富血小板血浆诱导骨髓间充质干细胞结合化学萃取去细胞神经修复坐骨神经缺损

Platelet-rich plasma induced bone marrow mesenchymal stem cells combined with chemical extraction of acellular nerve for repair of sciatic nerve defect

背景:周围神经损伤早期许旺细胞尚未大量分裂增殖,此时由于解剖连续性的中断,通过轴浆逆向运输提供的营养因子骤减,缺乏神经营养因子支持的神经元有可能死亡,从而使周围神经不能再生或再生乏力。目的:观察植入经富血小板血浆诱导的骨髓间充质干细胞结合去细胞神经修复坐骨神经缺损的效果。方法:取新西兰大耳白兔制备坐骨神经缺损模型,随机抽签法分成4组:去细胞神经组,移植同种异体去细胞神经;骨髓间充质干细胞组,移植同种异体骨髓间充质干细胞结合化学萃取的同种异体去细胞神经:经诱导骨髓间充质干细胞组,移植经富血小板血浆诱导的同种异体骨髓间充质干细胞结合化学萃取的同种异体去细胞神经;自体神经组,移植自体神经。术后进行形态学观察与靶肌肉肌湿质量恢复率、运动神经传导速度、轴突直径和髓鞘厚度的检测。结果与结论:经富血小板血浆诱导的骨髓间充质干细胞结合化学萃取的去细胞神经移植修复神经的靶肌肉肌湿质量恢复率、运动神经传导速度、轴突直径和髓鞘厚度及形态学观察明显优于移植单纯化学萃取的去细胞神经与骨髓间充质干细胞结合化学萃取的去细胞神经的效果,而与移植自体神经修复结果相似。说明经诱导后的骨髓间充质干细胞在体内具有许旺细胞的部分功能,可作为组织工程化外周神经的种子细胞,用于周围神经缺损的修复。

BACKGROUND：Schwann cells have not yet a large number of division and proliferationin following early peripheral nerve injury.As anatomic discontinuity,the nutritional factors through axoplasmic retrograde transport reduce sharply.The neurons are likely to die due to lack of neurotrophic factors support,so peripheral nerves cannot regenerate or show weak regeneration.OBJECTIVE：To evaluate the effects of the implantation of bone marrow mesenchymal stem cells（BMSCs） induced by the platelet-rich plasma（PRP） combined with chemical extraction of acellular nerve on repairing sciatic nerve defect.METHODS：New Zealand white rabbits were selected to establish sciatic nerve defect models,and randomly divided into four groups,namely pure chemical extracted acellular nerve group,transplantation of allogenic acellular nerve;BMSC group,transplantation of allogenic BMSCs combined with chemical extraction of allogenic acellular nerve;induced BMSC group,transplantation of the PRP-induced allogenic BMSCs combined with chemical extraction of allogenic acellular nerve;and autologous nerve group,transplantation of autologous nerve.Detection indicators include morphological observation,the target muscle recovery rate of muscle wet weight,motor nerve conduction velocity（MNCV） and the axon diameter and myelin sheath thickness.RESULTS AND CONCLUSION：Target muscle to restore the rate of muscle wet weight,MNCV,axon diameter,myelin sheath thickness and the morphology in PRP induced by BMSCs combined with chemical extraction of acellular nerve group was significantly superior to a pure chemical extracted acellular nerve group and BMSCs combined with chemical extraction of acellular nerve group,but there were similar with autologous nerve repair group.BMSCs have the function of Schwann cells in vivo after induction.BMSCs can be used as tissue-engineered peripheral nerve of the seed cells for the repair of peripheral nerve defects.