2019-12-06
Stem cells in nerve reconstruction: Hype, hope or reality?
Publication
Publication
Stamcellen in zenuw reconstructie: Hype, hoop of realiteit?
The overarching goal of this thesis is to further improve outcomes after nerve reconstruction
by individualizing nerve allograft repair with the addition of adipose-derived MSCs. The
aim of the first part was to investigate the clinical problem. In chapter 2, an evidencebased overview of the effectiveness of nerve conduits and allografts in motor and mixed sensory/motor nerve reconstruction is provided. In chapter 3, the outcomes of digital
nerve gap reconstruction with the NeuraGen type 1 collagen nerve conduit and the Avance
Nerve Graft are reported in a retrospective observational study.
The second part of this thesis focuses on the addition of adipose derived MSCs to
decellularized nerve allografts and the in-vitro characteristics on human tissue, as well as
the in-vivo characteristics in a rat-model. An adequate, reliable and validated cell seeding
technique is an essential step for evaluating the translational utility of MSC-enhanced
decellularized nerve grafts. Therefore in chapter 4, a new method to effectively seed
decellularized nerve allografts with MSCs is described and validated. To understand how
the functions of MSCs can be leveraged for peripheral nerve repair, in chapter 5, we
investigated whether interactions of MSCs with decellularized nerve allografts can improve
mRNA and protein expression of growth factors that may support nerve regeneration. After
in-vitro testing, the MSC seeded nerve allograft was implemented in a rat model. As there is
a paucity of information regarding the ultimate survivorship of implanted MSCs or if these
cells remain where they are placed, in chapter 6, the in-vivo distribution and survival of MSCs seeded on a decellularized nerve allograft was tracked using luciferase based bioluminescent imaging (BLI). In chapter 7, the molecular mechanisms underlying nerve repair by a decelullarized nerve allograft preseeded with autologous, undifferentiated, adipose derived MSCs are studied and compared to the unseeded allograft and autograft
nerve.
In the general discussion (chapter 8) the results of this thesis are put into a broader
perspective and compared to other recent publications. Furthermore, the implications
of this research for future perspectives are discussed.
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S.E.R. Hovius (Steven) , T.H.J. Nijhuis (Tim) | |
Erasmus University Rotterdam | |
hdl.handle.net/1765/121726 | |
Organisation | Department of Plastic and Reconstructive Surgery |
Rbia, N. (2019, December 6). Stem cells in nerve reconstruction: Hype, hope or reality?. Retrieved from http://hdl.handle.net/1765/121726 |