Culture of olfactory ensheathing cells for central nerve repair: the limitations and potential of endoscopic olfactory mucosal biopsy.

BACKGROUND: Autotransplantation of olfactory ensheathing cells (OECs) into the damaged central nervous system is a potential therapeutic strategy for spinal cord and root cord injuries. One limiting factor has been the poor OEC yields from human mucosal biopsies. Previous studies have only commented on their success in obtaining mucosal specimens containing olfactory mucosa, but have not commented on the yield of OECs from those specimens. OBJECTIVE: To describe a reproducible and safe surgical technique for obtaining human olfactory mucosa and identify patient factors that possibly affect the yield of OEC cultures from the human olfactory mucosa. METHODS: We obtained mucosal biopsies from 43 consecutive patients by using a novel reproducible surgical technique and our laboratory culture protocol. The Spearman rank correlation coefficient was used to assess the relationship between OECs and fibroblast yield with patient characteristics and specimen factors. RESULTS: A greater yield of OECs was obtained from patients of younger age. In addition, patients with worse mucosal disease yielded poorer cell cultures. Greatest yields were found in patients with absence of mucosal disease. Furthermore, a higher yield of OECs was obtained from specimens harvested from the more caudal portions of the superior turbinate, and OEC yield did not correlate with the ventroposterior location of the biopsy. CONCLUSION: We have provided evidence that biopsies closer to the cribriform plate can produce larger yields of OECs, and that patient factors like age and mucosal disease adversely affect the culture yield.