Rehabilitation Of Peripheral Nerve Defects With Autologous Fat And Nerve Transplantation

Objective:The aim of our research is to study the biocompatibility of the PLGA nerve conduit and to evaluate whether the combination of autologous fat and minced nerve tissue with poly-lactic-co-glycolic-acid(PLGA)scaffolds can improve peripheral nerve regeneration more effectively.Methods:The sciatic nerves and subcutaneous inguinal fat were isolated from SD rats under microscope,then adherent culture of adipose tissue and nerve tissue was performed.Proliferation and purification of Schwann cells,fibroblasts and adipose derived stem cells(ADSCs)were conducted after the isolation of the sciatic nerves and subcutaneous inguinal fat from the newborn Sprague-Dawley rats.Then Schwann cells,fibroblasts and ADSCs were cultured with PLGA fibre yarn to detect their ability to attach to and extend on the biomaterial using Calcein staining.CCK8 assay was performed to test the cytotoxicity of the extracts from the PLGA nerve conduit.Following the establishment of the 10 mm sciatic nerve defect models,the twenty four Sprague-Dawley rats were divided equally and randomly into four groups,they are group PLGA,PLGA-SN,PLGA-SN-Fat and Autograft.The 10 mm sciatic nerve defects in the four groups were rehabilitated with empty PLGA nerve scaffolds,PLGA nerve scaffolds with autologous minced nerve tissue,PLGA nerve scaffolds combined with autologous fat and autologous minced nerve tissue,autograft respectively.After 12 weeks,detection and analysis involved general observation,HE staining,Masson staining,immunofluorescence S100 and toluidine blue staining of the regenerated nerves to assess the nerve regeneration.Electromyogram,HE and Masson staining of the gastrocnemius muscle were conducted to evaluate the targeted muscle reinnervation.Results:We achieved highly purified Schwann cells,fibroblasts and ADSCs and our results demonstrated that Schwann cells,fibroblasts and ADSCs were able to adhere to and extend on fibre yarn avtively.CCK8 assay results showed that the extracts from the PLGA nerve conduit had no cytotoxicity to Schwann cells,fibroblasts and ADSCs.Besides,general observation,detection and analysis of electromyogram and histomorphometric indicate that the PLGA scaffolds containing autologous fat and autologous minced nerve tissue can rehabilitate rats’ sciatic nerve defects effectively.Conclusions: PLGA nerve conduits containing autologous fat and autologous minced nerve tissue can support,guide and enhance peripheral nerve regeneration,which makes contributions to the repair of peripheral nerve defects,providing a new method for peripheral nerve rehabilitation.