Periferik Sinir Defekt Onarımında Biyolojik Kondüit Modeli: De-Epitelize İnsan Amniyotik Membranı ve Adipoz Kökenli Mezenkimal Kök Hücre Tabakası İçeren Sinir Kondüit Modelinin Sinir İyileşmesine Etkisinin Değerlendirilmesi
Yilmaz, Mahmut Muhsin
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Although the first choice for reconstruction of nerve defects in peripheral nerve injuries is autologous nerve graft, new searches continue due to the fact that it requires functional nerve sacrification, severe donor site disadvantages and suboptimal neural regeneration. In the study, as an alternative to the nerve graft, a biological conduit, consisting of an adipocyte-derived mesenchymal stem cell sheet (ADMSC) and amniotic membrane (AM), which is thought to create a favorable environment for nerve regeneration, was designed. In order to evaluate the effect of the produced conduit on neural regeneration, 10 mm sciatic nerve defect was created in rats and as control groups; sham control group, negative control group and nerve autograft group; As the experimental groups, the conduit consisting of the ADMSC sheet and AM, the PGA tube conduit, only the conduit consisting of AM were used. The effects of different nerve repair methods on the peripheral nerve and gastrocnemius muscle were evaluated by functional, histological and immunohistochemical tests. When comparing the number of myelinated axons between groups; The mean value of the number of myelinated axons of the mid section was significantly higher in the group using the AM and ADMSC sheet compared to the groups using PGA tube conduit and only AM. It was observed that the number of myelinated axons belonging to the distal part of the peripheral nerve was significantly higher in the group using AM and ADMSC sheet than the group using PGA tube conduit (p <0.05). Percentage of S100 positive area in the proximal nerve section the group using AM and ADMSC sheet were found to be significantly higher than groups that PGA tube conduit and using only AM (respectively; p<0.05, p<0.001); in the middle part, the AM and ADMSC sheet were found to be significantly higher than the group using AM only (p<0.05). Percentage of gastrocnemius collagen fiber area AM and ADMSC sheet was found to be statistically lower than the group using PGA tube (p<0.05). In the evaluation of muscle fiber diameter; While the group using AM and ADMSC sheet was lower than the group using autologous nerve graft, the PGA tube conduit was found to be significantly higher than the group using only AM (p<0.001). Muscle weight index was significantly higher in the group using AM and ADMSC sheet compared to the group using PGA tube conduit (p<0.05). In the group using AM and ADMSC sheet, it was observed that nerve regeneration was faster by detecting PGA tube conduit and earlier improvement in pin-prick test and SFI compared to the groups using only AM. As a result; It is thought that the biological conduit formed from the AM and ADMSC sheet is a new biological conduit that is an alternative to nerve autograft in peripheral nerve defects and can be used in clinical applications.