Limitations of Conduits in Peripheral Nerve Repairs

Moore, Amy M.; Kasukurthi, Rahul; Magill, Christina K.; Farhadi, H. Francis; Borschel, Gregory H.; Mackinnon, Susan E.

doi:10.1007/s11552-008-9158-3

Cited by 239 publications

(197 citation statements)

References 23 publications

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“…Decellularized grafts and biomaterial-based nerve conduits to regenerate nervous system pathways (especially peripheral nerves) have been proposed as a promising tool in the last decades, but results rarely show a significant improvement compared with mere epineural suture or autografts [18,28,55], in particular for PNS human models [56] or CNS repair procedures [11,57]. Even more sophisticated and long-term in vivo experiments have not obtained remarkable functional restoration [9,58].…”

Section: Discussionmentioning

confidence: 99%

Schwann-cell cylinders grown inside hyaluronic-acid tubular scaffolds with gradient porosity

et al. 2016

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Cell transplantation therapies in the nervous system are frequently hampered by glial scarring and cell drain from the damaged site, among others. To improve this situation, new biomaterials may be of help. Here, novel single-channel tubular conduits based on hyaluronic acid (HA) with and without poly-L-lactide acid fibers in their lumen were fabricated. Rat Schwann cells were seeded within the conduits and cultured for 10 days.The conduits possessed a three-layered porous structure that impeded the leakage of the cells seeded in their interior and made them impervious to cell invasion from the exterior, while allowing free transport of nutrients and other molecules needed for cell survival. The channel's surface acted as a template for the formation of a cylindrical sheath-like tapestry of Schwann cells continuously spanning the whole length of the lumen. Schwann-cell tubes having a diameter of around 0.5 mm and variable lengths can thus be generated. This structure is not found in nature and represents a truly engineered tissue, the outcome of the specific cell-material interactions. The conduits might be useful to sustain and protect cells for transplantation, and the biohybrids here described, together with neuronal precursors, might be of help in building bridges across significant distances in the central and peripheral nervous system.

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Section: Discussionmentioning

confidence: 99%

Schwann-cell cylinders grown inside hyaluronic-acid tubular scaffolds with gradient porosity

et al. 2016

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“…Over relatively short distances (less than 5 mm), axons can spontaneously regenerate (Rangappa et al, 2000). While the capacity of regeneration is a possibility for PNS injuries, complete functional recovery is infrequent and often misdirected in defects greater than 30 mm (Moore et al, 2009). …”

Section: Introductionmentioning

confidence: 99%

Decellularisation and histological characterisation of porcine peripheral nerves

Žilić

Wilshaw

Haycock

2016

Biotech & Bioengineering

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Peripheral nerve injuries affect a large proportion of the global population, often causing significant morbidity and loss of function. Current treatment strategies include the use of implantable nerve guide conduits (NGC's) to direct regenerating axons between the proximal and distal ends of the nerve gap. However, NGC's are limited in their effectiveness at promoting regeneration Current NGCs are not suitable as substrates for supporting either neuronal or Schwann cell growth, as they lack an architecture similar to that of the native extracellular matrix (ECM) of the nerve. The aim of this study was to create an acellular porcine peripheral nerve using a novel decellularisation protocol, in order to eliminate the immunogenic cellular components of the tissue, while preserving the three‐dimensional histoarchitecture and ECM components. Porcine peripheral nerve (sciatic branches were decellularised using a low concentration (0.1%; w/v) sodium dodecyl sulphate in conjunction with hypotonic buffers and protease inhibitors, and then sterilised using 0.1% (v/v) peracetic acid. Quantitative and qualitative analysis revealed a ≥95% (w/w) reduction in DNA content as well as preservation of the nerve fascicles and connective tissue. Acellular nerves were shown to have retained key ECM components such as collagen, laminin and fibronectin. Slow strain rate to failure testing demonstrated the biomechanical properties of acellular nerves to be comparable to fresh controls. In conclusion, we report the production of a biocompatible, biomechanically functional acellular scaffold, which may have use in peripheral nerve repair. Biotechnol. Bioeng. 2016;113: 2041–2053. © 2016 The Authors. Biotechnology and Bioengineering published by Wiley Periodicals, Inc.

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“…A recent study addressed this issue of large-bore nerves in 4 patients with injuries of the median nerve (1 case), ulnar nerve (1 case), and brachial plexus (2 cases), using absorbable collagen or polyglycolic acid conduits. 32 Authors followed the patients for variable lengths of time (range 9 months-4 years) and, unfortunately, observed relatively poor outcomes in all 4 cases. 32 They went on to hypothesize that the larger diameter of the nerves grafted played a major role in their poor results.…”

Section: Discussionmentioning

confidence: 99%

“…32 Authors followed the patients for variable lengths of time (range 9 months-4 years) and, unfortunately, observed relatively poor outcomes in all 4 cases. 32 They went on to hypothesize that the larger diameter of the nerves grafted played a major role in their poor results. Regarding AGC improvement strategies, some approaches include incorporation of extracellular matrix proteins and/or neurotrophic factors.…”

Section: Discussionmentioning

confidence: 99%