Comparison of Regenerative Changes in Peripheral Nerve Injuries Treated with a Regenerative Tube with Human Mesenchymal Cells and Platelet Rich Plasma Lysate Versus a Nerve Graft in Rats

Peripheral nerve injuries are a frequent pathology, and complete recovery cannot be achieved if nerve segment loss accompanied by soft tissue and concomitant bone injuries occurs. Objective: To compare the degree of nerve regeneration in peripheral nerve lesions with loss of nervous tissue after treatment with the current "gold standard", consisting of interposition of a nerve graft, and the use of a decellularized regenerative tube including mesenchymal stem cells (MSCs) and platelet rich plasma lysate. Materials and Methods: An experimental study was conducted in Wistar rats weighing 250-300 gdivided into three groups as follows: Group 1, a 1.5-cm resection was reconstructed with a nerve graft. Group 2, a 1.5-cm resection was reconstructed with interposition of a regenerative tube. Group 3, a 1.5-cm resection was reconstructed with an interpositional regenerative tube with MSCs derived from adipose tissue and platelet-rich plasma lysate. After four weeks, a biopsy of the nerve distal to the lesion and reconstruction, along with axonal counting by hematoxylin and eosin staining, were performed to compare the three groups (STATA 12). Results: The quantitative variables were compared among the three groups. The mean numbers of regenerated type A axons obtained in each group were as follows: Group 1: 485.1, Group 2: 14.2, and Group 3: 93.8.Astatistically significant difference was found among the groups. Conclusions: Improvement of axonal regeneration was observed in Group 3 compared to Group 2. This is the first experimental study to use this novel biological platform for the regeneration of peripheral nerves with xenogeneic MSCs; however, the follow-up time was limited, and the results may be improved with a longer follow-up period.