Effect of Citicoline Loaded PHBA Tubular Grafts on Axonal Regeneration in Sciatic Nerve Injury : An Experimental Approach as an Autograft Alternative.

Abstract

Objective: This study aims to evaluate the effects of poly(3-hydroxybutyrate)/alginate (PHBA/ALG) tubular graft containing cytidine 5'-diphosphocholine (citicoline) on axonal regeneration in an experimental rat sciatic nerve injury model and to compare the results of this method with autologous nerve grafting.

Methods: A total of 24 Wistar-Hannover albino rats were randomly divided into three groups (n=8). In all animals, a 10 mm segment was removed from the right sciatic nerve under microscope. The nerve defect was repaired using autologous nerve graft (group O), PHBA graft only (group T), and PHBA graft containing citicoline (group S). Sixteen weeks later, all animals were euthanized and sciatic nerve samples were taken for histopathological examination. Sections were stained with hematoxylin-eosin and Masson Trichrome.

Results: The groups were compared statistically in terms of regenerated axon diameter, number of blood vessels, nerve sheath degeneration, edema, inflammatory cell infiltration, and necrosis. Histopathological evaluation showed that regenerative axons were formed in all three groups. PHBA and citicoline-containing PHBA grafts successfully bridged the damaged area. While the best results were obtained in the autograft group, the results of the PHBA group containing citicoline were statistically significantly better than the PHBA group. In general, the distribution of histopathological parameters showed that citicoline administration showed protective effects on parameters such as inflammation and cell death. Axon diameter : group S had significantly larger axon diameters than group T (p<0.05). Number of blood vessels : the highest values were in the autograft group and the difference between groups O and T was significant (p<0.05).

Conclusion: PHBA-based tubular graft with oriented nanofiber structure containing citicoline supports peripheral nerve regeneration. Although our results are not better than autograft, it may be a promising alternative for cases where autologous graft is not available.