Plastic Surgery Research Council
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PSRC 60th Annual Meeting

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Systemic Application Of Adipose Derived Stem Cells Accelerates Functional Peripheral Nerve Regeneration In A Rodent Transection And Repair Model
Jonas T. Schnider, MD1, Paolo M. Fanzio, MD2, Wakako Tsuji, MD2, Natalya Kostereva, PhD2, Mario G. Solari, MD2, Kacey Marra, PhD2, Jan A. Plock, MD3, Vijay S. Gorantla, MD, PhD2.
1University Hospital Bern, Bern, Switzerland, 2University of Pittsburgh Medical Center, Pittsburgh, PA, USA, 3University Hospital Zurich, Zurich, Switzerland.

PURPOSE:
Complete disruption of peripheral nerves represents a severe injury leading to total loss of motor or sensory function and often results in unsatisfactory regeneration. The improvement of nerve regeneration after local application of adipose derived stem cells (ASCs) has been described recently. Possible mechanisms include transdifferentiation of ASCs into Schwann cells (SC) as well as paracrine effects. The aim of this study was to evaluate the functional outcome after systemic application of ASCs.
METHODS:
Lewis rats underwent resection of the sciatic nerve (Res, n=10), transection and repair (TSR, n=10), TSR + ASCs (TSRA, n=12), or reconstruction with 15mm PCL conduits (CC, n=12) or 15mm PCL conduits + ASCs (CA, n=12). ASCs (1 million) were administered intravenously on postoperative day one. Functional outcome was evaluated on a weekly basis with a swim test, static sciatic index (SSI), and CatWalk XT during 6 weeks (TSR, TSRA) or 8 weeks (CC, CA). Sciatic nerve and gastrocnemius muscle was harvested at 2, 4, (n=2 per group) and at 6 weeks (Res / TSR n=6; TSRA, n=8) or 8 weeks (CC, n=6; CA, n=8) for histological and histomorphometrical analysis.
RESULTS:
TSRA showed a clear improvement in SSI, as well as the swim test compared to TSR. The swim test showed improved functional recovery for TSRA at week 2 followed by further improvement over 4 weeks. A superior outcome could be observed at the 6 weeks endpoint. On the contrary, the CatWalk was only able to detect a postoperative decline due to the trauma, but did not exhibit sensitivity for differences between the groups. CC and CA remained at the same levels as Res and no functional recovery was monitored during 8 weeks.
CONCLUSION:
We conclude that systemic administration of ASCs after peripheral nerve transection and repair has the potential to enhance motor functional recovery and can be detected by static and functional tests. Systemic application of ASCs appears to be a promising approach in cases where multiple peripheral nerves are involved or in order to avoid direct access to the nerve as necessary in local application.


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