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Epineural Sheath Conduit Supported with Bone Marrow Stromal Cells as a Novel Technique in Restoration of 6 cm Nerve Defects.
Maria Madajka PhD ,Can Oztürk MD , Safak Uygur MD, Jacek Szopinski MD PhD , Grzegorz Kwiecien MD, Miroslaw Lukaszuk MD, Adam Bobkiewicz MD, Vlodek Siemionow PhD, Maria Siemionow MD PhD DSc
Cleveland Clinic Research Program
2013-03-15
Presenter: Maria Madajka PhD
Affidavit:
All the above work represents the original work of the resident
Director Name: Maria Siemionow
Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Hypothesis: The present standard of care for repair of nerve defects is autograft but in case of multiple injuries it becomes challenging and requires supportive immunosuppression.
To address these needs we engineered epineural sheath conduit supported with bone marrow stromal cells (BMSCs) to restore 6 cm nerve defects in sheep model. We hypothesized that laminin rich and immunologically neutral epineural sheath filled with BMSCs can enhance neuronal growth.
Methods: Epineural sheath tube was created from the median nerve. BMSCs were obtained from donor animal and cultured. Fluorescently labeled BMSCs were injected into the empty epineural tube in the range of 50- 80 x 10 millions. Restoration of 6cm median nerve defect with epineural conduit was performed. Sheep median nerves were evaluated in the following groups: autograft controls (n=6), saline control without BMSCs (n=6), autologous and allogenic conduits (n=6 each) filled with BMSCs. At 3 and 6 months follow up, nerve conduction velocity (NCV) and somatosensory evoked potential (SSEP) measurements were taken. Immunohistochemistry of nerve samples was performed.
Results: All animals recovered from surgery without complications. Immunofluorescent staining at 3 months in saline filled conduit showed presence of fascicle-like structure in the proximal, middle, and distal parts of the conduit. The preliminary analysis of NCV and SSEP assessment data confirmed presence of neurosensory responses in both saline and BMSC-filled conduit groups.
Conclusions: We confirmed feasibility of using epineural sheath conduit to restore 6 cm nerve defects. Preliminary results of immunohistochemical and neurosensory assessment confirmed regenerative properties of engineered conduit.
