Comparable functional motor outcomes after repair of peripheral nerve injury with an elastase‐processed allograft in a rat sciatic nerve model

Hundepool, Caroline A.; Bulstra, Liselotte F.; Kotsougiani, Dimitra; Friedrich, Patricia F.; Hovius, Steven E.R.; Bishop, Allen T.; Shin, Alexander Y.

doi:10.1002/micr.30371

Cited by 23 publications

(19 citation statements)

References 38 publications

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“…The use of autologous nerve grafts, which promise the most predictable outcomes, has inherent problems such as potential neuroma formation, sensory loss, and tingling sensation at the donor site. Therefore, various materials have been evaluated as alternative treatments for nerve grafts, including non‐synthetic or synthetic conduits, allogenic grafts, and other autologous tissue (Beigi, Ghasemi‐Mobarakeh, Prabhakaran, et al, ; Hundepool, Bulstra, Kotsougiani, et al, ; Manoli, Schulz, Stahl, Jaminet, & Schaller, ).…”

Section: Introductionmentioning

confidence: 99%

A scaffold‐free Bio 3D nerve conduit for repair of a 10‐mm peripheral nerve defect in the rats

et al. 2019

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Introduction A Bio 3D printed nerve conduit was reported to promote nerve regeneration in a 5 mm nerve gap model. The purpose of this study was to fabricate Bio 3D nerve conduits suitable for a 10 mm nerve gap and to evaluate their capacity for nerve regeneration in a rat sciatic nerve defect model. Materials and Methods Eighteen F344 rats with immune deficiency (9–10 weeks old; weight, 200–250 g) were divided into three groups: a Bio 3D nerve conduit group (Bio 3D, n = 6), a nerve graft group (NG, n = 6), and a silicon tube group (ST, n = 6). A 12‐mm Bio 3D nerve conduit or silicon tube was transplanted into the 10‐mm defect of the right sciatic nerve. In the nerve graft group, reverse autografting was performed with an excised 10‐mm nerve segment. Assessments were performed at 8 weeks after the surgery. Results In the region distal to the suture site, the number of myelinated axons in the Bio 3D group were significantly larger compared with the silicon group (2,548 vs. 950, p < .05). The myelinated axon diameter (MAD) and the myelin thickness (MT) of the regenerated axons in the Bio 3D group were significantly larger compared with those of the ST group (MAD: 3.09 vs. 2.36 μm; p < .01; MT: 0.59 vs. 0.40 μm, p < .01). Conclusions This study indicates that a Bio 3D nerve conduit can enhance peripheral nerve regeneration even in a 10 mm nerve defect model.

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Section: Introductionmentioning

confidence: 99%

A scaffold‐free Bio 3D nerve conduit for repair of a 10‐mm peripheral nerve defect in the rats

et al. 2019

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“…Briefly, for RCTs, randomization methods were described in 2 studies (Greene et al, ; Rodriguez et al, ) and allocation concealments were adequate in 1 studies. For blindness, 4 studies utilized blind observers to assess outcome, though blinded for carers were unlikely in all studies (Hundepool et al, ; Simoes et al, ; Valero‐Cabre et al, ; Wu et al, ).…”

Section: Resultsmentioning

confidence: 99%

Efficacy evaluation of personalized coaptation in neurotization for motor deficit after peripheral nerve injury: A systematic review and meta‐analysis

Qian

et al. 2020

Brain and Behavior

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Introduction: Peripheral neurotization, recently as a promising approach, has taken effect in recovering motor function after damage to a peripheral nerve root. Neural anastomosis comprised of nerve conduit and neurorrhaphy participates in the nerve reconstruction. Current literature lacks evidence supporting an individualized coaptation for rescue of locomotor loss in rat subjects with paraplegia secondary to peripheral nerve injury (PNI). Methods:This meta-analysis intends to qualify the specificity of gap-specific coaptation in treating a paralyzed limb following PNI. We used a highly sensitive search strategy to identify all published studies in multiple databases up to 1 May 2019. All identified trials were systematically evaluated using specific inclusion and exclusion criteria. Cochrane methodology was also applied to the results of this study.Results: Twelve studies, including 349 rat subjects, met eligibility criteria. For a medium nerve defect (0.5-3.0 cm), nerve conduit was more likely than neurorrhaphy to precipitate axon regeneration and improve motor outcome of the hemiplegic limb (OR = 3.61, 95% CI = 1.80, 7.26, p < .0003) at 3-month follow-up, whereas neurorrhaphy might take its place in promoting limb motor function in a small nerve gap (<0.5 cm) (OR = 0.48, 95% CI = 0.22, 1.07, p < .007). For a small nerve defect, nerve conduit still demonstrated visible effectiveness in recovery of limb motion albeit poorer than neurorrhaphy (OR = 1.50, 95% CI = 0.92, 2.47, p < .05). Conclusion: Selective neurotization facilitates motor regeneration after nerve transection, and advisable choice of neural coaptation can maximize functional outcome on an individual basis. K E Y W O R D S functional recovery, neurotization, neurotube, peripheral nerve injury, personalized coaptation

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“…[ 20–22 ] Allografts and artificial tissue models are either preserved at cold temperatures or are frozen and stored using a physiological buffer in wet conditions. [ 33–35 ] Hence, in this study, we designed a sterilization chamber that could sterilize packaged products stored in wet conditions at low temperatures using ES. Previous studies have applied silver electrodes for ES; however, serious problems were reported owing to the continuous release of silver ions that resulted from the denaturation of DNA or proteins and the production of reactive oxygen species.…”

Section: Discussionmentioning

confidence: 99%

Sterilization of sealed PVDF pouches containing decellularized scaffold by electrical stimulation

Lee

Jeong

Koo

et al. 2021

Biotechnology Journal

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A terminal sterilization process for tissue engineering products, such as allografts and biomaterials is necessary to ensure complete removal of pathogenic microorganisms such as the bacteria, fungi, and viruses. However, it can be difficult to sterilize allografts and artificial tissue models packaged in wet conditions without deformation. In this study, we investigated the sterilization effects of electrical stimulation (ES) and assessed its suitability by evaluating sterility assurance levels in pouches at a constant current. Stability of polyvinylidene fluoride pouches was determined by a sterility test performed after exposure to five microorganisms (Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, Escherichia coli, and Candida albicans) for 5 days; the sterility test was also performed with decellularized human dermal tissues inoculated with the five microorganisms. Sterilization using ES inactivated microorganisms both inside and outside of sealed pouches and caused no damage to the packaged tissue. Our results support the development of a novel system that involves ES sterilization for packaging of implantable biomaterials and human derived materials.

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Comparable functional motor outcomes after repair of peripheral nerve injury with an elastase‐processed allograft in a rat sciatic nerve model

Abstract: A nerve allograft decellularized with elastase, if stored under the right conditions, results in comparable functional motor outcomes as the gold standard, the autograft.

Cited by 23 publications

References 38 publications

A scaffold‐free Bio 3D nerve conduit for repair of a 10‐mm peripheral nerve defect in the rats

A scaffold‐free Bio 3D nerve conduit for repair of a 10‐mm peripheral nerve defect in the rats

Efficacy evaluation of personalized coaptation in neurotization for motor deficit after peripheral nerve injury: A systematic review and meta‐analysis

Sterilization of sealed PVDF pouches containing decellularized scaffold by electrical stimulation

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