Positive effect of ulnar nerve fascicle transfer to musculocutaneous nerve seeded with allogeneic adipose tissue derived stem cells on nerve regeneration for repairing upper brachial plexus injury in a rat model: A preliminary study

IF 1.5 3区 医学 Q3 SURGERY
Microsurgery Pub Date : 2024-07-16 DOI:10.1002/micr.31208
Muhammed Nebil Selimoglu MD, Metin Kocacan MD, Seçkin Tuncer PhD, Zekeriya Tosun MD, Ender Erdogan MD
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Abstract

Background

Traumatic peripheral nerve injury, with an annual incidence reported to be approximately 13–23 per 100,000 people, is a serious clinical condition that can often lead to significant functional impairment and permanent disability. Although nerve transfer has become increasingly popular in the treatment of brachial plexus injuries, satisfactory results cannot be obtained even with total nerve root transfer, especially after serious injuries. To overcome this problem, we hypothesize that the application of stem cells in conjunction with nerve transfer procedures may be a viable alternative to more aggressive treatments that do not result in adequate improvement. Similarly, some preliminary studies have shown that adipose stem cells combined with acellular nerve allograft provide promising results in the repair of brachial plexus injury. The purpose of this study was to assess the efficacy of combining adipose-derived stem cells with nerve transfer procedure in a rat brachial plexus injury model.

Methods

Twenty female Wistar rats weighing 300–350 g and aged 8–10 weeks were randomly divided into two groups: a nerve transfer group (NT group) and a nerve transfer combined adipose stem cell group (NT and ASC group). The upper brachial plexus injury model was established by gently avulsing the C5–C6 roots from the spinal cord with microforceps. A nerve transfer from the ulnar nerve to the musculocutaneous nerve (Oberlin procedure) was performed with or without seeded allogeneic adipose tissue-derived stem cells. Adipose tissue-derived stem cells at a rate of 2 × 106 cells were injected locally to the surface of the nerve transfer area with a 23-gauge needle. Immunohistochemistry (S100 and PGP 9.5 antibodies) and electrophysiological data were used to evaluate the effect of nerve repair 12 weeks after surgery.

Results

The mean latency was significantly longer in the NT group (2.0 ± 0.0 ms, 95% CI: 1.96–2.06) than in the NT and ASC group (1.7 ± 0.0 ms, 95% CI: 1.7–1.7) (p < .001). The mean peak value was higher in the NT group (1.7 ± 0.0 mV, 95% CI: 1.7–1.7) than in the NT and ASC group (1.7 ± 0.3 mV, 95% CI: 1.6–1.9) with no significant difference (p = .61). Although S100 and PGP 9.5 positive areas were observed in higher amounts in the NT and ASC group compared to the NT group, the differences were not statistically significant (p = .26 and .08, respectively).

Conclusions

This study conducted on rats provides preliminary evidence that adipose-derived stem cells may have a positive effect on nerve transfer for the treatment of brachial plexus injury. Further studies with larger sample sizes and longer follow-up periods are needed to confirm these findings.

用异体脂肪组织衍生干细胞播种尺神经束转移到肌皮神经对修复大鼠模型上臂丛神经损伤的神经再生有积极作用:初步研究。
背景:据报道,外伤性周围神经损伤的年发病率约为十万分之十三至二十三,是一种严重的临床症状,通常会导致严重的功能障碍和永久性残疾。虽然神经转移在臂丛神经损伤的治疗中越来越受欢迎,但即使是全神经根转移也无法获得令人满意的效果,尤其是在严重损伤后。为了克服这一问题,我们假设,干细胞与神经转移手术的结合应用,可能是一种可行的替代方法,以取代无法充分改善病情的更激进的治疗方法。同样,一些初步研究表明,脂肪干细胞与无细胞神经异体移植相结合,在修复臂丛神经损伤方面具有良好效果。本研究的目的是在大鼠臂丛神经损伤模型中评估脂肪干细胞与神经移植手术相结合的疗效:方法:20只体重300-350克、年龄8-10周的雌性Wistar大鼠被随机分为两组:神经转移组(NT组)和神经转移联合脂肪干细胞组(NT和ASC组)。上臂丛神经损伤模型是用微型钳子将C5-C6神经根从脊髓中轻轻剥离而建立的。从尺骨神经到肌皮神经的神经转移(奥伯林手术)在播种或不播种异体脂肪组织衍生干细胞的情况下进行。用23号针头将2×106个脂肪组织衍生干细胞局部注射到神经转移区域的表面。免疫组化(S100和PGP 9.5抗体)和电生理数据用于评估术后12周的神经修复效果:结果:NT 组的平均潜伏期(2.0 ± 0.0 ms,95% CI:1.96-2.06)明显长于 NT 和 ASC 组(1.7 ± 0.0 ms,95% CI:1.7-1.7)(p 结论:该研究对大鼠的神经修复效果进行了初步评估:这项在大鼠身上进行的研究提供了初步证据,证明脂肪源性干细胞可能对治疗臂丛神经损伤的神经转移有积极作用。要证实这些发现,还需要样本量更大、随访时间更长的进一步研究。
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来源期刊
Microsurgery
Microsurgery 医学-外科
CiteScore
3.80
自引率
19.00%
发文量
128
审稿时长
4-8 weeks
期刊介绍: Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.
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