Autologous Myoblasts Attenuate Atrophy and Improve Tongue Force in a Denervated Tongue Model: A Pilot Study

Objectives/HypothesisAutologous muscle-derived stem cell (MdSC) therapy is a promising treatment to restore function. No group has evaluated MdSC therapy in a denervated tongue model. The purpose of this pilot investigation was to determine the extent of autologous MdSC survival, effects on tongue muscle atrophy, maximal contractile force, and lingual pressure in a denervated ovine tongue model. Study DesignPilot animal experiment. MethodsBilateral implantable cuff electrodes were placed around the hypoglossal nerves in two Dorper cross ewes. Tensometer and high-resolution manometry (HRM) testing were performed during supermaximum hypoglossal nerve stimulation to assess baseline tongue strength. Sternocleidomastoid muscle biopsies were acquired to create autologous MdSC cultures. At 1 month, 5 x 10(8) green fluorescent protein (GFP)-labeled autologous MdSCs were injected into the partially denervated tongue. Two-months postinjection, lingual tensometer testing, HRM, and postmortem histological assessment were performed. ResultsGFP+ myofibers were identified in denervated tongue specimens indicating MdSC survival. Muscle fiber diameter was larger in GFP+ fibers for both tongue specimens, suggesting attenuation of muscle atrophy. Myofiber diameter was larger in GFP+ myofibers than preinjury diameters, providing evidence of new muscle formation. These myogenic changes led to a 27% increase in maximal tongue contractile force and a 54% increase in maximum base of tongue pressure in one animal. ConclusionsAutologous MdSC therapy may be a viable treatment for the partially denervated tongue, with current findings demonstrating that injected MdSCs survived and fused with tongue myofibers, with a resultant increase in myofiber diameter and an increase in tongue strength. Level of EvidenceN/A. Laryngoscope, 124:E20-E26, 2014