Stem cells in end-to-side neurorrhaphy. Experimental study in rats

Abstract Purpose: To evaluate the influence of mesenchymal stem cells from adipose tissue in the end-to-side neurorrhaphy, focusing in the nerve regeneration and the muscle reinnervation in acute trauma. Methods: 140 animals were randomly divided in seven groups: control, denervated, end-to-side neurorrhaphy between distal stump of common peroneal nerve and tibial nerve (ESN), ESN wrapped in fascia, ESN wrapped in fascia and platelet gel, ESN wrapped in platelet gel, ESN wrapped in fascia and platelet gel within stem cells (without culture) removed from the adipose tissue. Mass measurements of the animal and of cranial tibial muscles, electromyography, walking track analysis tests and histological examinations of the nerves and muscles after 180 days was performed. Results: In the groups where the ESN was performed, the results were always better when compared to the denervated group, showing reinnervation in all ESN groups. The most sensitive methods were walking track and histological analysis. Only the group with stem cells showed values similar to the control group, as well as the functional indices of peroneal nerve and the number of nerve fibers in the peroneal nerve. Conclusions: Stem cells were effective in ESN according with the functional index of the peroneal nerve, evaluated by walking track analysis and the number of nerve fibers in the peroneal nerve.

摘要 目的：评估脂肪间充质干细胞（mesenchymal stem cells from adipose tissue）在端侧神经吻合术（end-to-side neurorrhaphy）中的作用，重点关注急性创伤中的神经再生与肌肉再支配情况。
方法：将140只实验动物随机分为7组：对照组、失神经支配组、腓总神经远端残端与胫神经行端侧神经吻合术（ESN）组、包裹筋膜的ESN组、包裹筋膜与血小板凝胶的ESN组、包裹血小板凝胶的ESN组，以及包裹筋膜与血小板凝胶并植入未经过体外培养的脂肪间充质干细胞的ESN组。术后180天，对所有动物及胫骨前肌进行重量测量、肌电图检测、步态分析及神经与肌肉的组织病理学检查。
结果：所有接受ESN术的各组实验结果均优于失神经支配组，所有ESN组均观察到肌肉再支配现象。其中最为敏感的检测方法为步态分析与组织病理学检查。仅植入脂肪间充质干细胞的ESN组各项指标与对照组相近，包括腓总神经功能指数及腓总神经纤维数目均达到对照组水平。
结论：结合步态分析评估的腓总神经功能指数及腓总神经纤维数目均证实，脂肪间充质干细胞应用于端侧神经吻合术具有确切效果。