Repairing nerve gaps by vein conduits filled with lipoaspirate-derived entire adipose tissue hinders nerve regeneration

Papalia, I.; Raimondo, Stefania; Ronchi, Giulia; Magaudda, Ludovico; Giacobini-Robecchi, Maria G.; Geuna, Stefano

doi:10.1016/j.aanat.2012.10.012

Cited by 36 publications

(24 citation statements)

References 31 publications

(30 reference statements)

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“…Reinnervation and maturation of motor nerves have been reported in previous studies of autogenous vein grafting to repair nerve defects of less than 30 mm[3435]. The results of this study show that use of autogenous vein grafts to bridge small nerve defects results in reinnervation and functional recovery of muscle spindles, confirming the clinical usefulness of autogenous vein grafts for bridging short nerve defects.…”

Section: Discussionsupporting

confidence: 86%

“…Among them, autogenous vein grafts are a good option for bridging defects of less than 30 mm[33]. Over the last 30 years, autogenous vein grafts have been used both experimentally and clinically to bridge peripheral nerve defects, because of their ready accessibility and minimal donor-site morbidity compared with nerve grafts[3435363738]. Excellent nerve regeneration and functional recovery were observed in rats[4] and rabbits[39] who underwent autogenous vein grafting for repair of peripheral defects of less than 30 mm.…”

Section: Discussionmentioning

confidence: 99%

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Sensory reinnervation of muscle spindles after repair of tibial nerve defects using autogenous vein grafts

2014

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Motor reinnervation after repair of tibial nerve defects using autologous vein grafts in rats has previously been reported, but sensory reinnervation after the same repair has not been fully investigated. In this study, partial sensory reinnervation of muscle spindles was observed after repair of 10-mm left tibial nerve defects using autologous vein grafts with end-to-end anastomosis in rats, and functional recovery was confirmed by electrophysiological studies. There were no significant differences in the number, size, or electrophysiological function of reinnervated muscle spindles between the two experimental groups. These findings suggest that repair of short nerve defects with autologous vein grafts provides comparable results to immediate end-to-end anastomosis in terms of sensory reinnervation of muscle spindles.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Sensory reinnervation of muscle spindles after repair of tibial nerve defects using autogenous vein grafts

2014

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“…If a peripheral nerve injury is associated with a loss of substance, autologous nerve grafts are usually employed conduits [5][6][7][8]. Ideally, the degradation kinetic of the conduit is to match the nerve regeneration rate.…”

Section: Introductionmentioning

confidence: 99%

Peripheral Nerve Repair: Multimodal Comparison of the Long-Term Regenerative Potential of Adipose Tissue-Derived Cells in a Biodegradable Conduit

Kappos

Engels

Tremp

et al. 2015

Stem Cells and Development

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Tissue engineering is a popular topic in peripheral nerve repair. Combining a nerve conduit with supporting adipose-derived cells could offer an opportunity to prevent time-consuming Schwann cell culture or the use of an autograft with its donor site morbidity and eventually improve clinical outcome. The aim of this study was to provide a broad overview over promising transplantable cells under equal experimental conditions over a long-term period. A 10-mm gap in the sciatic nerve of female Sprague-Dawley rats (7 groups of 7 animals, 8 weeks old) was bridged through a biodegradable fibrin conduit filled with rat adipose-derived stem cells (rASCs), differentiated rASCs (drASCs), human (h)ASCs from the superficial and deep abdominal layer, human stromal vascular fraction (SVF), or rat Schwann cells, respectively. As a control, we resutured a nerve segment as an autograft. Long-term evaluation was carried out after 12 weeks comprising walking track, morphometric, and MRI analyses. The sciatic functional index was calculated. Cross sections of the nerve, proximal, distal, and in between the two sutures, were analyzed for re-/myelination and axon count. Gastrocnemius muscle weights were compared. MRI proved biodegradation of the conduit. Differentiated rat ASCs performed significantly better than undifferentiated rASCs with less muscle atrophy and superior functional results. Superficial hASCs supported regeneration better than deep hASCs, in line with published in vitro data. The best regeneration potential was achieved by the drASC group when compared with other adipose tissue-derived cells. Considering the ease of procedure from harvesting to transplanting, we conclude that comparison of promising cells for nerve regeneration revealed that particularly differentiated ASCs could be a clinically translatable route toward new methods to enhance peripheral nerve repair.

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“…Although the most preferred approach is filling the vein conduit with skeletal muscle (13,17,18), many other tissue fillers have also been addressed by several studies (19,20,21,22,23). However, not all supporting tissues have yielded proper regeneration and some may hinder axonal sprouting (24). …”

Section: Discussionmentioning

confidence: 99%

Can a Small Intestine Segment Be an Alternative Biological Conduit for Peripheral Nerve Regeneration?

et al. 2017

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Background:Autologous nerve grafts are used to bridge peripheral nerve defects. Limited sources and donor site morbidity are the major problems with peripheral nerve grafts. Although various types of autologous grafts such as arteries, veins and muscles have been recommended, an ideal conduit has not yet been described.Aims:To investigate the effectiveness of a small intestinal conduit for peripheral nerve defects.Study Design:Animal experimentation.Methods:Twenty-one rats were divided into three groups (n=7). Following anaesthesia, sciatic nerve exploration was performed in the Sham group. The 10 mm nerve gap was bridged with a 15 mm ileal segment in the small intestinal conduit group and the defect was replaced with orthotopic nerve in autologous nerve graft group. The functional recovery was tested monthly by walking-track analysis and the sciatic functional index. Histological evaluation was performed on the 12th week.Results:Sciatic functional index tests are better in autologous nerve graft group (-55.09±6.35); however, during follow-up, progress in sciatic functional index was demonstrated, along with axonal regeneration and innervation of target muscles in the small intestinal conduit group (-76.36±12.08) (p<0.05). In histologic sections, distinctive sciatic nerve regeneration was examined in the small intestinal conduit group. The expression of S-100 and neurofilament was observed in small intestinal conduit group but was less organised than in the autologous nerve graft group. Although the counted number (7459.79±1833.50 vs. 4226.51±1063.06 mm2), measured diameter [2.19 (2.15-2.88) vs. 1.74 (1.50-2.09) µm] and myelin sheath thickness [1.18 (1.09-1.44) vs. 0.66 (0.40-1.07) µm] of axons is significantly high in the middle sections of autologous nerve graft compared to the small intestinal conduit group, respectively (p<0.05), the peripheral nerve regeneration was also observed in the small intestinal conduit group.Conclusion:Small intestinal conduit should not be considered as an alternative to autologous nerve grafts in its current form; however, the results are promising. Even though the results are no better than autologous nerve grafts, with additional procedures, it might be a good alternative due to harvesting abundant sources without donor site morbidity.

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Repairing nerve gaps by vein conduits filled with lipoaspirate-derived entire adipose tissue hinders nerve regeneration

Cited by 36 publications

References 31 publications

Sensory reinnervation of muscle spindles after repair of tibial nerve defects using autogenous vein grafts

Sensory reinnervation of muscle spindles after repair of tibial nerve defects using autogenous vein grafts

Peripheral Nerve Repair: Multimodal Comparison of the Long-Term Regenerative Potential of Adipose Tissue-Derived Cells in a Biodegradable Conduit

Can a Small Intestine Segment Be an Alternative Biological Conduit for Peripheral Nerve Regeneration?

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