Abstract
Peripheral nerve injury occurs in 3-10% of extremity trauma patients. Mesenchymal stem cells (MSCs) have been used in injuries. Nevertheless, the mechanism of human umbilical cord MSCs (UC-MSCs) and/or their conditioned medium (CM) capacity in regenerating peripheral nerves is not widely known. This study is aimed to determine the mechanism, of UC-MSC CM in improving the structure and function of the nerves after peripheral nerve injury. This experimental study used Sprague-Dawley rats. The experimental animals were divided into 3 groups: control (Sham [SH]), and treatment groups (standard therapy [ST] and CM). The sciatic nerve of the SH group was not injured (only exposed and closed), while those of the ST and CM groups were both cut and given standard sutures. The CM group was treated with topical UC-MSCs CM. The study was divided into two stages i.e. a short-term and long-term research to check the parameters at 7 and 70 days post injury (dPI), respectively. The parameters collected were motor functions (walking analysis), electrophysiology and structural parameters. There were signs of nerve injury in all rats on 3 dPI. CM group showed faster recovery on 14 dPI compared with the ST group that only showed improvement after the 28th dPI. Electrophysiological images showed better electrical conduction in CM than ST group, while histological features showed higher S100 marker was expressed in CM compared with ST, as well as SH group on 7 and 70 dPI. Overall, UC-MSC CM affected peripheral nerve regeneration after 14 dPI.
Highlights
Acute peripheral nerve injury occurs in 3-10% of extremity trauma patients [33]
These results proved that the footprint angles of rats can be used for motor function examination because the obtained results are in line with sciatic functional index (SFI), tibia functional index (TFI) and peroneal functional index (PFI) values (Table 2)
conditioned medium (CM) group had better electrical activity because with the smallest stimulus CM group could trigger the occurrence of combined action potential
Summary
Acute peripheral nerve injury occurs in 3-10% of extremity trauma patients [33]. The injury is thought to have occurred in 18 out of 100,000 people each year in developed countries, and the number is relatively higher in developing countries [24]. The target of healing a nerve injury is to return of nerve function as it was before the injury. To achieve the therapeutic target of nerve injury, a huge cost [33, 47], long duration of hospitalization and outpatient treatment are required, and the result is influenced by various factors [47]. The repair of nerve injury continues to be a major challenge in the management of peripheral nerve injury therapy. The repair of nerve injury to normal sensory and motor functions is very rarely achieved even though nerve and nerve tissue repairs have occurred [12,29,25,22,28]. One factor that influences the management of peripheral nerve injury is the microenvironment factor (niche). It is suspected that the microenvironment of tissues can be enhanced by administering supportive therapy such as the administration of Mesenchymal Stem Cells (MSC) and/or MSC conditioned
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