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首页> 外文会议>The 2nd World Congress for Chinese Biomedical Engineers >Pre-clinical and Preliminary Clinical Studies of Chemically Extracted Acellular Nerve Allograft
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Pre-clinical and Preliminary Clinical Studies of Chemically Extracted Acellular Nerve Allograft

机译：化学提取的脱细胞神经同种异体移植物的临床前和初步临床研究

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Our previous studies showed that chemical extraction could remove Schwann cells and myelinated sheath in the peripheralrnnerves of big mammalian animals, reduce the immonogenicity of nerve allografts, and therefore decrease the immunernrejection after allotransplantation. Acellular nerve allograft by chemical extraction supported nerve regeneration of 5cmrnsegment sciatic nerve defect in dogs. Our present studies were undertaken to investigate the immune response of allogeneicrnnerve grafts in rats,observe the effects of repair of long-length nerve loss in dogs and in primates,examine the biologicalrnsafety of acellular nerve allografts chemically extracted from human peripheral nerves. Peripheral nerves of inbred SD ratsrnwere harvested and made acellular by chemical extraction. Acellular and fresh allogeneic nerve grafts from SD rats wererntransplanted into subcutaneous tissue of inbred Wistar rats.The humoral immune response was evaluated via measuring thernlevels of antibody specific to nerve antigen at 2,4,8,and 12 weeks after transplantation. Cell-mediated immune responsernwas assessed with the scales of infiltration of T lymphocyte and its subgroups. Immunological experiments showed lowrnimmune response in chemically extracted acellular nerve allografts,because the number of CD3,CD4 and CD8 positive rnlymphocytes infiltration was far lower than that in the control group of fresh nerve allografts. Studies on repair ofrnlong-length nerve defect suggested that 8cm segment acellular nerve allografts may be the longest distance for supportingrnnerve regeneration with good function. The number of regenerated axons across the nerve allograft and motor end-plates inrnthe reinnervated muscles in 8cm group were far more than those in 10cm group. Study on preservation showed thatrnfreeze-drying did not affect Schwann cell basal lamina or laminin distribution in the acellular nerves and 5cm segmentrnfreeze-dried acellular nerve allografts had good nerve regeneration in the repair of nerve defect in dogs. Experiments inrnprimates showed that chemically acellular nerve allotransplantation could repair 5cm gap of median nerves in the arm.rnExaminations of biological safety demonstrated that human acellular nerve by chemical extraction had good safetyrnaccording to the national criteria. Six patients repaired nerve defect with chemically extracted acellular nerve allograft hadrnsatisfying results in the preliminary clinical application.
机译：我们以前的研究表明，化学提取可以去除大型哺乳动物外周神经中的雪旺细胞和髓鞘，降低同种异体神经的免疫原性，从而降低同种异体移植后的免疫排斥反应。化学提取的脱细胞神经同种异体移植物支持狗5厘米段坐骨神经缺损的神经再生。我们目前的研究旨在调查同种异体神经移植物在大鼠中的免疫反应，观察在狗和灵长类动物中修复长距离神经丧失的效果，并检查从人外周神经化学提取的脱细胞神经异体移植物的生物安全性。通过化学提取收获近交SD大鼠的周围神经并将其脱细胞。将自SD大鼠的脱细胞和新鲜异体神经移植到近交Wistar大鼠的皮下组织中。通过在移植后2、4、8和12周测量对神经抗原具有特异性的抗体的水平来评估体液免疫反应。用T淋巴细胞及其亚组的浸润程度评估细胞介导的免疫反应。免疫学实验表明，化学提取的脱细胞神经同种异体移植物免疫反应低，因为新鲜神经同种异体移植物中CD3，CD4和CD8阳性淋巴细胞浸润的数目远低于对照组。修复长直神经缺损的研究表明，同种异体8cm段脱细胞神经移植可能是支持神经再生且功能良好的最长距离。在8cm组中，同种异体神经和运动终板中神经支配神经再生轴突的数量远多于10cm组。保存的研究表明，冷冻干燥不会影响雪旺细胞的基底层或层粘连蛋白在脱细胞神经中的分布，而5cm段冷冻干燥的脱细胞神经同种异体移植物在修复狗的神经缺损方面具有良好的神经再生。灵长类动物的实验表明，化学脱细胞神经异体移植可以修复手臂正中神经5cm的间隙。生物学安全性测试表明，化学脱细胞对人脱细胞神经的安全性符合国家标准。化学脱细胞同种异体神经移植修复神经缺损6例，临床初步应用效果令人满意。

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