壳聚糖神经支架复合免疫性脱髓鞘剂修复长节段神经缺损研究

Study on the repair of long segment nerve defects with chitosan nerve scaffold combined with immune demyelination agent

目的探讨壳聚糖神经支架复合免疫性脱髓鞘剂修复长节段神经缺损临床效果。方法选取成年SD雌性大鼠48只,将其分为神经支架+免疫脱髓鞘剂注射组、神经支架组及自体神经修复组,每组各16只。使用壳聚糖神经支架复合抗半乳糖神经酰胺抗体(Gal-C抗体)及豚鼠补体脱髓鞘剂治疗大鼠坐骨神经12 mm缺损。于第8、12周,观察各组大鼠的NF-200和S-100免疫组化染色情况、坐骨神经指数(SFI),以及再生神经的面积、神经元数量、有髓神经的平均直径。结果第8、12周时,神经支架+免疫脱髓鞘剂注射组的S-100、NF-200标记物的走形和分布明显优于神经支架组,但稍差于自体神经修复组(P<0.05)。透射电镜显示出同样的趋势,神经支架+免疫脱髓鞘剂组的再生神经面积、有髓神经数量、有髓神经平均直径在12周时均优于神经支架组(P<0.05)。SFI指数证实神经支架+免疫脱髓鞘剂注射组的患肢运动功能恢复明显优于单纯支架组(P<0.05)。结论采用壳聚糖神经支架复合免疫脱髓鞘剂进行长节段神经缺损治疗能够明显提高神经生长速度,促进神经再生,可成为新型治疗神经缺损的方法。

Objective To investigate the clinical effect of chitosan nerve scaffold combined with immune demyelination agent in repairing long segment nerve defect.Methods Forty-eight adult SD female rats were selected and divided into the nerve scaffold+immune demyelination agent group,nerve scaffold group and autologous nerve repair group,with 16 rats in each group.Chitosan nerve scaffold combined with anti-galactose ceramide antibody(Gal-C antibody)and guinea pig complement demining agent were used to treat 12 mm sciatic nerve defect in rats.At 8 and 12 weeks,the immunohistochemical staining of NF-200 and S-100,the sciatic nerve index(SFI),the area of regenerated nerve,the number of neurons,and the average diameter of medullated nerve were observed.Results At 8 and 12 weeks,the shape and distribution of S-100 and NF-200 markers in the nerve scaffold+immune demyelination agent group was significantly better than that in the nerve scaffold group,while slightly worse than that in the autologous nerve repair group(P<0.05).Transmission electron microscopy showed the same trend.The regenerated nerve area,the number of myelinated nerves,the average diameter of myelinated nerves in the nerve scaffold+immune demyelination agent group were better than in the nerve scaffold group at 12 weeks(P<0.05).SFI confirmed that the recovery of injury limb in the nerve scaffold+immune demyelination agent group was significantly better than in the nerve scaffold group(P<0.05).Conclusion Chitosan nerve scaffold combined with immune demyelination agent for the treatment of long segment nerve defect can significantly improve the growth rate of nerve and promote nerve regeneration,which can be a new method for the treatment of nerve defect.