The Role of Current Techniques and Concepts in Peripheral Nerve Repair

Houschyar, Khosrow Siamak; Momeni, Arash; Pyles, M.N.; Y., J.; Maan, Zeshaan N.; Duscher, Dominik; Jew, Olivia S.; Siemers, Frank; Schoonhoven, Jörg van

doi:10.1155/2016/4175293

Cited by 92 publications

(91 citation statements)

References 55 publications

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“…19 In this study, we evaluate ECM derived from porcine bladder matrix to serve as a novel scaffold. In comparison with other xenogeneic ECM, porcine UBM has demonstrated fewer invasions of fibroblasts because of its intact basement membrane complex on its surface, thereby decreasing scar tissue formation.…”

Section: Discussionmentioning

confidence: 99%

Bridging the Gap

Nguyen¹,

Afshari²,

Kelm³

et al. 2017

Annals of Plastic Surgery

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Purpose This study aims to compare engineered nerve conduits constructed from porcine-derived urinary bladder matrix (UBM) with the criterion-standard nerve autografts, for segmental loss peripheral nerve repairs. Methods Forty-eight Sprague-Dawley rats were divided into 2 groups. All underwent a 10-mm sciatic nerve gap injury. This was repaired using either (1) reverse autograft—the 10-mm cut segment was oriented 180 degrees and used to coapt the proximal and distal stumps or (2) UBM conduit—the 10-mm nerve gap was bridged with UBM conduit. Behavior assessments such as sciatic function index and foot fault asymmetry scores were performed weekly. At 3- or 6-week time endpoints, the repaired nerves and bilateral gastrocnemius/soleus muscles were harvested from each animal. Nerves were evaluated using immunohistochemistry for motor and sensory axon staining and with diffusion tensor imaging. The net wet muscle weights were calculated to assess the degree of muscle atrophy. Results The UBM group demonstrated significantly improved foot fault asymmetry scores at 2 and 4 weeks, whereas there was no difference in sciatic function index. The net muscle weights were similar between both groups. Motor axon counts proximal/inside/distal to the conduit/graft were similar between UBM conduits and reverse autografts, whereas sensory axon counts within and distal to the conduit were significantly higher than those of the autograft at 6 weeks. Sensory axonal regeneration seemed to be adherent to the inner surface of the UBM conduit, whereas it had a scattered appearance in autografts. Diffusion tensor imaging parameters between groups were similar. Conclusions Urinary bladder matrix conduits prove to be at least similar to nerve autografts for the repair of peripheral nerve injuries with a short gap. The matrix perhaps serves as a scaffold to augment sensory nerve growth. Clinical Relevance In a clinical setting, UBM may eliminate the donor site morbidity and increased operative time associated with nerve autografting.

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Section: Discussionmentioning

confidence: 99%

Bridging the Gap

Nguyen¹,

Afshari²,

Kelm³

et al. 2017

Annals of Plastic Surgery

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“…In ifth-degree lesions, the epineurium is also injured and the formation of end-bulb neuromas is observed. In both cases, recovery without surgical or similar intervention is impossible (Figure 3) [8,36,39].…”

Section: Nerve Injury Grading Systemmentioning

confidence: 99%

“…This process, however, is not free of complications. Uncontrolled branching or misdirecting of growing axons and dysfunctional innervation of target organs are common occurrences (Figure 2) [8]. Disruption of motor or peripheral targets secondary to PNI decreases the cortical representation of this zone in the ipsilateral cerebral hemisphere.…”

Section: Introductionmentioning

confidence: 99%

Olfactory Mucosa Mesenchymal Stem Cells and Biomaterials: A New Combination to Regenerative Therapies after Peripheral Nerve Injury

Alvites¹,

Santos²,

ProençaVarejão³

et al. 2017

Mesenchymal Stem Cells - Isolation, Characterization and Applications

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The peripheral nerve injury after trauma is a common occurrence in both human and veterinary medicine and has severe consequences for the survival and quality of life of the patients. Despite the continuous eforts and the creation of diverse medical and surgical techniques, the harmful efects of this type of injury are far from being overcome. Regenerative medicine has been growing in the scientiic milieu as a new therapeutic approach for diferent situations. Among the cell-based therapies explored, the mesenchymal stem cells are evidenced by their features, versatility and potential applications. The olfactory mucosa mesenchymal stem cells, components of the olfactory system and identiied in the lamina propria, were newly identiied and are still undergoing characterization, appearing as a new promise in the regenerative therapy of several tissues but with special emphasis on the nervous system in general and the peripheral nervous system in particular, for which they appear to have special regenerative aptitude.

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“…Nerve growth factor (NGF) is one of these neurotrophins and is present at low concentrations in healthy nerves. Following nerve injury, NGF is upregulated in the distal nerve stump and plays an important role in the survival of sensory neurons and outgrowth of their neuritis [44,45]. NGF promotes proliferation and differentiation of neurons, and also modulates the repair of injured nerves [46,47].…”

Section: Growth Factorsmentioning

confidence: 99%

“…There are numerous other growth factors that play important roles in nerve regeneration. They include fibroblast growth factor (FGF), glial growth factor (GGF), glial cell derived neurotrophic factor (GDNF), ciliary neurotrophic factor, neurotrophin 3(NT-3), and leupeptin [44,54]. NGF, GGF, GDNF, and NT-3 have been applied in nerve conduits to models of nerve gap injury (1-4 cm gap), demonstrating improved functional outcomes, electrophysiological and histological recovery, compared to conduit controls [44].…”

Section: Growth Factorsmentioning

confidence: 99%

Recent Approaches for Augmenting Peripheral Nerve Regeneration: Mini Review

2017

MOJS

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The Role of Current Techniques and Concepts in Peripheral Nerve Repair

Cited by 92 publications

References 55 publications

Bridging the Gap

Bridging the Gap

Olfactory Mucosa Mesenchymal Stem Cells and Biomaterials: A New Combination to Regenerative Therapies after Peripheral Nerve Injury

Recent Approaches for Augmenting Peripheral Nerve Regeneration: Mini Review

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