Deneysel Siyatik Sinir Yaralanmasında Poli(3-Hidroksibütirat) (Phb) Vechitosan Kaplı Tübüler Greftler ile Birlikte Mezenşimal Kök Hücre Kullanımının Aksonalrejenerasyona Etkisi
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The gold standard in the treatment of peripheral neuronal injury is end to end anastomosis of the nerve endings, but in case of tension or segmental neuronal tissue loss, neuronal garfts must be used. Disadvantages of neuronal grafting are motor or sensory neurological loss in the donor site, insufficient length and diameter of the neuronal graft and aberrant pairing of the nerve fibers. For the reasons mentioned, entubulation strategies and stem cell applications are being developed. In this research, we investigated the effects of tubular grafts covered with bacterial polyesters and chitosan and human mesenchymal stem cells on the axonal regeneration. Biocomformability, bioresorbable, nontoxic and formability characteristics of bacterial polyesters and chitosan makes them suitable for nerve grafting. In this study, the inner surface of the tubular structure is covered with polyhydroxy butyrate (PHB), which is a member of bacterial polyesters, and the outer surface is covered with chitosan. Chitosan cover is used to prevent the collapse of tubular structure and the inner cover PHB used to facilitate the neuronal growth. Thirty Wistar-Hannover albino rats weighting 225-275 gr. were divided into three groups, autorgaft, synthetic tubular graft and synthetic tubular graft plus stem cells. A ten millimeter nerve segment was sectioned out from the sciatic nerves of the rats and autografts form is used in the first group, the gap was grafted by tube shaped three dimensional directed nanofiber surfaced PHB and chitosan formed tubular graft without any content in the second group and tube shaped three dimensional directed nanofiber surfaced PHB and chitosan formed tubular graft with human mesenchymal stem cells in the third group. Functional improvement was assessed by sciatic nerve function index after four and eight weeks. Statistically significant improvements were observed in all groups by the time. Regenerated axons were seen in histopathological evaluation in all groups after eight weeks. There were significant differences in axonal regeneration in auto graft group compared with V other two groups and in synthetic tubular graft-stem cell group compared with only synthetic tubular graft group. PHB and chitosan modificated tubular grafts provided neuronal regeneration alone or combined with hMSC. PHB and chitosan grafts with mesenchymal stem cells provided better axonal regeneration than they used alone.