In utero repair of an experimental neural tube defect in a chronic sheep model using biomatrices.
SourceFetal Diagnosis and Therapy, 20, 5, (2005), pp. 335-340
Article / Letter to editor
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Paediatrics - OUD tm 2017
Fetal Diagnosis and Therapy
SubjectDCN 1: Perception and Action; DCN 2: Functional Neurogenomics; IGMD 8: Mitochondrial medicine; IGMD 9: Renal disorder; NCEBP 12: Human Reproduction; NCMLS 3: Tissue engineering and pathology; UMCN 3.1: Neuromuscular development and genetic disorders; UMCN 3.3: Neurosensory disorders; UMCN 4.3: Tissue engineering and reconstructive surgery; UMCN 5.1: Genetic defects of metabolism
OBJECTIVE: Persistent exposure of the unprotected spinal cord to amniotic fluid and the uterine wall can lead to progressive damage of neural tissue in case of a myelomeningocele (two-hit hypothesis). The aim of this study was to evaluate whether in utero repair of an experimental neural tube defect in a fetal lamb could protect neural tissue from secondary injury and save neurologic functions after birth. METHODS: In 19 fetal lambs, a neural tube defect was created at 79 days' gestation. In 12 lambs the defect was covered either with a novel, molecular defined collagen-based biocompatible and biodegradable matrix (UMC) or with a small intestinal submucosa (SIS) biomatrix (Cook) or by closing the skin over the defect. RESULTS: All lambs with the defect covered showed no or minor neurologic morbidity in contrast to the lambs with the defect uncovered in which major neurologic morbidity was seen. CONCLUSIONS: These results demonstrate that long-term exposure of the open spinal cord to the intrauterine environment can lead to damage of neural tissue and, consequently loss of neurologic functions and that coverage of the defect can lead to a better neurologic outcome. Furthermore, we could show that a UMC biomatrix and an SIS biomatrix are useful for in utero coverage of a surgically created neural tube defect in our model.
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