新型神经修复技术—神经异体移植术

2014年8月12日 讯 /生物谷BIOON/ --近日，来自肯塔基大学的研究人员通过进行一项多中心的研究发现了一种新型的神经修复机制，相比当前技术来讲，这种新型技术或可给患者带来更大的效益以及更少的副作用。

创伤性神经损伤较为常见，一旦当神经被切断其就不能够自愈了，而且必须通过外科手术来进行修复；对于不是很清晰的损伤，比如锯伤、枪伤等，其往往会在神经间产生缺口。为了填补这些缺口，外科医生会使用两种方法，其中一种就是神经自体移植术，即通过病人机体其它部位的神经将缺口自连起来，这种方法会在供体神经位点产生一种神经缺失；第二种方法就是神经导管法，即合成神经管，其会引发异物反应甚至感染发生。

研究者Brian Rinker教授表示，我们进行了一项前瞻性随机研究，将神经导管法和神经异体移植法进行了对比，神经异体移植就是利用来自死尸的成熟神经组织，这种成熟神经组织经过处理后会移除所有的微孔材料，保留其基本架构，从而可以一直进行疾病传播和发生过敏反应。

研究中神经损伤的参与者被随机进行神经导管法和神经异体移植法治疗，结果显示，相比神经导管法，神经异体移植法可以给患者带来持续性的移除，并且预后情况较好，还可以避免机体捐献神经组织的部位出现病灶。Rinker博士说道，神经移植术在近100年来还是治疗神经损伤的较好疗法，本文的研究中我们揭示了这种神经异体移植的新型技术，其相比之前的技术，可以为患者提供一种更可靠更加安全的神经修复技术。

新闻原文：

A multicenter study including University of Kentucky researchers found that a new nerve repair technique yields better results and fewer side effects than other existing techniques.

Traumatic nerve injuries are common, and when nerves are severed, they do not heal on their own and must be repaired surgically. Injuries that are not clean-cut -- such as saw injuries, farm equipment injuries, and gunshot wounds -- may result in a gap in the nerve.

To fill these gaps, surgeons have traditionally used two methods: a nerve autograft (bridging the gap with a patient's own nerve taken from elsewhere in the body), which leads to a nerve deficit at the donor site; or nerve conduits (synthetic tubes), which can cause foreign body reactions or infections.

The prospective, randomized study, conducted by UK Medical Director of Hand Surgery Service Dr. Brian Rinker and others, compared the nerve conduit to a newer technique called a nerve allograft. The nerve allograft uses human nerves harvested from cadavers. The nerves are processed to remove all cellular material, preserving their architecture while preventing disease transmission or allergic reactions.

Participants with nerve injuries were randomized into either conduit or allograft repair groups. Following the surgeries, independent blind observers performed standardized assessments at set time points to determine the degree of sensory or motor recovery.

The results of the study suggested that nerve allografts had more consistent results and produced better outcomes than nerve conduits, while avoiding the donor site morbidity of a nerve autograft.

Rinker, a principal investigator of the study, describes it as a "game-changer."

"Nerve grafting has remained relatively unchanged for nearly 100 years, and both of the existing nerve repair options had serious drawbacks," Rinker said. "Our study showed that the new technique processed nerve allograft ­- provides a better, more predictable and safer nerve gap repair compared to the previous techniques."

Rinker also noted that work is underway to engineer nerve allografts with growth factors which would guide and promote nerve regeneration, theoretically leading to even faster recoveries and better results.