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J Reconstr Microsurg 2023; 39(05): 392-404
DOI: 10.1055/s-0042-1758182
Original Article

Assessment of Human Epineural Conduit of Different Size Diameters on Efficacy of Nerve Regeneration and Functional Outcomes

Marcin Michal Strojny
1   Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, United States
2   Department of Surgery, Poznan University of Medical Sciences, Poznan, Poland
,
Katarzyna Kozlowska 
1   Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, United States
2   Department of Surgery, Poznan University of Medical Sciences, Poznan, Poland
,
Sonia Brodowska 
1   Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, United States
,
Klaudia Różczka 
1   Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, United States
2   Department of Surgery, Poznan University of Medical Sciences, Poznan, Poland
,
Maria Siemionow 
1   Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, United States
2   Department of Surgery, Poznan University of Medical Sciences, Poznan, Poland
› Institutsangaben Funding This study was supported by the Musculoskeletal Transplant Foundation (MTF, NJ) grant #2014-06351.
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Abstract

Background Different types of nerve conduits are used to bridge peripheral nerve gaps when a tension-free repair is unattainable. To best support nerve regeneration, naturally occurring conduits have been tested. Since allografts offer an unlimited source of epineurium, we have developed human epineural conduit (hEC) as a novel technology to bridge nerve gaps. Considering acellular properties, and lack of immunogenic response, epineurium-derived conduits represent an attractive material, when compared with nerve allografts that require systemic immunosuppression. In this study, we introduce the hEC as a novel naturally occurring material applied for repair of nerve gaps after trauma.

Methods We tested the application of hEC created from human sciatic nerve in the restoration of 20 mm sciatic nerve defects in the nude rat model. Four experimental groups were studied: group 1: no repair control (n = 6), group 2: autograft control (n = 6), group 3: matched diameter hEC (n = 6), and group 4: large diameter hEC (n = 6). Functional tests of toe-spread and pin prick were performed at 1, 3, 6, 9, 12 weeks after repair. At 12 weeks, nerve samples were collected for immunostaining of Laminin B, S-100, glial fibrillary acidic protein (GFAP), nerve growth factor (NGF), vascular endothelial growth factor (VEGF), von Willebrand factor, and histomorphometric analysis of myelin thickness, axonal density, fiber diameter, and percentage of the myelinated nerve fibers. Muscle samples were gathered for gastrocnemius muscle index (GMI) and muscle fiber area ratio measurements.

Results Best functional recovery, as well as GMI, was revealed for the autograft group, and was comparable to the matched hEC group. Significant differences were revealed between matched and large hEC groups in expression of S100 (p = 0.0423), NGF (p = 0.269), VEGF (p = 0.0003) as well as in percentage of myelinated fibers (p < 0.001) and axonal density (p = 0.0003).

Conclusion We established the feasibility of hEC creation. The innovative method introduces an alternative technique to autograft repair of nerve defects.

Keywords

nerve gap repair - human epineural conduit - allograft - nerve regeneration - conduit of different size diameters

Authors' Contributions

M.M.S. performed experiments, collected, analyzed data, and wrote the manuscript. K.K. analyzed data and wrote the manuscript. S.B. analyzed data, performed statistical analysis, prepared figures, and edited manuscript. K.R. performed graphs, figures and edited manuscript. M.S. designed and supervised the project, and reviewed the article. All authors edited and approved the manuscript.




Publikationsverlauf

Eingereicht: 07. Juni 2022

Angenommen: 17. September 2022

Artikel online veröffentlicht:
15. November 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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