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Peripheral Nerve Regeneration in Diabetic Rat Sciatic Nerve Injury Model. A Preliminary Report
Miroslaw Lukaszuk MD, Maria Madajka PhD, Maria Siemionow MD PhD DSc
Cleveland Clinic Department of Plastic Surgery Research Fellowship
2012-02-15
Presenter: Miroslaw Lukaszuk MD
Affidavit:
All the surgeries and animal evaluation were done by the first author. Samples evaluation was performed by the first two authors.
Director Name: Maria Siemionow MD PhD DSc
Author Category: Other Specialty Resident
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
How does this presentation meet the established conference educational objectives?
3. The technique of peripheral nerve repair is presented. This is a new approach in nerve reconstruction with the use of natural epineural sheath conduit and bone marrow stromal cells in diabetic model.
How will your presentation be used by practicing physicians in the audience?
We established a peripheral nerve injury repair model in diabetes. It can be used for clinical application in the future.
Purpose:
Currently there are 15 million diabetic patients in the USA with emerging problem of neuropathy. To investigate neuropathic nerve regeneration we used sciatic nerve injury model in diabetic rats (20mm nerve defects).
Methods
In fifty-eight Zucker Diabetic Fatty (ZDF) rats a 20mm sciatic nerve defect was created and rats were divided into 4 different nerve repair techniques: Group 1- epineural sheath conduit filled with bone marrow stromal cells (BMSCs, 3-4 x 10 6 per injection) or saline (Group 2), nerve autograft (Group 3) (n=16 each) and 20mm nerve gap without repair (Group 4, n=10). Sciatic nerve epineural sheath conduit was created by fascicles removal using pull out technique. BMSCs were harvested from the femurs and tibias of the isogenic donors. Epineural sheath conduit or nerve autograft was implanted using microsurgical techniques. Assessments included motor and sensory recovery at 3 weeks intervals. At 6 and 12 weeks follow up somatosensory evoked potentials (SSEP) were recorded and nerve samples were taken for immunohistochemistry and histomorphometric analysis. Muscle atrophy was assessed by Gastrocnemius Muscle Index (GMI).
Results:
Clinical evaluation confirmed better functional recovery in groups 1 and 2 and the outcomes were comparable to nerve autograft repair. Preliminary analysis of SSEP data, GMI and nerve morphometry confirmed clinical functional assessment.
Conclusions:
This study confirmed feasibility of application of epineural sheath conduits supported with BMSCs in restoration of nerve function in diabetic rats. Preliminary results confirmed supportive role of BMSC in diabetic nerve regeneration comparable with nerve autograft.
