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Tan CW, Ng MH, Ohnmar H, Lokanathan Y, Nur-Hidayah H, Roohi SA, Ruszymah BHI, Nor-Hazla MH, Shalimar A, Naicker AS. Sciatic nerve repair with tissue engineered nerve: Olfactory ensheathing cells seeded poly(lactic-co-glygolic acid) conduit in an animal model. Indian J Orthop 2013; 47:547-52. [PMID: 24379458 PMCID: PMC3868134 DOI: 10.4103/0019-5413.121572] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIM Synthetic nerve conduits have been sought for repair of nerve defects as the autologous nerve grafts causes donor site morbidity and possess other drawbacks. Many strategies have been investigated to improve nerve regeneration through synthetic nerve guided conduits. Olfactory ensheathing cells (OECs) that share both Schwann cell and astrocytic characteristics have been shown to promote axonal regeneration after transplantation. The present study was driven by the hypothesis that tissue-engineered poly(lactic-co-glycolic acid) (PLGA) seeded with OECs would improve peripheral nerve regeneration in a long sciatic nerve defect. MATERIALS AND METHODS Sciatic nerve gap of 15 mm was created in six adult female Sprague-Dawley rats and implanted with PLGA seeded with OECs. The nerve regeneration was assessed electrophysiologically at 2, 4 and 6 weeks following implantation. Histopathological examination, scanning electron microscopic (SEM) examination and immunohistochemical analysis were performed at the end of the study. RESULTS Nerve conduction studies revealed a significant improvement of nerve conduction velocities whereby the mean nerve conduction velocity increases from 4.2 0.4 m/s at week 2 to 27.3 5.7 m/s at week 6 post-implantation (P < 0.0001). Histological analysis revealed presence of spindle-shaped cells. Immunohistochemical analysis further demonstrated the expression of S100 protein in both cell nucleus and the cytoplasm in these cells, hence confirming their Schwann-cell-like property. Under SEM, these cells were found to be actively secreting extracellular matrix. CONCLUSION Tissue-engineered PLGA conduit seeded with OECs provided a permissive environment to facilitate nerve regeneration in a small animal model.
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Affiliation(s)
- C W Tan
- Department of Orthopedic, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Kuala Lumpur, Malaysia
| | - M H Ng
- Tissue Engineering Centre, Medical Faculty, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - H Ohnmar
- Department of Orthopedic and Traumatology, Medical Faculty, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - Y Lokanathan
- Tissue Engineering Centre, Medical Faculty, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - H Nur-Hidayah
- Institute of Medical Science Technology, Universiti Kuala Lumpur, Kajang, Selangor, Malaysia
| | - S A Roohi
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - BHI Ruszymah
- Tissue Engineering Centre, Medical Faculty, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia,Department of Physiology, Medical Faculty, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - M H Nor-Hazla
- Department of Orthopedic and Traumatology, Medical Faculty, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - A Shalimar
- Department of Orthopedic and Traumatology, Medical Faculty, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - A S Naicker
- Department of Orthopedic and Traumatology, Medical Faculty, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia,Address for correspondence: Dr. Amaramalar Selvi Naicker, Department of Orthopedic and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras (56000), Kuala Lumpur, Malaysia. E-mail:
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Gambarotta G, Fregnan F, Gnavi S, Perroteau I. Neuregulin 1 role in Schwann cell regulation and potential applications to promote peripheral nerve regeneration. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2013; 108:223-56. [PMID: 24083437 DOI: 10.1016/b978-0-12-410499-0.00009-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Neuregulin 1 (NRG1) is a multifunctional and versatile protein: its numerous isoforms can signal in a paracrine, autocrine, or juxtacrine manner, playing a fundamental role during the development of the peripheral nervous system and during the process of nerve repair, suggesting that the treatment with NRG1 could improve functional outcome following injury. Accordingly, the use of NRG1 in vivo has already yielded encouraging results. The aim of this review is to focus on the role played by the different NRG1 isoforms during peripheral nerve regeneration and remyelination and to identify good candidates to be used for the development of tissue engineered medical devices delivering NRG1, with the objective of promoting better nerve repair.
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Affiliation(s)
- Giovanna Gambarotta
- Nerve Regeneration Group, Department of Clinical and Biological Sciences, University of Torino, Torino, Italy.
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53
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Mauro N, Manfredi A, Ranucci E, Procacci P, Laus M, Antonioli D, Mantovani C, Magnaghi V, Ferruti P. Degradable Poly(amidoamine) Hydrogels as Scaffolds for In Vitro Culturing of Peripheral Nervous System Cells. Macromol Biosci 2012; 13:332-47. [DOI: 10.1002/mabi.201200354] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 11/08/2012] [Indexed: 02/02/2023]
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54
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Early regenerative effects of NGF-transduced Schwann cells in peripheral nerve repair. Mol Cell Neurosci 2012; 50:103-12. [PMID: 22735691 DOI: 10.1016/j.mcn.2012.04.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 03/27/2012] [Accepted: 04/06/2012] [Indexed: 01/04/2023] Open
Abstract
Peripheral nerve injury leads to a rapid and robust increase in the synthesis of neurotrophins which guide and support regenerating axons. To further optimize neurotrophin supply at the earliest stages of regeneration, we over-expressed NGF in Schwann cells (SCs) by transducing these cells with a lentiviral vector encoding NGF (NGF-SCs). Transplantation of NGF-SCs in a rat sciatic nerve transection/repair model led to significant increase of NGF levels 2weeks after injury and correspondingly to substantial improvement in axonal regeneration. Numbers of NF200, ChAT and CGRP-positive axon profiles, as well as the gastrocnemius muscle weights, were significantly higher in the NGF-Schwann cell group compared to the animals that received control SCs transduced with a lentiviral vector encoding GFP (GFP-SCs). Comparison with other models of NGF application signifies the important role of this neurotrophin during the early stages of regeneration, and supports the importance of developing combined gene and cell therapy for peripheral nerve repair.
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Bryan DJ, Litchfield CR, Manchio JV, Logvinenko T, Holway AH, Austin J, Summerhayes IC, Rieger-Christ KM. Spatiotemporal expression profiling of proteins in rat sciatic nerve regeneration using reverse phase protein arrays. Proteome Sci 2012; 10:9. [PMID: 22325251 PMCID: PMC3295716 DOI: 10.1186/1477-5956-10-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 02/10/2012] [Indexed: 01/19/2023] Open
Abstract
Background Protein expression profiles throughout 28 days of peripheral nerve regeneration were characterized using an established rat sciatic nerve transection injury model. Reverse phase protein microarrays were used to identify the spatial and temporal expression profile of multiple proteins implicated in peripheral nerve regeneration including growth factors, extracellular matrix proteins, and proteins involved in adhesion and migration. This high-throughput approach enabled the simultaneous analysis of 3,360 samples on a nitrocellulose-coated slide. Results The extracellular matrix proteins collagen I and III, laminin gamma-1, fibronectin, nidogen and versican displayed an early increase in protein levels in the guide and proximal sections of the regenerating nerve with levels at or above the baseline expression of intact nerve by the end of the 28 day experimental course. The 28 day protein levels were also at or above baseline in the distal segment however an early increase was only noted for laminin, nidogen, and fibronectin. While the level of epidermal growth factor, ciliary neurotrophic factor and fibroblast growth factor-1 and -2 increased throughout the experimental course in the proximal and distal segments, nerve growth factor only increased in the distal segment and fibroblast growth factor-1 and -2 and nerve growth factor were the only proteins in that group to show an early increase in the guide contents. As expected, several proteins involved in cell adhesion and motility; namely focal adhesion kinase, N-cadherin and β-catenin increased earlier in the proximal and distal segments than in the guide contents reflecting the relatively acellular matrix of the early regenerate. Conclusions In this study we identified changes in expression of multiple proteins over time linked to regeneration of the rat sciatic nerve both demonstrating the utility of reverse phase protein arrays in nerve regeneration research and revealing a detailed, composite spatiotemporal expression profile of peripheral nerve regeneration.
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Affiliation(s)
- David J Bryan
- Tissue Engineering Laboratory, Lahey Clinic Medical Center, Burlington, Massachusetts, USA.,Department of Plastic and Reconstructive Surgery, Lahey Clinic Medical Center, Burlington, Massachusetts, USA
| | - C Robert Litchfield
- Tissue Engineering Laboratory, Lahey Clinic Medical Center, Burlington, Massachusetts, USA
| | - Jeffrey V Manchio
- Tissue Engineering Laboratory, Lahey Clinic Medical Center, Burlington, Massachusetts, USA.,Department Surgery, Section of General Surgery, Saint Joseph Mercy Hospital, Ann Arbor, Michigan, USA
| | - Tanya Logvinenko
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA
| | - Antonia H Holway
- Ian C. Summerhayes Cell and Molecular Biology Laboratory, Lahey Clinic Medical Center, Burlington, Massachusetts, USA.,Aushon BioSystems Inc., Billerica, Massachusetts, USA
| | - John Austin
- Aushon BioSystems Inc., Billerica, Massachusetts, USA
| | - Ian C Summerhayes
- Ian C. Summerhayes Cell and Molecular Biology Laboratory, Lahey Clinic Medical Center, Burlington, Massachusetts, USA
| | - Kimberly M Rieger-Christ
- Ian C. Summerhayes Cell and Molecular Biology Laboratory, Lahey Clinic Medical Center, Burlington, Massachusetts, USA
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56
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Toll EC, Seifalian AM, Birchall MA. The role of immunophilin ligands in nerve regeneration. Regen Med 2012; 6:635-52. [PMID: 21916598 DOI: 10.2217/rme.11.43] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Tacrolimus (FK506) is a widely used immunosuppressant in organ transplantation. However, it also has neurotrophic activity that occurs independently of its immunosuppressive effects. Other neurotrophic immunophilin ligands that do not exhibit immunosuppression have subsequently been developed and studied in various models of nerve injury. This article reviews the literature on the use of tacrolimus and other immunophilin ligands in peripheral nerve, cranial nerve and spinal cord injuries. The most convincing evidence of enhanced nerve regeneration is seen with systemic administration of tacrolimus in peripheral nerve injury, although clinical use is limited due to its immunosuppressive side effects. Local tacrolimus delivery to the site of nerve repair in peripheral and cranial nerve injury is less effective but requires further investigation. Tacrolimus can enhance outcomes in nerve allograft reconstruction and accelerates reinnervation of complex functional allograft transplants. Other non-immunosuppressive immunophilins ligands such as V-10367 and FK1706 demonstrate enhanced neuroregeneration in the peripheral nervous system and CNS. Mixed results are found in the application of immunophilin ligands to treat spinal cord injury. Immunophilin ligands have great potential in the treatment of nerve injury, but further preclinical studies are necessary to permit translation into clinical trials.
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Affiliation(s)
- Edward C Toll
- Division of Surgery and Interventional Science, University College London, UK.
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57
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Madduri S, Gander B. Growth factor delivery systems and repair strategies for damaged peripheral nerves. J Control Release 2011; 161:274-82. [PMID: 22178593 DOI: 10.1016/j.jconrel.2011.11.036] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 11/29/2011] [Accepted: 11/30/2011] [Indexed: 11/28/2022]
Abstract
Artificial nerve conduits (NCs) are, in certain cases, instrumental for repairing damaged peripheral nerves, although therapeutic efficacy remains often suboptimal. Considerable efforts have been made to improve the therapeutic performance of NCs. This article reviews recent developments in NC-technology for peripheral nerve regeneration with a main focus on growth factors delivery systems and repair strategies. Commonly used materials for NC fabrication include collagen, silk fibroin, and biodegradable aliphatic polyesters. The basic NC structure, i.e., a hollow tube, can be manufactured by diverse methods: spinning mandrel technology, sheet rolling, injection-molding, freeze-drying, and electro-spinning. Polymeric and cellular delivery systems for growth factors can be integrated in the NC wall or within luminal structures such as gels, fibers, or biological materials providing binding affinity for the bioactive compounds. NCs with sustained growth factor delivery generally improve significantly the axonal outgrowth in nerve defect models, although restoration of sensory and motor functions remains inferior to that achieved with autologous nerve grafts. To improve therapeutic outcomes, further biofunctionalization of NCs will be needed, i.e., adjusting degradation kinetics of NC scaffolding to be compatible with axonal regeneration; delivering multiple growth factors at individually optimized kinetics; incorporating modality specific glial cells and furnishing NCs with guiding nanostructures.
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Affiliation(s)
- Srinivas Madduri
- Department of Urology, University Hospital Zurich, 8091 Zurich, Switzerland
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59
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Wilkinson AE, McCormick AM, Leipzig ND. Central Nervous System Tissue Engineering: Current Considerations and Strategies. ACTA ACUST UNITED AC 2011. [DOI: 10.2200/s00390ed1v01y201111tis008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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60
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Pabari A, Yang SY, Mosahebi A, Seifalian AM. Recent advances in artificial nerve conduit design: Strategies for the delivery of luminal fillers. J Control Release 2011; 156:2-10. [DOI: 10.1016/j.jconrel.2011.07.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 06/29/2011] [Indexed: 12/20/2022]
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Scott JB, Afshari M, Kotek R, Saul JM. The promotion of axon extension in vitro using polymer-templated fibrin scaffolds. Biomaterials 2011; 32:4830-9. [DOI: 10.1016/j.biomaterials.2011.03.037] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 03/18/2011] [Indexed: 01/03/2023]
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Rustad KC, Sorkin M, Levi B, Longaker MT, Gurtner GC. Strategies for organ level tissue engineering. Organogenesis 2011; 6:151-7. [PMID: 21197216 DOI: 10.4161/org.6.3.12139] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 04/16/2010] [Accepted: 04/21/2010] [Indexed: 01/22/2023] Open
Abstract
The field of tissue engineering has made considerable strides since it was first described in the late 1980s. The advent and subsequent boom in stem cell biology, emergence of novel technologies for biomaterial development and further understanding of developmental biology have contributed to this accelerated progress. However, continued efforts to translate tissue-engineering strategies into clinical therapies have been hampered by the problems associated with scaling up laboratory methods to produce large, complex tissues. The significant challenges faced by tissue engineers include the production of an intact vasculature within a tissue-engineered construct and recapitulation of the size and complexity of a whole organ. Here we review the basic components necessary for bioengineering organs-biomaterials, cells and bioactive molecules-and discuss various approaches for augmenting these principles to achieve organ level tissue engineering. Ultimately, the successful translation of tissue-engineered constructs into everyday clinical practice will depend upon the ability of the tissue engineer to "scale up" every aspect of the research and development process.
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Affiliation(s)
- Kristine C Rustad
- Stanford University, Hagey Laboratory for Pediatric Regenerative Medicine, Stanford, CA, USA
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63
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In vitro comparison of motor and sensory neuron outgrowth in a 3D collagen matrix. J Neurosci Methods 2011; 198:53-61. [DOI: 10.1016/j.jneumeth.2011.03.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 02/07/2011] [Accepted: 03/08/2011] [Indexed: 02/01/2023]
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Wang M, Zhai P, Chen X, Schreyer DJ, Sun X, Cui F. Bioengineered scaffolds for spinal cord repair. TISSUE ENGINEERING PART B-REVIEWS 2011; 17:177-94. [PMID: 21338266 DOI: 10.1089/ten.teb.2010.0648] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Spinal cord injury can lead to devastating and permanent loss of neurological function, affecting all levels below the site of trauma. Unfortunately, the injured adult mammalian spinal cord displays little regenerative capacity and little functional recovery in large part due to a tissue environment that is nonpermissive for regenerative axon growth. Artificial tissue repair scaffolds may provide a physical guide to allow regenerative axon growth that bridges the lesion cavity and restores functional neural connectivity. By integrating different strategies, including the use of various biomaterials and microstructures as well as incorporation of bioactive molecules and living cells, combined or synergistic effects for spinal cord repair through regenerative axon growth may be achieved. This article briefly reviews the development of bioengineered scaffolds for spinal cord repair, focusing on spinal cord injury and the subsequent cellular response, scaffold materials, fabrication techniques, and current therapeutic strategies. Key issues and challenges are also identified and discussed along with recommendations for future research.
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Affiliation(s)
- Mindan Wang
- Division of Biomedical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Siemionow M, Bozkurt M, Zor F. Regeneration and repair of peripheral nerves with different biomaterials: review. Microsurgery 2011; 30:574-88. [PMID: 20878689 DOI: 10.1002/micr.20799] [Citation(s) in RCA: 136] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Peripheral nerve injury may cause gaps between the nerve stumps. Axonal proliferation in nerve conduits is limited to 10-15 mm. Most of the supportive research has been done on rat or mouse models which are different from humans. Herein we review autografts and biomaterials which are commonly used for nerve gap repair and their respective outcomes. Nerve autografting has been the first choice for repairing peripheral nerve gaps. However, it has been demonstrated experimentally that tissue engineered tubes can also permit lead to effective nerve repair over gaps longer than 4 cm repair that was previously thought to be restorable by means of nerve graft only. All of the discoveries in the nerve armamentarium are making their way into the clinic, where they are, showing great potential for improving both the extent and rate of functional recovery compared with alternative nerve guides.
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Affiliation(s)
- Maria Siemionow
- Department of Plastic Surgery, The Cleveland Clinic, Cleveland, OH 44195, USA.
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66
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Zeng X, Zeng YS, Ma YH, Lu LY, Du BL, Zhang W, Li Y, Chan WY. Bone marrow mesenchymal stem cells in a three-dimensional gelatin sponge scaffold attenuate inflammation, promote angiogenesis, and reduce cavity formation in experimental spinal cord injury. Cell Transplant 2011; 20:1881-99. [PMID: 21396163 DOI: 10.3727/096368911x566181] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Three-dimensional (3D) gelatin sponge (GS) scaffolds were constructed by ensheathing GS with a thin film of poly-(lactide-co-glycolide) (PLGA). Rat bone marrow-derived mesenchymal stem cells (MSCs) were isolated, cultured, and then seeded to the scaffolds. Distribution of cells and cell growth, survival, and proliferation within the scaffolds were then determined. Immunofluorescence and Western blot analysis were employed to detect the deposition of fibronectin to the scaffolds on day 3 and day 7 of culture. Scaffolds with or without MSCs were then transplanted into the transected rat spinal cord. One or 8 weeks following transplantation, cavity areas, activated macrophages/microglia, expression of TNF-α and IL-1β, and neovascularization within the grafts were examined and quantified. Deposition of fibronectin (FN) and expression of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1α (HIF-1α) as potential inducing factors for angiogenesis were also examined. Results showed that 3D GS scaffolds allowed MSCs to adhere, survive, and proliferate and also FN to deposit. In vivo transplantation experiments demonstrated that these scaffolds were biocompatible, and MSCs seeded to the scaffolds played an important role in attenuating inflammation, promoting angiogenesis, and reducing cavity formation. Therefore, the GS scaffolds with MSCs may serve as promising supporting transplants for repairing spinal cord injury.
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Affiliation(s)
- Xiang Zeng
- Research Center for Stem Cell Biology and Tissue Engineering, Sun Yat-sen University, Guangzhou, China
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67
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Cellular and paracellular transplants for spinal cord injury: a review of the literature. Childs Nerv Syst 2011; 27:237-43. [PMID: 20972681 DOI: 10.1007/s00381-010-1312-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Accepted: 10/11/2010] [Indexed: 01/01/2023]
Abstract
BACKGROUND Experimental approaches to limit the spinal cord injury and to promote neurite outgrowth and improved function from a spinal cord injury have exploded in recent decades. Due to the cavitation resulting after a spinal cord injury, newer important treatment strategies have consisted of implanting scaffolds with or without cellular transplants. There are various scaffolds, as well as various different cellular transplants including stem cells at different levels of differentiation, Schwann cells and peripheral nerve implants, that have been reviewed. Also, attention has been given to different re-implantation techniques in avulsion injuries. METHODS Using standard search engines, this literature is reviewed. CONCLUSION Cellular and paracellular transplantation for application to spinal cord injury offers promising results for those patients with spinal cord pathology.
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Poly(amidoamine) Hydrogels as Scaffolds for Cell Culturing and Conduits for Peripheral Nerve Regeneration. INT J POLYM SCI 2011. [DOI: 10.1155/2011/161749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Biodegradable and biocompatible poly(amidoamine)-(PAA-) based hydrogels have been considered for different tissue engineering applications. First-generation AGMA1 hydrogels, amphoteric but prevailing cationic hydrogels containing carboxylic and guanidine groups as side substituents, show satisfactory results in terms of adhesion and proliferation properties towards different cell lines. Unfortunately, these hydrogels are very swellable materials, breakable on handling, and have been found inadequate for other applications. To overcome this problem, second-generation AGMA1 hydrogels have been prepared adopting a new synthetic method. These new hydrogels exhibit good biological propertiesin vitrowith satisfactory mechanical characteristics. They are obtained in different forms and shapes and successfully testedin vivofor the regeneration of peripheral nerves. This paper reports on our recent efforts in the use of first-and second-generation PAA hydrogels as substrates for cell culturing and tubular scaffold for peripheral nerve regeneration.
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69
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Vetter I, Pujic Z, Goodhill GJ. The response of dorsal root ganglion axons to nerve growth factor gradients depends on spinal level. J Neurotrauma 2010; 27:1379-86. [PMID: 20504159 DOI: 10.1089/neu.2010.1279] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Directed sensory axon regeneration has the potential to promote functional recovery after peripheral nerve injury. Using a novel guidance assay to generate precisely controllable nerve growth factor gradients, we show for the first time that the guidance and outgrowth response of rat dorsal root ganglion neurons to identical nerve growth factor gradients depends on the rostrocaudal origin of the dorsal root ganglion explant. These findings have implications for the study of peripheral nerve regeneration in response to exogenous neurotrophins such as nerve growth factor, and provide new insight into the clinical potential of nerve growth factor in the treatment of nerve injury.
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Affiliation(s)
- Irina Vetter
- The Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
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Gu X, Ding F, Yang Y, Liu J. Construction of tissue engineered nerve grafts and their application in peripheral nerve regeneration. Prog Neurobiol 2010; 93:204-30. [PMID: 21130136 DOI: 10.1016/j.pneurobio.2010.11.002] [Citation(s) in RCA: 416] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 11/02/2010] [Accepted: 11/23/2010] [Indexed: 01/01/2023]
Abstract
Surgical repair of severe peripheral nerve injuries represents not only a pressing medical need, but also a great clinical challenge. Autologous nerve grafting remains a golden standard for bridging an extended gap in transected nerves. The formidable limitations related to this approach, however, have evoked the development of tissue engineered nerve grafts as a promising alternative to autologous nerve grafts. A tissue engineered nerve graft is typically constructed through a combination of a neural scaffold and a variety of cellular and molecular components. The initial and basic structure of the neural scaffold that serves to provide mechanical guidance and optimal environment for nerve regeneration was a single hollow nerve guidance conduit. Later there have been several improvements to the basic structure, especially introduction of physical fillers into the lumen of a hollow nerve guidance conduit. Up to now, a diverse array of biomaterials, either of natural or of synthetic origin, together with well-defined fabrication techniques, has been employed to prepare neural scaffolds with different structures and properties. Meanwhile different types of support cells and/or growth factors have been incorporated into the neural scaffold, producing unique biochemical effects on nerve regeneration and function restoration. This review attempts to summarize different nerve grafts used for peripheral nerve repair, to highlight various basic components of tissue engineered nerve grafts in terms of their structures, features, and nerve regeneration-promoting actions, and finally to discuss current clinical applications and future perspectives of tissue engineered nerve grafts.
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Affiliation(s)
- Xiaosong Gu
- Jiangsu Key Laboratory of Neuroregeneration, Nantong University, 19 Qixiu Road, Nantong, JS 226001, PR China.
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Abstract
This review considers the 2 sources of neurotrophic factors in the peripheral nervous system (PNS), the neurons and the nonneuronal cells in the denervated distal nerve stumps, and their role in axon regeneration. Morphological assessment of regenerative success in response to administration of exogenous growth factors after nerve injury and repair has indicated a role of the endogenous neurotrophic factors from Schwann cells in the distal nerve stump. However, the increased number of axons may reflect more neurons regenerating their axons and/or increased numbers of axon sprouts from the same number of neurons. Using fluorescent dyes to count neurons that regenerated their axons across a suture site and into distal nerve stumps, brain-derived neurotrophic factor (BDNF) and glial cell-derived neurotrophic factor (GDNF) were found not to increase the number of neurons that regenerated their axons after immediate nerve repair. Nevertheless, the factors did reverse the deleterious effect of delayed nerve repair, indicating that the axons that regenerate into the distal nerve stump normally have access to sufficient levels of endogenous neurotrophic factors to sustain their regeneration, while neurons that do not have access to these factors require exogenous factors to sustain axon regeneration. Neurons upregulate neurotrophic factors after axotomy. The upregulation is normally slow, beginning after 7 days and occurring in association with a protracted period of axonal regeneration in which axons grow out from the proximal nerve stump across a suture site over a period of 1 month in rodents. This staggered axon regeneration across the suture site is accelerated by a 1-hour period of low-frequency electrical stimulation that simultaneously accelerates the expression of BDNF and its trkB receptor in the neurons. Elevation of the level of BDNF after 2 days to > 3 times that found in unstimulated neurons was accompanied by elevation of the level of cAMP and followed by accelerated upregulation of growth-associated genes, tubulin, actin, and GAP-43 and downregulation of neurofilament protein. Elevation of cAMP levels via rolipram inhibition of phosphodiesterase 4 mimicked the effect of the low-frequency electrical stimulation. In conclusion, the enhanced upregulation of neurotrophic factors in the electrically stimulated axotomized neurons accelerates axon outgrowth into the distal nerve stumps where endogenous sources of growth factors in the Schwann cells support the regeneration of the axons toward the denervated targets. The findings provide strong support for endogenous neurotrophic factors of axotomized neurons and of denervated Schwann cells playing a critical role in supporting axon regeneration in the PNS.
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Affiliation(s)
- Tessa Gordon
- Centre for Neuroscience, Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
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74
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Deumens R, Bozkurt A, Meek MF, Marcus MAE, Joosten EAJ, Weis J, Brook GA. Repairing injured peripheral nerves: Bridging the gap. Prog Neurobiol 2010; 92:245-76. [PMID: 20950667 DOI: 10.1016/j.pneurobio.2010.10.002] [Citation(s) in RCA: 347] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Revised: 09/30/2010] [Accepted: 10/05/2010] [Indexed: 02/06/2023]
Abstract
Peripheral nerve injuries that induce gaps larger than 1-2 cm require bridging strategies for repair. Autologous nerve grafts are still the gold standard for such interventions, although alternative treatments, as well as treatments to improve the therapeutic efficacy of autologous nerve grafting are generating increasing interest. Investigations are still mostly experimental, although some clinical studies have been undertaken. In this review, we aim to describe the developments in bridging technology which aim to replace the autograft. A multi-disciplinary approach is of utmost importance to develop and optimise treatments of the most challenging peripheral nerve injuries.
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Affiliation(s)
- Ronald Deumens
- Department of Anesthesiology, Maastricht University Medical Center, Maastricht, The Netherlands.
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75
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Wang D, Liu XL, Zhu JK, Hu J, Jiang L, Zhang Y, Yang LM, Wang HG, Zhu QT, Yi JH, Xi TF. Repairing Large Radial Nerve Defects by Acellular Nerve Allografts Seeded with Autologous Bone Marrow Stromal Cells in a Monkey Model. J Neurotrauma 2010; 27:1935-43. [PMID: 20701436 DOI: 10.1089/neu.2010.1352] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Dong Wang
- Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xiao-Lin Liu
- Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jia-Kai Zhu
- Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jun Hu
- Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Li Jiang
- Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yang Zhang
- Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Li-Min Yang
- Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Hong-Gang Wang
- Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Qing-Tang Zhu
- Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jian-Hua Yi
- Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Ting-Fei Xi
- National Institute for the Control of Pharmaceutical and Biological Products, No. 2, Tiantanxili, Beijing, China
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76
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Research tip neurotropin incorporated nerve sutures. Tech Hand Up Extrem Surg 2010; 14:200. [PMID: 20818226 DOI: 10.1097/bth.0b013e3181cbba28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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77
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Abstract
Nerve repair after transection has variable and unpredictable outcomes. In addition to advancements in microvascular surgical techniques, nerve allografts and conduits are available options in peripheral nerve reconstruction. When tensionless nerve repair is not feasible, or in chronic injuries, autografts have been traditionally used. As substitute to autografts, decellularized allografts and conduits have become available. These conduits can reduce donor site morbidity, functional loss at the donor area in cases where autografts are used, and immune reaction from transplants or unprocessed allografts. The development of new biomaterials for use in conduits, as well as use of cytokines, growth factors, and other luminal fillers, may help in the treatment of acute and chronic nerve injuries. The indications and properties of nerve conduits and allografts are detailed in this article.
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Affiliation(s)
- Michael Rivlin
- Department of Orthopaedics, Thomas Jefferson University Hospital, 1015 Walnut Street, Curtis Building, Room 801, Philadelphia, PA 19107, USA
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78
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Madduri S, Gander B. Schwann cell delivery of neurotrophic factors for peripheral nerve regeneration. J Peripher Nerv Syst 2010; 15:93-103. [DOI: 10.1111/j.1529-8027.2010.00257.x] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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79
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Ni HC, Lin ZY, Hsu SH, Chiu IM. The use of air plasma in surface modification of peripheral nerve conduits. Acta Biomater 2010; 6:2066-76. [PMID: 20040388 DOI: 10.1016/j.actbio.2009.12.038] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 12/16/2009] [Accepted: 12/21/2009] [Indexed: 12/27/2022]
Abstract
Surface modification is a conventional approach in biomaterials development, but most of the modification processes are intricate and time inefficient. In this study, a convenient open air plasma treatment was employed to modify the surface of poly(d,l-lactide) (PLA). Chitosan and fibroblast growth factor 1 (FGF1) were sequentially grafted with the assistance of open air plasma treatment onto the PLA nerve conduits with designed micropores and surface microgrooves. Grafting of these components was verified by electron spectroscopy for chemical analysis. The modified nerve conduits showed enhanced ability in the repair of 10-mm sciatic nerve transection defects in rats. The sequential air plasma treatment can be a convenient way to introduce biocompatible (e.g., chitosan) and bioactive components (e.g., growth factors) onto the surface of biomaterials.
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80
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Sun W, Lin H, Chen B, Zhao W, Zhao Y, Xiao Z, Dai J. Collagen scaffolds loaded with collagen-binding NGF-beta accelerate ulcer healing. J Biomed Mater Res A 2010; 92:887-95. [PMID: 19283824 DOI: 10.1002/jbm.a.32445] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Studies have shown that exogenous nerve growth factor (NGF) accelerates ulcer healing, but the inefficient growth factor delivery system limits its clinical application. In this report, we found that the native human NGF-beta fused with a collagen-binding domain (CBD) could form a collagen-based NGF targeting delivery system, and the CBD-fused NGF-beta could bind to collagen membranes efficiently. Using the rabbit dermal ischemic ulcer model, we have found that this targeting delivery system maintains a higher concentration and stronger bioactivity of NGF-beta on the collagen membranes by promoting peripheral nerve growth. Furthermore, it enhances the rate of ulcer healing through accelerating the re-epithelialization of dermal ulcer wounds and the formation of capillary lumens within the newly formed tissue area. Thus, collagen membranes loaded with collagen-targeting human NGF-beta accelerate ulcer healing efficiently.
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Affiliation(s)
- Wenjie Sun
- Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
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81
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Abstract
Peripheral nerve regeneration is a complicated and long-term medical challenge that requires suitable guides for bridging nerve injury gaps and restoring nerve functions. Many natural and synthetic polymers have been used to fabricate nerve conduits as well as luminal fillers for achieving desired nerve regenerative functions. It is important to understand the intrinsic properties of these polymers and techniques that have been used for fabricating nerve conduits. Previously extensive reviews have been focused on the biological functions and in vivo performance of polymeric nerve conduits. In this paper, we emphasize on the structures, thermal and mechanical properties of these naturally derived synthetic polymers, and their fabrication methods. These aspects are critical for the performance of fabricated nerve conduits. By learning from the existing candidates, we can advance the strategies for designing novel polymeric systems with better properties for nerve regeneration.
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82
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Abstract
Silk from the Bombyx mori silkworm is a protein-based fiber. Bombyx mori silk fibroin (SF) is one of the most important candidates for biomedical porous material based on its superior machinability, biocompatibility, biodegradation, bioresorbability, and so on. In this paper, we have reviewed the key features of SF. Moreover we have focused on the morphous, technical processing, and biocompatibility of SF porous materials, followed by the application research. Finally, we provide a perspective the potential and problems of SF porous materials.
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Affiliation(s)
| | | | - Mingzhong Li
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +86-512-6706-1150; Fax: +86-512-6724-6786
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83
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Jiang X, Lim SH, Mao HQ, Chew SY. Current applications and future perspectives of artificial nerve conduits. Exp Neurol 2009; 223:86-101. [PMID: 19769967 DOI: 10.1016/j.expneurol.2009.09.009] [Citation(s) in RCA: 268] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Revised: 09/09/2009] [Accepted: 09/11/2009] [Indexed: 12/27/2022]
Abstract
Artificial nerve guide conduits have the advantage over autografts in terms of their availability and ease of fabrication. However, clinical outcomes associated with the use of artificial nerve conduits are often inferior to that of autografts, particularly over long lesion gaps. There have been significant advances in the designs of artificial nerve conduits over the years. In terms of materials selection and design, a wide variety of new synthetic polymers and biopolymers have been evaluated. The inclusion of nerve conduit lumen fillers has also been demonstrated as essential to enable nerve regeneration across large defect gaps. These lumen filler designs have involved the integration of physical cues for contact guidance and biochemical signals to control cellular function and differentiation. Novel conduit architectural designs using porous and fibrous substrates have also been developed. This review highlights the recent advances in synthetic nerve guide designs for peripheral nerve regeneration, and the in vivo applicability and future prospects of these nerve guide conduits.
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Affiliation(s)
- Xu Jiang
- School of Chemical & Biomedical Engineering, Nanyang Technological University, 62 Nanyang Drive, Block N1.2-B2-20, Singapore 637459, Singapore
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84
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de Ruiter GCW, Malessy MJA, Yaszemski MJ, Windebank AJ, Spinner RJ. Designing ideal conduits for peripheral nerve repair. Neurosurg Focus 2009; 26:E5. [PMID: 19435445 DOI: 10.3171/foc.2009.26.2.e5] [Citation(s) in RCA: 221] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Nerve tubes, guides, or conduits are a promising alternative for autologous nerve graft repair. The first biodegradable empty single lumen or hollow nerve tubes are currently available for clinical use and are being used mostly in the repair of small-diameter nerves with nerve defects of < 3 cm. These nerve tubes are made of different biomaterials using various fabrication techniques. As a result these tubes also differ in physical properties. In addition, several modifications to the common hollow nerve tube (for example, the addition of Schwann cells, growth factors, and internal frameworks) are being investigated that may increase the gap that can be bridged. This combination of chemical, physical, and biological factors has made the design of a nerve conduit into a complex process that demands close collaboration of bioengineers, neuroscientists, and peripheral nerve surgeons. In this article the authors discuss the different steps that are involved in the process of the design of an ideal nerve conduit for peripheral nerve repair.
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85
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Hood B, Levene HB, Levi AD. Transplantation of autologous Schwann cells for the repair of segmental peripheral nerve defects. Neurosurg Focus 2009; 26:E4. [PMID: 19435444 DOI: 10.3171/foc.2009.26.2.e4] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Peripheral nerve injuries are a source of chronic disability. Incomplete recovery from such injuries results in motor and sensory dysfunction and the potential for the development of chronic pain. The repair of human peripheral nerve injuries with traditional surgical techniques has limited success, particularly when a damaged nerve segment needs to be replaced. An injury to a long segment of peripheral nerve is often repaired using autologous grafting of "noncritical" sensory nerve. Although extensive axonal regeneration can be observed extending into these grafts, recovery of function may be absent or incomplete if the axons fail to reach their intended target. The goal of this review was to summarize the progress that has occurred in developing an artificial neural prosthesis consisting of autologous Schwann cells (SCs), and to detail future directions required in translating this promising therapy to the clinic. In the authors' laboratory, methods are being explored to combine autologous SCs isolated using cell culture techniques with axon guidance channel (AGC) technology to develop the potential to repair critical gap length lesions within the peripheral nervous system. To test the clinical efficacy of such constructs, it is critically important to characterize the fate of the transplanted SCs with regard to cell survival, migration, differentiation, and myelin production. The authors sought to determine whether the use of SC-filled channels is superior or equivalent to strategies that are currently used clinically (for example, autologous nerve grafts). Finally, although many nerve repair paradigms demonstrate evidence of regeneration within the AGC, the authors further sought to determine if the regeneration observed was physiologically relevant by including electrophysiological, behavioral, and pain assessments. If successful, the development of this reparative approach will bring together techniques that are readily available for clinical use and should rapidly accelerate the process of bringing an effective nerve repair strategy to patients with peripheral nerve injury prior to the development of pain and chronic disability.
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Affiliation(s)
- Brian Hood
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
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86
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Kemp SWP, Walsh SK, Midha R. Growth factor and stem cell enhanced conduits in peripheral nerve regeneration and repair. Neurol Res 2009; 30:1030-8. [PMID: 19079977 DOI: 10.1179/174313208x362505] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Despite the capacity for spontaneous axonal regeneration, recovery after severe peripheral nerve injury remains variable and often very poor. In addition, autologous nerve grafts, considered to be the 'gold standard' in nerve repair technique, are plagued by restricted donor tissue availability and donor site morbidity. Our primary objective is to highlight new and emerging methods of nerve repair, which have the potential to significantly improve both the functional and behavioral outcome after clinical nerve injury. METHODS A critical analysis of nerve injury and regeneration literature concentrating on outcome measures from both immediate and chronically denervated experimental works was conducted. RESULTS Results of numerous works employing both growth factor and stem cell enhanced nerve guidance conduits have shown encouraging results. However, further research is needed to optimize guidance conduit dynamics, bioavailability and delivery of both growth factors and stem cells to enhance peripheral nerve regeneration and functional recovery. DISCUSSION This review discusses current animal and clinical growth factor and stem cell studies, specifically focusing on future bio-engineering approaches in developing a nerve guidance conduit in the future.
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Affiliation(s)
- Stephen W P Kemp
- Department of Clinical Neuroscience, Faculty of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, Alta, Canada.
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87
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de Ruiter GCW, Spinner RJ, Yaszemski MJ, Windebank AJ, Malessy MJA. Nerve tubes for peripheral nerve repair. Neurosurg Clin N Am 2009; 20:91-105, vii. [PMID: 19064182 DOI: 10.1016/j.nec.2008.08.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The concept of the nerve tube has been a major topic of research in the field of peripheral nerve regeneration for more than 25 years. The first nerve tubes are currently available for clinical use. This article gives an overview of the experimental and clinical data on nerve tubes for peripheral nerve repair and critically analyzes the data on which the step from laboratory to clinical use is based. In addition, it briefly discusses the different modifications to the common single lumen nerve tubes that may improve the results of generation.
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Affiliation(s)
- Godard C W de Ruiter
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands
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88
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Yan H, Zhang F, Chen MB, Lineaweaver WC. Chapter 10 Conduit Luminal Additives for Peripheral Nerve Repair. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2009; 87:199-225. [DOI: 10.1016/s0074-7742(09)87010-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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89
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Hsu SH, Su CH, Chiu IM. A Novel Approach to Align Adult Neural Stem Cells on Micropatterned Conduits for Peripheral Nerve Regeneration: A Feasibility Study. Artif Organs 2009; 33:26-35. [DOI: 10.1111/j.1525-1594.2008.00671.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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90
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Zhang H, Wei YT, Tsang KS, Sun CR, Li J, Huang H, Cui FZ, An YH. Implantation of neural stem cells embedded in hyaluronic acid and collagen composite conduit promotes regeneration in a rabbit facial nerve injury model. J Transl Med 2008; 6:67. [PMID: 18986538 PMCID: PMC2614414 DOI: 10.1186/1479-5876-6-67] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2008] [Accepted: 11/05/2008] [Indexed: 12/14/2022] Open
Abstract
The implantation of neural stem cells (NSCs) in artificial scaffolds for peripheral nerve injuries draws much attention. NSCs were ex-vivo expanded in hyaluronic acid (HA)-collagen composite with neurotrophin-3, and BrdU-labeled NSCs conduit was implanted onto the ends of the transected facial nerve of rabbits. Electromyography demonstrated a progressive decrease of current threshold and increase of voltage amplitude in de-innervated rabbits after implantation for one, four, eight and 12 weeks compared to readouts derived from animals prior to nerve transection. The most remarkable improvement, observed using Electrophysiology, was of de-innervated rabbits implanted with NSCs conduit as opposed to de-innervated counterparts with and without the implantation of HA-collagen, NSCs and HA-collagen, and HA-collagen and neurotrophin-3. Histological examination displayed no nerve fiber in tissue sections of de-innervated rabbits. The arrangement and S-100 immunoreactivity of nerve fibers in the tissue sections of normal rabbits and injured rabbits after implantation of NSCs scaffold for 12 weeks were similar, whereas disorderly arranged minifascicles of various sizes were noted in the other three arms. BrdU+ cells were detected at 12 weeks post-implantation. Data suggested that NSCs embedded in HA-collagen biomaterial could facilitate re-innervations of damaged facial nerve and the artificial conduit of NSCs might offer a potential treatment modality to peripheral nerve injuries.
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Affiliation(s)
- Han Zhang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, PR China.
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91
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Nisbet DR, Crompton KE, Horne MK, Finkelstein DI, Forsythe JS. Neural tissue engineering of the CNS using hydrogels. J Biomed Mater Res B Appl Biomater 2008; 87:251-63. [DOI: 10.1002/jbm.b.31000] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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92
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Casha S, Yong VW, Midha R. Minocycline for axonal regeneration after nerve injury: A double-edged sword. Exp Neurol 2008; 213:245-8. [DOI: 10.1016/j.expneurol.2008.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Revised: 06/26/2008] [Accepted: 06/27/2008] [Indexed: 10/21/2022]
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93
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Lu MC, Ho CY, Hsu SF, Lee HC, Lin JH, Yao CH, Chen YS. Effects of electrical stimulation at different frequencies on regeneration of transected peripheral nerve. Neurorehabil Neural Repair 2008; 22:367-73. [PMID: 18663248 DOI: 10.1177/1545968307313507] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Electrical stimulation of damaged peripheral nerve may aid regeneration. OBJECTIVE The purpose of this study was to determine whether 1 mA of percutaneous electrical stimulation at 1, 2, 20, or 200 Hz augments regeneration between the proximal and distal nerve stumps. METHODS A10-mm gap was made in rat sciatic nerve by suturing the stumps into silicone rubber tubes. A control group received no stimulation. Starting 1 week after transection, electrical stimulation was applied between the cathode placed at the distal stump and the anode at the proximal stump every other day for 6 weeks. RESULTS Higher frequency stimulation led to less regeneration compared to lower frequencies. Quantitative histology of the successfully regenerated nerves revealed that the groups receiving electrical treatment, especially at 2 Hz, had a more mature structure with a smaller cross-sectional area, more myelinated fibers, higher axon density, and higher ratio of blood vessel to total nerve area compared with the controls. Electrophysiology showed significantly shorter latency, longer duration, and faster conduction velocity. CONCLUSION Electrical stimulation can have either a positive or negative impact on peripheral nerve regeneration. Clinical trials that combine stimulation with rehabilitation must determine the parameters that are most likely to be safe and effective.
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Affiliation(s)
- Ming-Chin Lu
- School of Post Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
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94
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Pierucci A, de Duek EAR, de Oliveira ALR. Peripheral Nerve Regeneration through Biodegradable Conduits Prepared Using Solvent Evaporation. Tissue Eng Part A 2008; 14:595-606. [DOI: 10.1089/tea.2007.0271] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- Amauri Pierucci
- Department of Anatomy, Institute of Biology, State University of Campinas, Campinas, SP, Brazil
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95
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Mironov V, Kasyanov V, Markwald RR, Prestwich GD. Bioreactor-free tissue engineering: directed tissue assembly by centrifugal casting. Expert Opin Biol Ther 2008; 8:143-52. [PMID: 18194071 DOI: 10.1517/14712598.8.2.143] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Casting is a process by which a material is introduced into a mold while it is liquid, allowed to solidify in a predefined shape inside the mold, and then removed to give a fabricated object, part or casing. Centrifugal casting could be defined as a process of molding using centrifugal forces. Although the centrifugal casting technology has a long history in metal manufacturing and in the plastics industry, only recently has this technology attracted the attention of tissue engineers. Initially, centrifugation was used to optimize cell seeding on a solid scaffold. More recently, centrifugal casting has been used to create tubular scaffolds and both tubular and flat multilayered, living tissue constructs. These newer applications were enabled by a new class of biocompatible in situ crosslinkable hydrogels that mimic the extracellular matrix. Herein the authors summarize the state of the art of centrifugal casting technology in tissue engineering, they outline associated technological challenges, and they discuss the potential future for clinical applications.
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Affiliation(s)
- Vladimir Mironov
- Medical University of South Carolina, Charleston, SC 29425, USA.
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96
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Inada Y, Hosoi H, Yamashita A, Morimoto S, Tatsumi H, Notazawa S, Kanemaru SI, Nakamura T. Regeneration of peripheral motor nerve gaps with a polyglycolic acid-collagen tube: technical case report. Neurosurgery 2008; 61:E1105-7; discussion E1107. [PMID: 18091262 DOI: 10.1227/01.neu.0000303210.45983.97] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE After previous success in regenerating canine peripheral nerves over 80 mm gaps using a bioabsorbable nerve guide tube, we have extended this method to the treatment of patients experiencing various types of nerve injury. This report describes the treatment of two cases of motor nerve disorder. METHODS The bioabsorbable nerve tube was a cylindrically woven polyglycolic acid (PGA) tube filled with collagen. A peripheral motor nerve defect (the frontalis branch of the facial nerve) was reconstructed using this PGA-collagen tube in two patients who experienced posttraumatic unilateral eyebrow ptosis for 3 months. RESULTS Five months after surgery, both patients regained their ability to voluntarily lift their eyebrows symmetrically. Electrophysiological examination at 5 months revealed recovery of compound muscle action potential and disappearance of distal latency on the affected side. CONCLUSION This is the first clinical report of motor nerve recovery achieved using the PGA-collagen nerve guide tube. The results suggest that use of a PGA-collagen tube is a promising option for the repair of motor nerve defects.
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Affiliation(s)
- Yuji Inada
- Department of Orthopedics, Inada Hospital, Nara, Japan
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97
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Vleggeert-Lankamp CLAM. The role of evaluation methods in the assessment of peripheral nerve regeneration through synthetic conduits: a systematic review. J Neurosurg 2007; 107:1168-89. [DOI: 10.3171/jns-07/12/1168] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
A number of evaluation methods that are currently used to compare peripheral nerve regeneration with alternative repair methods and to judge the outcome of a new paradigm were hypothesized to lack resolving power. This would too often lead to the conclusion that the outcome of a new paradigm could not be discerned from the outcome of the current gold standard, the autograft. As a consequence, the new paradigm would incorrectly be judged as successful.
Methods
An overview of the methods that were used to evaluate peripheral nerve regeneration after grafting of the rat sciatic nerve was prepared. All articles that were published between January 1975 and December 2004 and concerned grafting of the rat sciatic nerve (minimum graft length 5 mm) and in which the experimental method was compared with an untreated or another grafted nerve were included. The author scored the presence of statistically significant differences between paradigms.
Results
Evaluation of nerve fiber count, nerve fiber density, N-ratio, nerve histological success ratio, compound muscle action potential, muscle weight, and muscle tetanic force are methods that were demonstrated to have resolving power.
Conclusions
A number of evaluation methods are not suitable to demonstrate a significant difference between experimental paradigms in peripheral nerve regeneration. It is preferable to apply a combination of evaluation methods with resolving power to evaluate nerve regeneration properly.
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98
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Pfister LA, Papaloïzos M, Merkle HP, Gander B. Nerve conduits and growth factor delivery in peripheral nerve repair. J Peripher Nerv Syst 2007; 12:65-82. [PMID: 17565531 DOI: 10.1111/j.1529-8027.2007.00125.x] [Citation(s) in RCA: 191] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Peripheral nerves possess the capacity of self-regeneration after traumatic injury. Transected peripheral nerves can be bridged by direct surgical coaptation of the two nerve stumps or by interposing autografts or biological (veins) or synthetic nerve conduits (NC). NC are tubular structures that guide the regenerating axons to the distal nerve stump. Early synthetic NC have primarily been made of silicone because of the relative flexibility and biocompatibility of this material and because medical-grade silicone tubes were readily available in various dimensions. Nowadays, NC are preferably made of biodegradable materials such as collagen, aliphatic polyesters, or polyurethanes. Although NC assist in guiding regenerating nerves, satisfactory functional restoration of severed nerves may further require exogenous growth factors. Therefore, authors have proposed NC with integrated delivery systems for growth factors or growth factor-producing cells. This article reviews the most important designs of NC with integrated delivery systems for localized release of growth factors. The various systems discussed comprise NC with growth factors being released from various types of matrices, from transplanted cells (Schwann cells or mesenchymal stem cells), or through genetic modification of cells naturally present at the site of injured tissue. Acellular delivery systems for growth factors include the NC wall itself, biodegradable microspheres seeded onto the internal surface of the NC wall, or matrices that are filled into the lumen of the NC and immobilize the growth factors through physical-chemical interactions or specific ligand-receptor interactions. A very promising and elegant system appears to be longitudinally aligned fibers inserted in the lumen of a NC that deliver the growth factors and provide additional guidance for Schwann cells and axons. This review also attempts to appreciate the most promising approaches and emphasize the importance of growth factor delivery kinetics.
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Affiliation(s)
- Lukas A Pfister
- Institute of Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland
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Marcol W, Kotulska K, Larysz-Brysz M, Kowalik JL. BDNF contributes to animal model neuropathic pain after peripheral nerve transection. Neurosurg Rev 2007; 30:235-43; discussion 243. [PMID: 17530308 DOI: 10.1007/s10143-007-0085-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2006] [Accepted: 03/04/2007] [Indexed: 10/23/2022]
Abstract
The outcome of peripheral nerve injury is often impaired by neuropathic pain, which is resistant to most analgesics and presents a serious clinical problem. The mechanisms underlying post-traumatic neuropathic pain remain unclear, but they are likely associated with the regeneration processes. Brain-derived neurotrophic factor (BDNF) is known to enhance peripheral nerve regeneration and is also considered to be an endogenous modulator of nociceptive responses following spinal cord lesion. The aim of this work was to examine the local effect of BDNF in a neuropathic pain model. Sciatic nerves of adult male rats were transected and supplied with connective tissue chambers filled with (1) fibrin only, (2) fibrin with BDNF, or (3) fibrin with antibodies against BDNF. In control animals the nerve was transected and no chamber was applied. During follow-up, autotomy behavior was assessed. Seven weeks after the operation, the number of surviving and regenerating neurons in dorsal root ganglia was counted and the neuroma incidence was examined. We found that local inactivation of BDNF decreased the incidence as well as severity of autotomy and neuroma formation, but did not influence neuron regeneration into the chambers. These results indicate that BDNF plays a locally crucial role in neuropathic pain development after peripheral nerve injury.
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Affiliation(s)
- Wiesław Marcol
- Department of Physiology, Medical University of Silesia, 18 Medyków St., 40-752, Katowice, Poland.
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