Local host response of commercially available dural patches for fetal repair of spina bifida aperta in rabbit model.

Abstract

OBJECTIVE:

Fetal surgery for spina bifida aperta (SBA) by open hysterotomy typically repairs anatomical native tissue in layers. Increasingly, fetoscopic repair is performed using a dural patch followed by skin closure. We studied the host response to selected commercially available patches currently being used in a fetal rabbit model for spina bifida repair.

METHODS:

SBA was surgically induced at 23-24 days of gestation (term = 31 days). Fetal rabbits were assigned to unrepaired (SBA group), or immediate repair with Duragen™ or Durepair™. Non-operated littermates served as normal controls. At term, spinal cords underwent immunohistochemical staining including Nissl and glial fibrillary acidic protein. We hypothesized that spinal cord coverage with a dural patch and skin closure would preserve motor neuron density within the non-inferiority limit of 201.65 cells/mm2 and reduce inflammation compared to unrepaired SBA fetuses.

RESULTS:

Motor neuron density assessed by Nissl staining was conserved both by Duragen (n = 6, 89.5; 95% CI -158.3 to -20.6) and Durepair (n = 6, 37.0; 95% CI -132.6 to -58.5), whereas density of GFAP-positive cells to quantify inflammation was lower than in unrepaired SBA-fetuses (SBA 2366.0 ± 669.7 cells/mm2 vs. Duragen 1274.0 ± 157.2 cells/mm2 ; p = 0.0002, Durepair 1069.0 ± 270.7 cells/mm2 ; p < 0.0001).

CONCLUSIONS:

Covering the rabbit spinal cord with either Duragen or Durepair followed by skin closure preserves motor neuron density and reduces the inflammatory response.

• Authors: Yada Kunpalin, Simen Vergote, Luc Joyeux, Onur Telli, Anna L David, Michael Belfort, Paolo De Coppi, Jan Deprest
• Journal: Prenatal diagnosis (Prenat Diagn) Vol. 43 Issue 3 Pg. 370-381 (03 2023) ISSN: 1097-0223 [Electronic] England
• PMID: 36650109 (Publication Type: Journal Article)
• Copyright: © 2023 John Wiley & Sons Ltd.

Topics

• Pregnancy
• Female
• Humans
• Animals
• Rabbits
• Spina Bifida Cystica (surgery)
• Fetus (surgery)
• Prenatal Care
• Fetoscopy
• Spinal Cord (surgery)