title: Repairing nerve gaps by vein conduits filled with lipoaspirate-derived entire adipose tissue hinders nerve regeneration.
abstract: In spite of great recent advancements, the definition of the optimal strategy for bridging a nerve defect, especially across long gaps, still remains an open issue since the amount of autologous nerve graft material is limited while the outcome after alternative tubulization techniques is often unsatisfactory. The aim of this study was to investigate a new tubulization technique based on the employment of vein conduits filled with whole subcutaneous adipose tissue obtained by lipoaspiration. In adult rats, a 1cm-long defect of the left median nerve was repaired by adipose tissue-vein-combined conduits and compared with fresh skeletal muscle tissue-vein-combined conduits and autologous nerve grafts made by the excised nerve segment rotated by 180°. Throughout the postoperative period, functional recovery was assessed using the grasping test. Regenerated nerve samples were withdrawn at postoperative month-6 and processed for light and electron microscopy and stereology of regenerated nerve fibers. Results showed that functional recovery was significantly slower in the adipose tissue-enriched group in comparison to both control groups. Light and electron microscopy showed that a large amount of adipose tissue was still present inside the vein conduits at postoperative month-6. Stereology showed that all quantitative morphological predictors analyzed performed significantly worse in the adipose tissue-enriched group in comparison to the two control groups. On the basis of this experimental study in the rat, the use of whole adipose tissue for tissue engineering of peripheral nerves should be discouraged. Pre-treatment of adipose tissue aimed at isolating stromal vascular fraction and/or adipose derived stem/precursor cells should be considered a fundamental requisite for nerve repair.
authors.affiliation: Department of Biomorphology and Biotechnologies, University of Messina, Italy.
authors.forename: Igor
authors.initials: I
authors.lastname: Papalia
authors.forename: Stefania
authors.initials: S
authors.lastname: Raimondo
authors.forename: Giulia
authors.initials: G
authors.lastname: Ronchi
authors.forename: Ludovico
authors.initials: L
authors.lastname: Magaudda
authors.forename: Maria G
authors.initials: MG
authors.lastname: Giacobini-Robecchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Geuna
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000818:Animals; D019544:Equipment Failure Analysis; D005260:Female; D048091:Guided Tissue Regeneration / Q000295:instrumentation* / Q000379:methods; D009416:Nerve Regeneration; D059348:Peripheral Nerve Injuries / Q000473:pathology* / Q000601:surgery*; D011474:Prosthesis Design; D051381:Rats; D017208:Rats, Wistar; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D014680:Veins / Q000637:transplantation*