自体骨髓间充质干细胞组织工程化神经修复坐骨神经缺损的研究  

Dog sciatic nerve defect bridged by a tissue-engineered nerve of auto bone mesenchymal stem cells

作　　者：吴坚[1] 刘炎[1] 王洁[1] 姚健[1] 顾晓松[1] 

机构地区：[1]南通大学江苏省神经再生重点实验室,江苏226001

出　　处：《交通医学》2006年第6期639-641,647,共4页Medical Journal of Communications

基　　金：国家自然科学基金(30540063);江苏省高校自然科学基金(04KJB180112)

摘　　要：目的:研究医用人工组织神经移植物与自体骨髓间充质干细胞构建成的组织工程化神经桥接修复周围神经缺损的能力。方法:采用自体骨髓间充质干细胞组织工程化神经桥接毕格犬5cm缺损的坐骨神经,桥接组n=5,缺损组n=5。术后定期观察术肢运动功能情况。术后6月,进行电生理学检测,并对再生神经和靶肌进行形态学观察。结果:桥接组术后6月,组织工程化神经移植物已完全降解,再生神经组织修复了坐骨神经5cm缺损,动物术肢承重能力恢复较好,行走、奔跑或上下楼梯时两后肢比较协调;而缺损组动物术肢难以承重,两后肢运动极不协调。神经三色染色显示,桥接段再生神经纤维密集,形成大量的再生单位。电生理学检测,桥接组术侧均记录到了复合肌动作电位(CMAPs),而缺损组未记录到CMAPs。桥接组腓肠肌无明显萎缩,肌肉三色染色显示胶原纤维增生不明显。缺损组腓肠肌明显萎缩,胶原纤维增生明显。结论:自体骨髓间充质干细胞组织工程化神经桥接5cm坐骨神经缺损术后6月,再生神经修复了缺损,并在形态和生理功能上都得到了明显的恢复,靶肌实现了神经的重支配,动物术肢的运动功能取得了明显恢复。Objective： To study the faculty of a tissue-engineered nerve of auto bone mesenchymal stem cells bridge to repair longer dog sciatic nerve gap.Method： A tlssue-engineered nerve was made up of medical artificial nerve graft and auto bone mesenchymal stem cells （MSCs） by our laboratory. This tissue-engineered nerve was used to bridge sciatic nerve across a 50-mm defect in Beagle dogs（graft group, n=5） and a non-grafted group as the negative control （gap group, n=5）. Regular observation and evaluation of the locomotion of injured limbs were conducted after grafting. Six months post-operatively, electrophysiological examination and morphological analyses were carried out to both regenerated nerves and target muscles to evaluate the effects of nerve regeneration.Result： Six months after grafting, the tissue-engineered nerve was completely degraded, and regenerate nerve tissue connected the proximal and distal nerve stumps. Dogs in the graft group could walk with ease and cooperate well, and their implanted side had favourable weight-bearing capability. In gap group, however, their weight-bearing capability was lost, and movement of two hind limbs exhibited poor coordination. Nerve trichrome stain showed grafting segment was concentrated mainly by regenerate nerve fiber, which assemble mass regenerate units. Compound muscle action potentials （CMAPs） were detected in every dog of graft group and not detected in gap group. The gastrocnemius muscle on the grafted side showed no remarkable atrophy and there was no obvious hyperplasia of collagen fiber under the light microscope. But The gastrocnemius muscle on the gap side exhibited typical atrophy and hyperplasia of collagen fiber. Conclusion： Six months after tissue-engineered nerve implantation, regenerate nerve repaired the gap, and nerve continuity obtained restoration. The regenerate nerve reinervated its target muscle, and recovered obviously in the morphous and physiologic function.

关 键 词：组织工程化神经 自体骨髓间充质干细胞 周围神经再生 毕格犬 

分 类 号：R651.3[医药卫生—外科学]