Abstract:
Defects of the peripheral nervous system are extremely frequent in trauma and surgeries and have high socioeconomic costs. If the direct suture of a lesion is not possible, i.e., nerve gap > 2 cm, it is necessary to use grafts. While the gold standard is the autograft, it has disadvantages related to its harvesting, with an inevitable functional deficit and further morbidity. An alternative to autografting is represented by the acellular nerve allograft (ANA), which avoids disadvantages of autograft harvesting and fresh allograft rejection. In this research, the authors intend to transfer to human nerves a novel technique, previously implemented in animal models, to decellularize nerves. The new method is based on soaking the nerve tissues in decellularizing solutions while associating ultrasounds and freeze-thaw cycles. It is performed without interrupting the sterility chain, so that the new graft may not require post-production γ-ray irradiation, which is suspected to affect the structural and functional quality of tissues. The new method is rapid, safe, and inexpensive if compared with available commercial ANAs. Histology and immunohistochemistry have been adopted to evaluate the new decellularized nerves. The study shows that the new method can be applied to human nerve samples, obtaining similar, and, sometimes better, results compared with the chosen control method, the Hudson technique.
摘要:
周围神经系统的缺陷在创伤和手术中极为常见,并且具有很高的社会经济成本。如果无法直接缝合病变,即,神经间隙>2厘米,有必要使用移植物。虽然黄金标准是自体移植,它有与收获有关的缺点,不可避免的功能缺陷和进一步的发病率。自体移植的替代方案以脱细胞神经同种异体移植(ANA)为代表,避免了自体移植收获和新鲜同种异体移植排斥的缺点。在这项研究中,作者打算将一种新技术转移到人类神经中,以前在动物模型中实施,使神经去细胞化.新方法基于将神经组织浸入去细胞溶液中,同时将超声波和冻融循环相关联。它是在不中断无菌链的情况下进行的,这样新的移植物可能不需要生产后的γ射线照射,怀疑会影响组织的结构和功能质量。新方法快速,安全,如果与可用的商业ANA相比,价格低廉。组织学和免疫组织化学已被用于评估新的脱细胞神经。研究表明,新方法可应用于人体神经样本,获得类似的,and,有时更好,结果与所选控制方法进行比较,Hudson技术.