人类去细胞同种异体神经移植物化学萃取方法的研究(英文)  

Chemical extraction of human acellular nerve allograft

作　　者：衷鸿宾[1] 侯树勋[1] 徐莹[1] 

机构地区：[1]解放军第三○四医院骨科,北京市100037

出　　处：《中国临床康复》2004年第17期3402-3403,F003,共3页Chinese Journal of Clinical Rehabilitation

基　　金：首都医学发展基金(2002-3049)~~

摘　　要：背景:研究表明:应用化学消化剂处理同种异体神经可以有效地清除细胞、髓鞘而不出现宿主免疫排斥反应,但目前这种方法仅在小动物及低等哺乳类实验中取得成功,离临床应用尚有差距。目的:清除人类周围神经中的细胞和髓鞘,萃取粗大和长段的去细胞神经移植物。设计:非随机非对照实验研究。地点和对象:实验在解放军第三○四医院骨科完成,对象为急性脑外伤死亡者,男,26岁,体质量75kg,死者家属同意遗体捐献。干预:切取年轻男性遗体捐献者的长段尺神经,以TritonX-100和脱氧胆酸钠溶液按一定浓度和程序进行化学处理。萃取神经及新鲜神经行HE染色、髓鞘染色及纤维素染色,以观察细胞、髓鞘及神经基底膜;免疫组织化学染色以显示许旺细胞基底板层;行半薄切片及超薄切片透射电镜检查,观察超微结构。主要观察指标:去细胞神经的物理形状,组织学观察和超微结构。结果:去细胞神经的延展性及神经外膜的韧弹性良好。细胞和髓鞘被彻底清除,神经基底膜被保留;许旺细胞基底板层保留完好;去细胞神经为一种没有细胞髓鞘及其碎片的空的神经基质管。结论:TritonX-100及脱氧胆酸钠化学处理方法,可有效清除人类周围神经中的细胞及髓鞘,萃取粗大和长段的去细胞神经;该神经移植物保持了网管柱状组织结构,保留了许旺细胞基底板层及其主要?BACKGROUND:It was reported that chemical extraction could deprive nerve fiber of cells and myelin sheath. The nerve allograft made in this way did not induce host immunological rejection. However, this method has only been successful in little animals and inferior mammals. There is still a long way to go for clinical use. OBJECTIVE:To deprive human peripheral nerve of cell and myelin sheath to get long and thick acellular nerve allograft. DESIGN:A non random and uncontrolled experiment was conducted. SETTING and PARTICIPANTS:The experiment was conducted in the Department of Orthopaedics,the 304 Hospital of PLA. The subject was a man of 26 years old,weighing 75 kg who died of acute brain injury. The donation permission was guaranteed by his family mambers. METHODS:The ulnar nerve was taken out and treated with Triton X 100 and deoxycholate sodium of certain concentration in certain procedures. To observe cells, myelin sheath and basement membrane, the extracted nerve and normal nerve were stained in the following methods respectively:HE staining, myelin sheath staining and cellulose staining.Immunohistochemical staining was applied to display basal lamina of Schwann cells. The ultrastructure was observed with transmission electron microscope. MAIN OUTCOME MEASURES:The physical characters of acellular nerve, histological observation and ultrastructure. RESULTS:The acellular nerve showed good ductility and elasticity of perineurium. Basement membrane and basal lamina of Schwann cells were retained while cells and myelin sheath were totally cleared off. The acellular nerve was an empty matrix nerve duct without myelin sheath or its fragments. CONCLUSION:When treated with Triton X 100 and deoxycholate sodium, cells and myelin sheath can be effectively cleared from human peripheral nerve, thus leaving a long and thick acellular nerve. The nerve allograft maintains the reticular columnar structure and retains the basal lamina of Schwann cell and its main component lamin.

关 键 词：去细胞神经移植物 同种异体 化学萃取 板层素 许旺细胞 

分 类 号：R622.3[医药卫生—整形外科]