by SC-filled Neuragen ® 3D conduits. Significant improvements in total number of myelinated axons, axon diameter and myelin thickness throughout the SC-filled conduits allows for significant improvements in nerve conduction and a subsequent decrease in muscle atrophy.