Preparation of inorganic-organic hybrid membrane for peripheral nerve reconstruction

摘要

The treatment of peripheral nerve injuries is still one of the most challenging tasks in neurosurgery, as functional recovery is rarely satisfactory in these patients. The concept behind the use of biodegradable nerve guides is that no foreign material should be left in place after the device has fulfilled its task, so as to spare a second surgical intervention. In a previous study, flexible and biodegradable chitosan-3-glycidoxypropyltrimethoxysilane (GPTMS) hybrid membranes exhibited better cytocompatibility in terms of osteoblastic cells than chitosan membrane. Porous chitosan hybrid membranes, derived by freeze-drying the hybrid gels, showed that the cells were attached and proliferated both on the surface and into pores. In this study, the porous chitosan-silicate hybrid membranes with non-differentiated human mesenchymal stem cells isolated from Wharton's jelly of umbilical cord were used to reconstruct the crushed peripheral nerve. Axonotmesis lesion of 3 mm was enwrapped with the hybrid membranes with or without a monolayer of non-differentiated human mesenchymal stem cells. Motor and sensory functional recovery was evaluated throughout a healing period of 12 weeks. The combination of hybrid membranes and human MSCs infiltration showed a slightly better recovery than the untreated control (the just crushed nerve). On the other hand, the hybrid membrane alone promoted the crushed peripheral nerve reconstruction. It is expected that the porous chitosan hybrid membranes is candidate for the clinical tool in peripheral nerve reconstructive surgery.