151
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Zhang L, Han Q, Chen S, Suo D, Zhang L, Li G, Zhao X, Yang Y. Soft hydrogel promotes dorsal root ganglion by upregulating gene expression of Ntn4 and Unc5B. Colloids Surf B Biointerfaces 2020; 199:111503. [PMID: 33338883 DOI: 10.1016/j.colsurfb.2020.111503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/24/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
Mechanical property is an important factor of cellular microenvironment for neural tissue regeneration. In this study, polyacrylamide (PAM) hydrogels with systematically varying elastic modulus were prepared using in situ radical polymerization. We found that the hydrogel was biocompatible, and the length of dorsal root ganglion (DRG)'s axon and cell density were optimal on the hydrogels with elastic modulus of 5.1 kPa (among hydrogels with elastic modulus between 3.6 kPa and 16.5 kPa). These DRGs also exhibited highest gene and protein expression of proliferation marker Epha4, Ntn4, Sema3D and differentiation marker Unc5B. Our study revealed the mechanism of how material stiffness affects DRG proliferation and differentiation. It will also provide theoretical basis and evidence for the design and development of nerve graft with better repair performance.
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Affiliation(s)
- Liling Zhang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, 226001, Nantong, PR China; Co-Innovation Center of Neuroregeneration, Nantong University, 226001, Nantong, PR China
| | - Qi Han
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, 226001, Nantong, PR China; Co-Innovation Center of Neuroregeneration, Nantong University, 226001, Nantong, PR China
| | - Shiyu Chen
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, 226001, Nantong, PR China; Co-Innovation Center of Neuroregeneration, Nantong University, 226001, Nantong, PR China
| | - Di Suo
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong Special Administrative Region
| | - Luzhong Zhang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, 226001, Nantong, PR China; Co-Innovation Center of Neuroregeneration, Nantong University, 226001, Nantong, PR China
| | - Guicai Li
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, 226001, Nantong, PR China; Co-Innovation Center of Neuroregeneration, Nantong University, 226001, Nantong, PR China; Key Laboratory of Organ Regeneration & Transplantation of the Ministry of Education, Jilin University, 130061, Changchun, PR China.
| | - Xin Zhao
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong Special Administrative Region.
| | - Yumin Yang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, 226001, Nantong, PR China; Co-Innovation Center of Neuroregeneration, Nantong University, 226001, Nantong, PR China.
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152
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Wang L, Lu C, Yang S, Sun P, Wang Y, Guan Y, Liu S, Cheng D, Meng H, Wang Q, He J, Hou H, Li H, Lu W, Zhao Y, Wang J, Zhu Y, Li Y, Luo D, Li T, Chen H, Wang S, Sheng X, Xiong W, Wang X, Peng J, Yin L. A fully biodegradable and self-electrified device for neuroregenerative medicine. SCIENCE ADVANCES 2020; 6:eabc6686. [PMID: 33310851 PMCID: PMC7732202 DOI: 10.1126/sciadv.abc6686] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/26/2020] [Indexed: 05/08/2023]
Abstract
Peripheral nerve regeneration remains one of the greatest challenges in regenerative medicine. Deprivation of sensory and/or motor functions often occurs with severe injuries even treated by the most advanced microsurgical intervention. Although electrical stimulation represents an essential nonpharmacological therapy that proved to be beneficial for nerve regeneration, the postoperative delivery at surgical sites remains daunting. Here, a fully biodegradable, self-electrified, and miniaturized device composed of dissolvable galvanic cells on a biodegradable scaffold is achieved, which can offer both structural guidance and electrical cues for peripheral nerve regeneration. The electroactive device can provide sustained electrical stimuli beyond intraoperative window, which can promote calcium activity, repopulation of Schwann cells, and neurotrophic factors. Successful motor functional recovery is accomplished with the electroactive device in behaving rodent models. The presented materials options and device schemes provide important insights into self-powered electronic medicine that can be critical for various types of tissue regeneration and functional restoration.
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Affiliation(s)
- Liu Wang
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Center for Flexible Electronics Technology, Tsinghua University, Beijing 100084, P. R. China
| | - Changfeng Lu
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - Shuhui Yang
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Center for Flexible Electronics Technology, Tsinghua University, Beijing 100084, P. R. China
| | - Pengcheng Sun
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Center for Flexible Electronics Technology, Tsinghua University, Beijing 100084, P. R. China
| | - Yu Wang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing 100853, P. R. China.
| | - Yanjun Guan
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - Shuang Liu
- School of Life Sciences, IDG/McGovern Institute for Brain Research at Tsinghua University, Tsinghua University, Beijing 100084, P. R. China
| | - Dali Cheng
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, and Beijing Innovation Center for Future Chips, Tsinghua University, Beijing 100084, P. R. China
| | - Haoye Meng
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - Qiang Wang
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, and Beijing Innovation Center for Future Chips, Tsinghua University, Beijing 100084, P. R. China
| | - Jianguo He
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Center for Flexible Electronics Technology, Tsinghua University, Beijing 100084, P. R. China
| | - Hanqing Hou
- School of Life Sciences, IDG/McGovern Institute for Brain Research at Tsinghua University, Tsinghua University, Beijing 100084, P. R. China
| | - Huo Li
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - Wei Lu
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - Yanxu Zhao
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - Jing Wang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - Yaqiong Zhu
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - Yunxuan Li
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Center for Flexible Electronics Technology, Tsinghua University, Beijing 100084, P. R. China
| | - Dong Luo
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - Tong Li
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing 100853, P. R. China
| | - Hao Chen
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Center for Flexible Electronics Technology, Tsinghua University, Beijing 100084, P. R. China
| | - Shirong Wang
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing 100081, P. R. China
| | - Xing Sheng
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, and Beijing Innovation Center for Future Chips, Tsinghua University, Beijing 100084, P. R. China
| | - Wei Xiong
- School of Life Sciences, IDG/McGovern Institute for Brain Research at Tsinghua University, Tsinghua University, Beijing 100084, P. R. China
| | - Xiumei Wang
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Center for Flexible Electronics Technology, Tsinghua University, Beijing 100084, P. R. China
| | - Jiang Peng
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing 100853, P. R. China.
| | - Lan Yin
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, Center for Flexible Electronics Technology, Tsinghua University, Beijing 100084, P. R. China.
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153
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The pudendal nerve motor branch regenerates via a brain derived neurotrophic factor mediated mechanism. Exp Neurol 2020; 334:113438. [DOI: 10.1016/j.expneurol.2020.113438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 01/13/2023]
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154
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Zavala A, Martinez PC, Gutierrez GG, Vara MD, Pawlikowski WD. The Combined Use of Curcumin and Platelet-Rich Plasma Enhances Axonal Regeneration in Acute Nerve Injuries: An Experimental Study in a Rat Model. J Hand Microsurg 2020; 15:31-36. [PMID: 36761053 PMCID: PMC9904982 DOI: 10.1055/s-0040-1721562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Introduction The aim of this study was to determine if the combined use of curcumin and platelet-rich plasma (PRP) improves the axonal regeneration process in acutely repaired nerve injuries. Materials and Methods The right sciatic nerves of 32 Holtzman albino rats were transected and immediately repaired. Four treatments were randomly allocated: (1) nerve repair only; (2) nerve repair + local PRP; (3) nerve repair + intraperitoneal curcumin; and (4) nerve repair + local PRP + intraperitoneal curcumin. Clinical (estimation of sciatic functional index) and electrophysiological outcomes were assessed 4 and 12 weeks after surgery, and histologic evaluations performed 12 weeks after surgery. Results Group IV (PRP + curcumin) resulted in significantly better outcomes across all the evaluation parameters, compared with the other three groups ( p < 0.05). Additionally, when used as single adjuvants, both the curcumin (group III) and PRP (group II) groups showed significant improvement over the control group ( p < 0.05). No significant differences were found between PRP and curcumin when used as sole adjuvants. Conclusion The combined administration of curcumin + PRP as adjuvants to nerve repair could enhance axonal regeneration in terms of clinical, electrophysiological, and histological parameters in a rat model of acute sciatic nerve injury.
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Affiliation(s)
- Abraham Zavala
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Instituto Nacional de Salud del Niño, San Borja, Lima, Peru,Address for correspondence Abraham Zavala, MD Instituto Nacional de Salud del NiñoSan Borja, Av. Agustin de la Rosa Toro 1399, San Borja, Lima 15023Peru
| | - Peggy C. Martinez
- Department of Neurology, Division of Neurophysiology, Instituto Nacional de Salud del Niño, San Borja, Lima, Peru
| | - Geovanna G. Gutierrez
- Department of Pathology, Instituto Nacional de Salud del Niño, San Borja, Lima, Peru
| | - Marino D. Vara
- Department of Experimental Surgery, Instituto Nacional de Salud del Niño, San Borja, Lima, Peru
| | - Wieslawa De Pawlikowski
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Instituto Nacional de Salud del Niño, San Borja, Lima, Peru
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155
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Fertala J, Rivlin M, Wang ML, Beredjiklian PK, Steplewski A, Fertala A. Collagen-rich deposit formation in the sciatic nerve after injury and surgical repair: A study of collagen-producing cells in a rabbit model. Brain Behav 2020; 10:e01802. [PMID: 32924288 PMCID: PMC7559634 DOI: 10.1002/brb3.1802] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/16/2020] [Accepted: 07/28/2020] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Posttraumatic scarring of peripheral nerves produces unwanted adhesions that block axonal growth. In the context of surgical nerve repair, the organization of the scar tissue adjacent to conduits used to span the gap between the stumps of transected nerves is poorly understood. The goal of this study was to elucidate the patterns of distribution of collagen-rich scar tissue and analyze the spatial organization of cells that produce fibrotic deposits around and within the conduit's lumen. METHODS Employing a rabbit model of sciatic nerve transection injury, we studied the formation of collagen-rich scar tissue both inside and outside conduits used to bridge the injury sites. Utilizing quantitative immunohistology and Fourier-transform infrared spectroscopy methods, we measured cellular and structural elements present in the extraneural and the intraneural scar of the proximal and distal nerve fragments. RESULTS Analysis of cells producing collagen-rich deposits revealed that alpha-smooth muscle actin-positive myofibroblasts were only present in the margins of the stumps. In contrast, heat shock protein 47-positive fibroblasts actively producing collagenous proteins were abundant within the entire scar tissue. The most prominent site of transected sciatic nerves with the highest number of cells actively producing collagen-rich scar was the proximal stump. CONCLUSION Our findings suggest the proximal region of the injury site plays a prominent role in pro-fibrotic processes associated with the formation of collagen-rich deposits. Moreover, they show that the role of canonical myofibroblasts in peripheral nerve regeneration is limited to wound contracture and that a distinct population of fibroblastic cells produce the collagenous proteins that form scar tissue. As scarring after nerve injury remains a clinical problem with poor outcomes due to incomplete nerve recovery, further elucidation of the cellular and spatial aspects of neural fibrosis will lead to more targeted treatments in the clinical setting.
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Affiliation(s)
- Jolanta Fertala
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Michael Rivlin
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.,Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Mark L Wang
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.,Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Pedro K Beredjiklian
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.,Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Andrzej Steplewski
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Andrzej Fertala
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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156
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Lien BV, Brown NJ, Ransom SC, Lehrich BM, Shahrestani S, Tafreshi AR, Ransom RC, Sahyouni R. Enhancing peripheral nerve regeneration with neurotrophic factors and bioengineered scaffolds: A basic science and clinical perspective. J Peripher Nerv Syst 2020; 25:320-334. [DOI: 10.1111/jns.12414] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Brian V. Lien
- School of Medicine University of California Irvine California USA
| | - Nolan J. Brown
- School of Medicine University of California Irvine California USA
| | - Seth C. Ransom
- College of Medicine University of Arkansas for Medical Sciences Little Rock Arkansas USA
| | - Brandon M. Lehrich
- Department of Biomedical Engineering University of California Irvine California USA
| | - Shane Shahrestani
- Keck School of Medicine University of Southern California Los Angeles California USA
- Department of Medical Engineering California Institute of Technology Pasadena California USA
| | - Ali R. Tafreshi
- Department of Neurological Surgery Geisinger Health System Danville Pennsylvania USA
| | - Ryan C. Ransom
- Department of Neurological Surgery Mayo Clinic Rochester Minnesota USA
| | - Ronald Sahyouni
- Department of Neurological Surgery University of California San Diego California USA
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157
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Stewart CE, Kan CFK, Stewart BR, Sanicola HW, Jung JP, Sulaiman OAR, Wang D. Machine intelligence for nerve conduit design and production. J Biol Eng 2020; 14:25. [PMID: 32944070 PMCID: PMC7487837 DOI: 10.1186/s13036-020-00245-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/13/2020] [Indexed: 02/08/2023] Open
Abstract
Nerve guidance conduits (NGCs) have emerged from recent advances within tissue engineering as a promising alternative to autografts for peripheral nerve repair. NGCs are tubular structures with engineered biomaterials, which guide axonal regeneration from the injured proximal nerve to the distal stump. NGC design can synergistically combine multiple properties to enhance proliferation of stem and neuronal cells, improve nerve migration, attenuate inflammation and reduce scar tissue formation. The aim of most laboratories fabricating NGCs is the development of an automated process that incorporates patient-specific features and complex tissue blueprints (e.g. neurovascular conduit) that serve as the basis for more complicated muscular and skin grafts. One of the major limitations for tissue engineering is lack of guidance for generating tissue blueprints and the absence of streamlined manufacturing processes. With the rapid expansion of machine intelligence, high dimensional image analysis, and computational scaffold design, optimized tissue templates for 3D bioprinting (3DBP) are feasible. In this review, we examine the translational challenges to peripheral nerve regeneration and where machine intelligence can innovate bottlenecks in neural tissue engineering.
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Affiliation(s)
- Caleb E. Stewart
- Current Affiliation: Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport Louisiana, USA
| | - Chin Fung Kelvin Kan
- Current Affiliation: Department of General Surgery, Brigham and Women’s Hospital, Boston, MA 02115 USA
| | - Brody R. Stewart
- Current Affiliation: Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Henry W. Sanicola
- Current Affiliation: Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport Louisiana, USA
| | - Jangwook P. Jung
- Department of Biological Engineering, Louisiana State University, Baton Rouge, LA 70803 USA
| | - Olawale A. R. Sulaiman
- Ochsner Neural Injury & Regeneration Laboratory, Ochsner Clinic Foundation, New Orleans, LA 70121 USA
- Department of Neurosurgery, Ochsner Clinic Foundation, New Orleans, 70121 USA
| | - Dadong Wang
- Quantitative Imaging Research Team, Data 61, Commonwealth Scientific and Industrial Research Organization, Marsfield, NSW 2122 Australia
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158
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Miclescu A, Straatmann A, Gkatziani P, Butler S, Karlsten R, Gordh T. Chronic neuropathic pain after traumatic peripheral nerve injuries in the upper extremity: prevalence, demographic and surgical determinants, impact on health and on pain medication. Scand J Pain 2020; 20:95-108. [PMID: 31536038 DOI: 10.1515/sjpain-2019-0111] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 08/23/2019] [Indexed: 01/10/2023]
Abstract
Background and aims Aside from the long term side effects of a nerve injury in the upper extremity with devastating consequences there is often the problem of chronic neuropathic pain. The studies concerning the prevalence of persistent pain of neuropathic origin after peripheral nerve injuries are sparse. The prevalence and risk factors associated with chronic neuropathic pain after nerve injuries in the upper extremity were assessed. Methods A standardized data collection template was employed prospectively and retrospectively for all patients with traumatic nerve injuries accepted at the Hand Surgery Department, Uppsala, Sweden between 2010 and 2018. The template included demographic data, pain diagnosis, type of injured nerve, level of injury, date of the lesion and repair, type of procedure, reoperation, time since the procedure, S-LANSS questionnaire (Self report-Leeds Assessment of Neuropathic Symptoms and Signs), RAND-36 (Item short form health survey), QuickDASH (Disability of Shoulder, Arm and Hand) and additional questionnaires concerned medication, pain intensity were sent to 1,051 patients with nerve injuries. Partial proportional odds models were used to investigate the association between persistent pain and potential predictors. Results More than half of the patients undergoing a surgical procedure developed persistent pain. Prevalence of neuropathic pain was 73% of the patients with pain (S-LANSS ≥ 12 or more). Multivariate analysis indicated that injury of a major nerve OR 1.6 (p = 0.013), years from surgery OR 0.91 (p = 0.01), younger age OR 0.7 (p < 0.001), were the main factors for predicting pain after surgery. The type of the nerve injured was the strongest predictor for chronic pain with major nerves associated with more pain (p = 0.019). Conclusions A high prevalence of chronic pain and neuropathic pain with a negative impact on quality of life and disability were found in patients after traumatic nerve injury. Major nerve injury, younger age and less time from surgery were predictors for chronic pain.
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Affiliation(s)
- Adriana Miclescu
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Antje Straatmann
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Stephen Butler
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Rolf Karlsten
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Torsten Gordh
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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159
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Lee JI, Hur JM, You J, Lee DH. Functional recovery with histomorphometric analysis of nerves and muscles after combination treatment with erythropoietin and dexamethasone in acute peripheral nerve injury. PLoS One 2020; 15:e0238208. [PMID: 32881928 PMCID: PMC7470391 DOI: 10.1371/journal.pone.0238208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022] Open
Abstract
Introduction Peripheral nerve injury (PNI) often leads to significant functional loss in patients and poses a challenge to physicians since treatment options for improving functional outcomes are limited. Recent studies suggest that erythropoietin and glucocoticoids have beneficial effects as mediators of neuro-regenerative processes. We hypothesized that combination treatment with erythropoietin and glucocoticoids would have a synergistic effect on functional outcome after PNI. Materials and methods Sciatic nerve crush injury was simulated in ten-week-old male C57BL/6 mice. The mice were divided into four groups according to the type of drugs administered (control, erythropoietin, dexamethasone, and erythropoietin with dexamethasone). Motor functional recovery was monitored by walking track analysis at serial time points up to 28 days after injury. Morphological analysis of the nerve was performed by immunofluorescent staining for neurofilament (NF) heavy chain and myelin protein zero (P0) in cross-sectional and whole-mount nerve preparations. Additionally, morphological analysis of the muscle was performed by Hematoxylin and eosin staining. Results Combination treatment with erythropoietin and dexamethasone significantly improved the sciatic functional index at 3, 7, 14, and 28 days after injury. Fluorescence microscopy of cross sectional nerve revealed that the combination treatment increased the ratio of P0/NF-expressing axons. Furthermore, confocal microscopy of the whole-mount nerve revealed that the combination treatment increased the fluorescence intensity of P0 expression. The cross-sectional area and minimum Feret’s diameter of the muscle fibers were significantly larger in the mice which received combination treatment than those in the controls. Conclusion Our results demonstrated that combination treatment with erythropoietin and dexamethasone accelerates functional recovery and reduces neurogenic muscle atrophy caused by PNI in mice, which may be attributed to the preservation of myelin and Schwann cell re-myelination. These findings may provide practical therapeutic options for patients with acute PNI.
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Affiliation(s)
- Jung Il Lee
- Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, South Korea
- College of Medicine, Hanyang University, Seoul, South Korea
- * E-mail:
| | - Jeong Min Hur
- Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, South Korea
| | - Jooyoung You
- Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, South Korea
| | - Duk Hee Lee
- Department of Emergency Medicine, Ewha Women's University Mokdong Hospital, Seoul, South Korea
- College of Medicine, Ewha Women's University, Seoul, South Korea
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160
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Limonene, a food additive, and its active metabolite perillyl alcohol improve regeneration and attenuate neuropathic pain after peripheral nerve injury: Evidence for IL-1β, TNF-α, GAP, NGF and ERK involvement. Int Immunopharmacol 2020; 86:106766. [DOI: 10.1016/j.intimp.2020.106766] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/25/2020] [Accepted: 06/29/2020] [Indexed: 12/14/2022]
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161
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Sensory profiles and immune-related expression patterns of patients with and without neuropathic pain after peripheral nerve lesion. Pain 2020; 160:2316-2327. [PMID: 31145221 DOI: 10.1097/j.pain.0000000000001623] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In this multicenter cross-sectional study, we determined sensory profiles of patients with (NL-1) and without neuropathic pain (NL-0) after nerve lesion and assessed immune-related systemic gene expression. Patients and matched healthy controls filled in questionnaires and underwent neurological examination, neurophysiological studies, quantitative sensory testing, and blood withdrawal. Neuropathic pain was present in 67/95 (71%) patients (NL-1). Tactile hyperalgesia was the most prominent clinical sign in NL-1 patients (P < 0.05). Questionnaires showed an association between neuropathic pain and the presence of depression, anxiety, and catastrophizing (P < 0.05 to P < 0.01). Neuropathic pain was frequently accompanied by other chronic pain (P < 0.05). Quantitative sensory testing showed ipsilateral signs of small and large fiber impairment compared to the respective contralateral side, with elevated thermal and mechanical detection thresholds (P < 0.001 to P < 0.05) and lowered pressure pain threshold (P < 0.05). Also, more loss of function was found in patients with NL-1 compared to NL-0. Pain intensity was associated with mechanical hyperalgesia (P < 0.05 to P < 0.01). However, quantitative sensory testing did not detect or predict neuropathic pain. Gene expression of peptidylglycine α-amidating monooxygenase was higher in NL patients compared with healthy controls (NL-1, P < 0.01; NL-0, P < 0.001). Also, gene expression of tumor necrosis factor-α was higher in NL-1 patients compared with NL-0 (P < 0.05), and interleukin-1ß was higher, but IL-10 was lower in NL-1 patients compared with healthy controls (P < 0.05 each). Our study reveals that nerve lesion presents with small and large nerve fiber dysfunction, which may contribute to the presence and intensity of neuropathic pain and which is associated with a systemic proinflammatory pattern.
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162
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Wang JB, Zhang Z, Li JN, Yang T, Du S, Cao RJ, Cui SS. SPP1 promotes Schwann cell proliferation and survival through PKCα by binding with CD44 and αvβ3 after peripheral nerve injury. Cell Biosci 2020; 10:98. [PMID: 32843960 PMCID: PMC7439540 DOI: 10.1186/s13578-020-00458-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/05/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Schwann cells (SCs) play a crucial role in Wallerian degeneration after peripheral nerve injury. The expression of genes in SCs undergo a series of changes, which greatly affect the proliferation and apoptosis of SCs as well as the fate of peripheral nerve regeneration. However, how do these genes regulate the proliferation and apoptosis of SCs remains unclear. RESULTS SPP1 and PKCα were found upregulated after human median peripheral nerve injury, which promoted SCs proliferation and survival. The promoted proliferation and inhibited apoptosis by SPP1 were blocked after the treatment of PKCα antagonist Gö6976. Whereas, the inhibited proliferation and enhanced apoptosis induced by silence of SPP1 could be rescued by the activation of PKCα, which suggested that SPP1 functioned through PKCα. Moreover, both CD44 and αvβ3 were found expressed in SCs and increased after peripheral nerve injury. Silence of CD44 or β3 alleviated the increased proliferation and inhibited apoptosis induced by recombinant osteopontin, suggesting the function of SPP1 on SCs were dependent on CD44 and β3. CONCLUSION These results suggested that SPP1 promoted proliferation and inhibited apoptosis of SCs through PKCα signaling pathway by binding with CD44 and αvβ3. This study provides a potential therapeutic target for improving peripheral nerve recovery.
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Affiliation(s)
- Jiang-Bo Wang
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130033 China
| | - Zhan Zhang
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130033 China
| | - Jian-Nan Li
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130033 China
| | - Tuo Yang
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130033 China
| | - Shuang Du
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130033 China
| | - Rang-Juan Cao
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130033 China
| | - Shu-Sen Cui
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130033 China
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163
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Smaila BD, Holland SD, Babaeijandaghi F, Henderson HG, Rossi FMV, Ramer MS. Systemic hypoxia mimicry enhances axonal regeneration and functional recovery following peripheral nerve injury. Exp Neurol 2020; 334:113436. [PMID: 32814068 DOI: 10.1016/j.expneurol.2020.113436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/28/2020] [Accepted: 08/13/2020] [Indexed: 01/15/2023]
Abstract
Despite the ability of peripheral nerves to regenerate after injury, failure occurs due to an inability of supporting cells to maintain growth, resulting in long-term consequences such as sensorimotor dysfunction and neuropathic pain. Here, we investigate the potential of engaging the cellular adaptive response to hypoxia, via inhibiting its negative regulators, to enhance the regenerative process. Under normoxic conditions, prolyl hydroxylase domain (PHD) proteins 1, 2, and 3 hydroxylate the key metabolic regulator hypoxia inducible factor 1α (HIF1α), marking it for subsequent proteasomal degradation. We inhibited PHD protein function systemically via either individual genetic deletion or pharmacological pan-PHD inhibition using dimethyloxalylglycine (DMOG). We show enhanced axonal regeneration after sciatic nerve crush injury in PHD1-/- mice, PHD3-/- mice, and in DMOG-treated mice, and in PHD1-/- and DMOG-treated mice a reduction in hypersensitivity to cooling after permanent sciatic ligation. Electromyographically, PHD1-/- and PHD3-/- mice showed an increased CMAP amplitude one-month post-injury, probably due to protection against denervation induced muscle atrophy, while DMOG-treated and PHD2+/- mice showed reduced latencies, indicating improved motor axon function. DMOG treatment did not affect the growth of dorsal root ganglion neurites in vitro, suggesting a lack of direct effects of DMOG on axonal regrowth. Enhanced regeneration in vivo was concurrent with an increase in macrophage density, and a shift in macrophage polarization state ratios (from M1-like toward M2-like) in DMOG-treated animals. These results indicate PHD proteins as a novel therapeutic target to improve regenerative and functional outcomes after peripheral nerve injury without manipulating molecular O2.
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Affiliation(s)
- Brittney D Smaila
- International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, 818 West 10(th) Ave, Vancouver, BC V5Z1M9, Canada
| | - Seth D Holland
- International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, 818 West 10(th) Ave, Vancouver, BC V5Z1M9, Canada
| | - Farshad Babaeijandaghi
- The Biomedical Research Centre, The University of British Columbia, 2222 Health Sciences Mall, Vancouver, BC V6T1Z3, Canada
| | - Holly G Henderson
- International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, 818 West 10(th) Ave, Vancouver, BC V5Z1M9, Canada
| | - Fabio M V Rossi
- The Biomedical Research Centre, The University of British Columbia, 2222 Health Sciences Mall, Vancouver, BC V6T1Z3, Canada
| | - Matt S Ramer
- International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, 818 West 10(th) Ave, Vancouver, BC V5Z1M9, Canada.
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164
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Tang W, Zhang X, Sun Y, Yao B, Chen X, Chen X, Gao X. Quantitative Assessment of Traumatic Upper-Limb Peripheral Nerve Injuries Using Surface Electromyography. Front Bioeng Biotechnol 2020; 8:795. [PMID: 32766224 PMCID: PMC7379167 DOI: 10.3389/fbioe.2020.00795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/22/2020] [Indexed: 11/13/2022] Open
Abstract
Background There is a great demand for convenient and quantitative assessment of upper-limb traumatic peripheral nerve injuries (PNIs) beyond their clinical routine. This would contribute to improved PNI management and rehabilitation. Objective The aim of this study was to develop a novel surface EMG examination method for quantitatively evaluating traumatic upper-limb PNIs. Methods Experiments were conducted to collect surface EMG data from forearm muscles on both sides of seven male subjects during their performance of eight designated hand and wrist motion tasks. All participants were clinically diagnosed as unilateral traumatic upper-limb PNIs on the ulnar nerve, median nerve, or radial nerve. Ten healthy control participants were also enrolled in the study. A novel framework consisting of two modules was also proposed for data analysis. One module was first used to identify whether a PNI occurs on a tested forearm using a machine learning algorithm by extracting and classifying features from surface EMG data. The second module was then used to quantitatively evaluate the degree of injury on three individual nerves on the examined arm. Results The evaluation scores yielded by the proposed method were highly consistent with the clinical assessment decisions for three nerves of all 34 examined arms (7 × 2 + 10 × 2), with a sensitivity of 81.82%, specificity of 98.90%, and significate linear correlation (p < 0.05) in quantitative decision points between the proposed method and the routine clinical approach. Conclusion This study offers a useful tool for PNI assessment and helps to promote extensive clinical applications of surface EMG.
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Affiliation(s)
- Weidi Tang
- School of Information Science and Technology, University of Science and Technology of China, Hefei, China
| | - Xu Zhang
- School of Information Science and Technology, University of Science and Technology of China, Hefei, China
| | - Yong Sun
- Institute of Criminal Sciences, Hefei Public Security Bureau, Hefei, China
| | - Bo Yao
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Xiang Chen
- School of Information Science and Technology, University of Science and Technology of China, Hefei, China
| | - Xun Chen
- School of Information Science and Technology, University of Science and Technology of China, Hefei, China
| | - Xiaoping Gao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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165
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Fregnan F, Muratori L, Bassani GA, Crosio A, Biagiotti M, Vincoli V, Carta G, Pierimarchi P, Geuna S, Alessandrino A, Freddi G, Ronchi G. Preclinical Validation of SilkBridge TM for Peripheral Nerve Regeneration. Front Bioeng Biotechnol 2020; 8:835. [PMID: 32850714 PMCID: PMC7426473 DOI: 10.3389/fbioe.2020.00835] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/29/2020] [Indexed: 12/19/2022] Open
Abstract
Silk fibroin (Bombyx mori) was used to manufacture a nerve conduit (SilkBridgeTM) characterized by a novel 3D architecture. The wall of the conduit consists of two electrospun layers (inner and outer) and one textile layer (middle), perfectly integrated at the structural and functional level. The manufacturing technology conferred high compression strength on the device, thus meeting clinical requirements for physiological and pathological compressive stresses. As demonstrated in a previous work, the silk material has proven to be able to provide a valid substrate for cells to grow on, differentiate and start the fundamental cellular regenerative activities in vitro and, in vivo, at the short time point of 2 weeks, to allow the starting of regenerative processes in terms of good integration with the surrounding tissues and colonization of the wall layers and of the lumen with several cell types. In the present study, a 10 mm long gap in the median nerve was repaired with 12 mm SilkBridgeTM conduit and evaluated at middle (4 weeks) and at longer time points (12 and 24 weeks). The SilkBridgeTM conduit led to a very good functional and morphological recovery of the median nerve, similar to that observed with the reference autograft nerve reconstruction procedure. Taken together, all these results demonstrated that SilkBridgeTM has an optimized balance of biomechanical and biological properties, which allowed proceeding with a first-in-human clinical study aimed at evaluating safety and effectiveness of using the device for the reconstruction of digital nerve defects in humans.
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Affiliation(s)
- Federica Fregnan
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Neuroscience Institute Cavalieri Ottolenghi, University of Turin, Turin, Italy
| | - Luisa Muratori
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Neuroscience Institute Cavalieri Ottolenghi, University of Turin, Turin, Italy
| | | | - Alessandro Crosio
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Department of Orthopaedics and Traumatology for Hand, ASST Gaetano Pini, Milan, Italy
| | | | | | - Giacomo Carta
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Neuroscience Institute Cavalieri Ottolenghi, University of Turin, Turin, Italy
| | | | - Stefano Geuna
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Neuroscience Institute Cavalieri Ottolenghi, University of Turin, Turin, Italy
| | | | | | - Giulia Ronchi
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Neuroscience Institute Cavalieri Ottolenghi, University of Turin, Turin, Italy
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166
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Shen YY, Gu XK, Zhang RR, Qian TM, Li SY, Yi S. Biological characteristics of dynamic expression of nerve regeneration related growth factors in dorsal root ganglia after peripheral nerve injury. Neural Regen Res 2020; 15:1502-1509. [PMID: 31997815 PMCID: PMC7059586 DOI: 10.4103/1673-5374.274343] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 06/21/2019] [Accepted: 09/20/2019] [Indexed: 01/23/2023] Open
Abstract
The regenerative capacity of peripheral nerves is limited after nerve injury. A number of growth factors modulate many cellular behaviors, such as proliferation and migration, and may contribute to nerve repair and regeneration. Our previous study observed the dynamic changes of genes in L4-6 dorsal root ganglion after rat sciatic nerve crush using transcriptome sequencing. Our current study focused on upstream growth factors and found that a total of 19 upstream growth factors were dysregulated in dorsal root ganglions at 3, 9 hours, 1, 4, or 7 days after nerve crush, compared with the 0 hour control. Thirty-six rat models of sciatic nerve crush injury were prepared as described previously. Then, they were divided into six groups to measure the expression changes of representative genes at 0, 3, 9 hours, 1, 4 or 7 days post crush. Our current study measured the expression levels of representative upstream growth factors, including nerve growth factor, brain-derived neurotrophic factor, fibroblast growth factor 2 and amphiregulin genes, and explored critical signaling pathways and biological process through bioinformatic analysis. Our data revealed that many of these dysregulated upstream growth factors, including nerve growth factor, brain-derived neurotrophic factor, fibroblast growth factor 2 and amphiregulin, participated in tissue remodeling and axon growth-related biological processes Therefore, the experiment described the expression pattern of upstream growth factors in the dorsal root ganglia after peripheral nerve injury. Bioinformatic analysis revealed growth factors that may promote repair and regeneration of damaged peripheral nerves. All animal surgery procedures were performed in accordance with Institutional Animal Care Guidelines of Nantong University and ethically approved by the Administration Committee of Experimental Animals, China (approval No. 20170302-017) on March 2, 2017.
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Affiliation(s)
- Yin-Ying Shen
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
| | - Xiao-Kun Gu
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
- Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Rui-Rui Zhang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
| | - Tian-Mei Qian
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
| | - Shi-Ying Li
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
| | - Sheng Yi
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
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167
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Bhandari L, Fleissig Y, Hoey R, Beare JE, Yarberry C, Yoshida S, Tsai TM. Comparison of End-to-End Technique, Helicoid Technique, and Modified Helicoid Weave Repair Technique in a Rat Sciatic Nerve Model: A Pilot Study. Cureus 2020; 12:e9196. [PMID: 32821552 PMCID: PMC7429665 DOI: 10.7759/cureus.9196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The gold standard for nerve repair is end-to-end (ETE) repair. Helicoid technique (HT) has also been previously described. In this pilot study, HT was compared to ETE and a modified helicoid weave technique (MHWT). In MHWT, recipient nerve is passed through rather than around the donor nerve, allowing for greater nerve-to-nerve interaction. Methods Eighteen adult male Lewis rats received a 2-cm sciatic nerve transection and were divided into three groups: ETE, HT, and MHWT. Five months later, electromyography (EMG), tetanic force of contraction, and wet weight of the extensor digitorum longus muscle were recorded in both the operated and non-operated sides. Nerve biopsies were taken proximal and distal to the site of the nerve graft for histological examination. Results One rat died following repair surgery and three rats died during the second surgery. The mean threshold of stimulation for ETE, HT, and MHWT were 183.3 µA, 3707.5 µA, and 656.6 µA, respectively. EMG analysis revealed that latency and duration are both affected by surgical repair type and injured or uninjured conditions. Threshold ratio (injured:non-injured) revealed pilot-level significant differences between HT and both MHWT (p = 0.069) and ETE (p = 0.082). Nerve biopsy demonstrated fascicles distally in all three groups. Conclusions While HT and MHWT function as a nerve repair technique, they are not superior to ETE. ETE remains the gold standard for nerve repair. While mean values were in favor of ETE, no statistical significance was attained.
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Affiliation(s)
| | - Yoram Fleissig
- Hand and Microsurgery, Christine M. Kleinert Institute, Louisville, USA
| | - Robert Hoey
- Anatomical Sciences & Neurobiology, University of Louisville, Louisville, USA
| | - Jason E Beare
- Medicine, Cardiovascular Innovation Institute, University of Louisville, Louisville, USA.,Medicine, Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, USA
| | - Christine Yarberry
- Neurological Surgery, Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, USA
| | - Shiro Yoshida
- Hand and Microsurgery, Christine M. Kleinert Institute, Louisville, USA
| | - Tsu-Min Tsai
- Hand and Microsurgery, Christine M. Kleinert Institute, Louisville, USA
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168
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Diffusion Magnetic Resonance Imaging Predicts Peripheral Nerve Recovery in a Rat Sciatic Nerve Injury Model. Plast Reconstr Surg 2020; 145:949-956. [PMID: 32221212 DOI: 10.1097/prs.0000000000006638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nerve regeneration after an injury should occur in a timely fashion for function to be restored. Current methods cannot monitor regeneration prior to muscle reinnervation. Diffusion tensor imaging has been previously shown to provide quantitative indices after nerve recovery. The goal of this study was to validate the use of this technology following nerve injury via a series of rat sciatic nerve injury/repair studies. METHODS Sprague-Dawley rats were prospectively divided by procedure (sham, crush, or cut/repair) and time points (1, 2, 4, and 12 weeks after surgery). At the appropriate time point, each animal was euthanized and the sciatic nerve was harvested and fixed. Data were obtained using a 7-Tesla magnetic resonance imaging system. For validation, findings were compared to behavioral testing (foot fault asymmetry and sciatic function index) and cross-sectional axonal counting of toluidine blue-stained sections examined under light microscopy. RESULTS Sixty-three rats were divided into three treatment groups (sham, n = 21; crush, n = 23; and cut/repair, n = 19). Fractional anisotropy was able to differentiate between recovery following sham, crush, and cut/repair injuries as early as 2 weeks (p < 0.05), with more accurate differentiation thereafter. More importantly, the difference in anisotropy between distal and proximal regions recognized animals with successful and failed recoveries according to behavioral analysis, especially at 12 weeks. In addition, diffusion tension imaging-based tractography provided a visual representation of nerve continuity in all treatment groups. CONCLUSIONS Diffuse tensor imaging is an objective and noninvasive tool for monitoring nerve regeneration. Its use could facilitate earlier detection of failed repairs to potentially help improve outcomes.
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169
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Zuo KJ, Gordon T, Chan KM, Borschel GH. Electrical stimulation to enhance peripheral nerve regeneration: Update in molecular investigations and clinical translation. Exp Neurol 2020; 332:113397. [PMID: 32628968 DOI: 10.1016/j.expneurol.2020.113397] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/16/2020] [Accepted: 06/27/2020] [Indexed: 02/06/2023]
Abstract
Peripheral nerve injuries are common and frequently result in incomplete functional recovery even with optimal surgical treatment. Permanent motor and sensory deficits are associated with significant patient morbidity and socioeconomic burden. Despite substantial research efforts to enhance peripheral nerve regeneration, few effective and clinically feasible treatment options have been found. One promising strategy is the use of low frequency electrical stimulation delivered perioperatively to an injured nerve at the time of surgical repair. Possibly through its effect of increasing intraneuronal cyclic AMP, perioperative electrical stimulation accelerates axon outgrowth, remyelination of regenerating axons, and reinnervation of end organs, even with delayed surgical intervention. Building on decades of experimental evidence in animal models, several recent, prospective, randomized clinical trials have affirmed electrical stimulation as a clinically translatable technique to enhance functional recovery in patients with peripheral nerve injuries requiring surgical treatment. This paper provides an updated review of the cellular physiology of electrical stimulation and its effects on axon regeneration, Level I evidence from recent prospective randomized clinical trials of electrical stimulation, and ongoing and future directions of research into electrical stimulation as a clinically feasible adjunct to surgical intervention in the treatment of patients with peripheral nerve injuries.
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Affiliation(s)
- Kevin J Zuo
- Division of Plastic & Reconstructive Surgery, University of Toronto, Toronto, ON, Canada; Neurosciences and Mental Health, SickKids Research Institute, Hospital for Sick Children, Toronto, ON, Canada
| | - Tessa Gordon
- Division of Plastic & Reconstructive Surgery, University of Toronto, Toronto, ON, Canada; Neurosciences and Mental Health, SickKids Research Institute, Hospital for Sick Children, Toronto, ON, Canada
| | - K Ming Chan
- Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Gregory H Borschel
- Division of Plastic & Reconstructive Surgery, University of Toronto, Toronto, ON, Canada; Neurosciences and Mental Health, SickKids Research Institute, Hospital for Sick Children, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
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170
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Donsante A, Xue J, Poth KM, Hardcastle NS, Diniz B, O'Connor DM, Xia Y, Boulis NM. Controlling the Release of Neurotrophin-3 and Chondroitinase ABC Enhances the Efficacy of Nerve Guidance Conduits. Adv Healthc Mater 2020; 9:e2000200. [PMID: 32548984 PMCID: PMC7751830 DOI: 10.1002/adhm.202000200] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/30/2020] [Indexed: 12/16/2022]
Abstract
Nerve guidance conduits (NGCs) have the potential to replace autografts in repairing peripheral nerve injuries, but their efficacy still needs to be improved. The efficacy of NGCs is augmented by neurotrophic factors that promote axon growth and by enzymes capable of degrading molecules that inhibit axon growth. In the current study, two types of NGCs loaded with factors (both neurotrophin-3 and chondroitinase ABC) are constructed and their abilities to repair an 8 mm gap in the rat sciatic nerve are examined. The factors are encapsulated in microparticles made of a phase-change material (PCM) or collagen and then sandwiched between two layers of electrospun fibers. The use of PCM allows to achieve pulsed release of the factors upon irradiation with a near-infrared laser. The use of collagen enables slow, continuous release via diffusion. The efficacy is evaluated by measuring compound muscle action potentials (CMAP) in the gastrocnemius muscle and analyzing the nerve histology. Continuous release of the factors from collagen results in enhanced CMAP amplitude and increased axon counts in the distal nerve relative to the plain conduit. In contrast, pulsed release of the same factors from PCM shows a markedly adverse impact on the efficacy, possibly by inhibiting axon growth.
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Affiliation(s)
- Anthony Donsante
- Department of Neurosurgery, Emory University, Atlanta, GA, 30322, USA
| | - Jiajia Xue
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
| | - Kelly M Poth
- Department of Neurosurgery, Emory University, Atlanta, GA, 30322, USA
| | | | - Bruna Diniz
- Department of Neurosurgery, Emory University, Atlanta, GA, 30322, USA
| | | | - Younan Xia
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Nicholas M Boulis
- Department of Neurosurgery, Emory University, Atlanta, GA, 30322, USA
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171
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Romeo-Guitart D, Leiva-Rodríguez T, Casas C. SIRT2 Inhibition Improves Functional Motor Recovery After Peripheral Nerve Injury. Neurotherapeutics 2020; 17:1197-1211. [PMID: 32323205 PMCID: PMC7609484 DOI: 10.1007/s13311-020-00860-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Sirtuin-2 (Sirt2) is a member of the NAD (+)-dependent protein deacetylase family involved in neuroprotection, cellular metabolism, homeostasis, and stress responses after injury of the nervous system. So far, no data have been published describing the role of SIRT2 in motor functional recovery after damage. We found that SIRT2 expression and deacetylase activity were increased within motoneurons after axotomy. To shed light onto the biological relevance of this change, we combined in vitro and in vivo models with pharmacological and genetic ablation approaches. We found that SIRT2 KO (knockout) mice exhibited improved functional recovery after sciatic nerve crush. SIRT2 activity blockage, using AK7, increased neurite outgrowth and length in organotypic spinal cord cultures and human cell line models. SIRT2 blockage enhanced the acetyltransferase activity of p300, which in turn increased the levels of an acetylated form of p53 (Ac-p53 k373), histone 3 (Ac-H3K9), and expression of GAP43, a downstream marker of regeneration. Lastly, we verified that p300 acetyltransferase activity is essential for these effects. Our results suggest that bolstering an epigenetic shift that promotes SIRT2 inhibition can be an effective therapy to increase functional recovery after peripheral nerve injury.
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Affiliation(s)
- David Romeo-Guitart
- Institut de Neurociències (INc) and Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
| | - Tatiana Leiva-Rodríguez
- Institut de Neurociències (INc) and Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
| | - Caty Casas
- Institut de Neurociències (INc) and Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain.
- Unitat de Fisiologia Mèdica, Facultat de Medicina, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Barcelona, Spain.
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172
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Apsite I, Constante G, Dulle M, Vogt L, Caspari A, Boccaccini AR, Synytska A, Salehi S, Ionov L. 4D Biofabrication of fibrous artificial nerve graft for neuron regeneration. Biofabrication 2020; 12:035027. [DOI: 10.1088/1758-5090/ab94cf] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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173
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Jaswal R, Shrestha S, Shrestha BK, Kumar D, Park CH, Kim CS. Nanographene enfolded AuNPs sophisticatedly synchronized polycaprolactone based electrospun nanofibre scaffold for peripheral nerve regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 116:111213. [PMID: 32806222 DOI: 10.1016/j.msec.2020.111213] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/15/2020] [Accepted: 06/18/2020] [Indexed: 12/12/2022]
Abstract
Herein, we report the bioactivity of monodispersed nanosized reduced graphene oxide (RGO) enfolded gold nanoparticles (AuNPs) engineered polycaprolactone (PCL) based electrospun composite scaffolds. The 2D patterns of PCL based nanofibers prepared by the homogenous distribution of RGO-AuNPs exhibited unique topological and biological features such as mechanical properties, porous structure, large surface area, high electrical conductivity, biodegradability, and resemble the natural extracellular matrix (ECM) that supports the adhesion, growth, proliferation, and differentiation of stem cells. The prepared composite nanofibers based scaffolds containing RGO-AuNPs accelerated neuronal cell functions and confirmed that the optimized concentration showed cytocompatibility to PC12 and S42 cells. The 0.0005 wt% loading of RGO-AuNPs on PCL has a huge impact on neurite growth which leads to an almost one-fold increase in neurite length growth. The present study provides a new strategic design of highly efficient scaffolds that have a significant direct impact on cell activity and could be a potential bioimplant for peripheral nerve repair.
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Affiliation(s)
- Richa Jaswal
- Department of Bionanosystem Engineering, Graduate School, Jeonbuk National University, Jeonju 561-756, South Korea; Division of Mechanical Design Engineering, Jeonbuk National University, Jeonju 561-756, South Korea
| | - Sita Shrestha
- Department of Bionanosystem Engineering, Graduate School, Jeonbuk National University, Jeonju 561-756, South Korea
| | - Bishnu Kumar Shrestha
- Department of Bionanosystem Engineering, Graduate School, Jeonbuk National University, Jeonju 561-756, South Korea.
| | - Dinesh Kumar
- Department of Bionanosystem Engineering, Graduate School, Jeonbuk National University, Jeonju 561-756, South Korea.
| | - Chan Hee Park
- Department of Bionanosystem Engineering, Graduate School, Jeonbuk National University, Jeonju 561-756, South Korea; Division of Mechanical Design Engineering, Jeonbuk National University, Jeonju 561-756, South Korea.
| | - Cheol Sang Kim
- Department of Bionanosystem Engineering, Graduate School, Jeonbuk National University, Jeonju 561-756, South Korea; Division of Mechanical Design Engineering, Jeonbuk National University, Jeonju 561-756, South Korea.
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174
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A Nanofiber Sheet Incorporating Vitamin B12 Promotes Nerve Regeneration in a Rat Neurorrhaphy Model. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 7:e2538. [PMID: 32537295 PMCID: PMC7288885 DOI: 10.1097/gox.0000000000002538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 10/03/2019] [Indexed: 11/26/2022]
Abstract
Outcomes of peripheral nerve repair after injury are often suboptimal. Therefore, developing biological approaches to augment nerve regeneration is important. In this in vivo study, we tested the hypothesis that augmentation with an electrospun nanofiber sheet incorporating methylcobalamin (MeCbl) would be effective for regeneration after peripheral nerve transection and repair. Methods Rats were divided into 3 groups that either underwent sciatic nerve repair with or without the MeCbl sheet, or a sham operation. At 4 and/or 8 weeks after the operation, sensory and motor functional recovery, along with histological findings, were compared among the groups using the toe-spreading test, mechanical and thermal algesimetry tests, tibialis anterior muscle weight measurements, electrophysiological analyses, which included nerve conduction velocity (NCV), compound muscle action potential (CMAP), and terminal latency (TL), and histological analyses involving the myelinated axon ratio, axon diameter, and total axon number. Results Compared with the repair group without the MeCbl sheet, the repair group with the MeCbl sheet showed significant recovery in terms of tibialis anterior muscle weight, NCV and CMAP, and also tended to improve in the toe-spreading test, mechanical and thermal algesimetry tests, and TL. Histological analyses also demonstrated that the myelinated axon ratios and axon diameters were significantly higher. Among these findings, the repair group with the MeCbl sheet demonstrated the same recovery in NCV as the sham group. Conclusion This study demonstrated that electrospun nanofiber MeCbl sheets promoted nerve regeneration and functional recovery, indicating that this treatment strategy may be viable for human peripheral nerve injuries.
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175
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Kamble N, Shukla D, Bhat D. Peripheral Nerve Injuries: Electrophysiology for the Neurosurgeon. Neurol India 2020; 67:1419-1422. [PMID: 31857526 DOI: 10.4103/0028-3886.273626] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Peripheral nerve injuries are a heterogeneous and distinct group of disorders that are secondary to various causes commonly including motor vehicle accidents, falls, industrial accidents, household accidents, and penetrating trauma. The earliest classification of nerve injuries was given by Seddon and Sunderland, which holds true till date and is commonly used. Neuropraxia, axonotmesis, and neurotmesis are the three main types of nerve injuries. The electrophysiological studies including nerve conduction studies (NCS) and electromyography (EMG) play a key role and are now considered an extension of the clinical examination in patients with peripheral nerve injuries. The electrophysiological results should be interpreted in the light of clinical examination. These studies help in localizing the site of lesion, determine the type and severity of lesion, and help in prognosticating. In neuropraxia, the compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) are elicitable on stimulating the nerve distal to the site of the lesion but demonstrate conduction block on proximal stimulation. The electrodiagnostic findings in axonotmesis and neurotmesis are similar. After few days of injury, Wallerian degeneration sets in with failure to record CMAP and SNAP. Intraoperative technique involves recording from the peripheral nerves during the intraoperative period and has proved useful in the surgical management of nerve injuries and helps in identifying the injured nerve, to determine whether the nerve is in continuity and in localizing the site of lesion. Intraoperative monitoring also helps in identifying the nerve close to an ongoing surgery so that surgical damage to the nerve can be prevented.
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Affiliation(s)
- Nitish Kamble
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Dhaval Shukla
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Dhananjay Bhat
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Alawadhi E, Chu TH, Midha R. Comparative Behavioral Assessment of Lewis and Nude Rats after Peripheral Nerve Injury. Comp Med 2020; 70:233-238. [PMID: 32384941 DOI: 10.30802/aalas-cm-19-000079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cell therapy has shown potential in the field of peripheral nerve repair, and research using rodents is a critical and essential step toward clinical development of this approach. Traditionally, most experimental peripheral nerve injuries are conducted in inbred Lewis or outbred Sprague-Dawley strains. However, transplantation of xenogeneic cells such as human-derived cells typically triggers rejection in these animals. An alternative approach is to use immunodeficient animals, such as athymic nude rats. The lack of functional T cells in these animals renders them more accommodating to foreign cells from a different host. Currently, no literature exists regarding sensorimotor behavioral assessment of nude rats after peripheral nerve injury. To this end, we compared the functional recovery during a 6-wk period of behavioral testing of Lewis and nude rats after unilateral sciatic nerve crushing injury. Three sensorimotor behavioral assessments were performed weekly: a ladder rungwalking task to assess slip ratio and cross duration, von Frey nociception testing to determine the paw withdrawal threshold thus monitoring the regaining of sensory function, and sciatic functional index evaluation to monitor the recovery of integrated motor function. Both strains demonstrated significant sensory and motor deficits in the first week after injury, with a slight regain of sensory function, reduced slip ratio, and increased sciatic functional index starting at 2 wk. No significance difference existed between nude and Lewis rats in their recovery courses. We conclude that nude rats are a suitable model for behavioral training and assessment for cell transplantation studies in peripheral nerve injury and repair.
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Affiliation(s)
- Ebrahim Alawadhi
- Hotchkiss Brain Institute, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Tak- Ho Chu
- Hotchkiss Brain Institute, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Rajiv Midha
- Hotchkiss Brain Institute, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada;,
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Wilcox MB, Laranjeira SG, Eriksson TM, Jessen KR, Mirsky R, Quick TJ, Phillips JB. Characterising cellular and molecular features of human peripheral nerve degeneration. Acta Neuropathol Commun 2020; 8:51. [PMID: 32303273 PMCID: PMC7164159 DOI: 10.1186/s40478-020-00921-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/26/2020] [Indexed: 12/23/2022] Open
Abstract
Nerve regeneration is a key biological process in those recovering from neural trauma. From animal models it is known that the regenerative capacity of the peripheral nervous system (PNS) relies heavily on the remarkable ability of Schwann cells to undergo a phenotypic shift from a myelinating phenotype to one that is supportive of neural regeneration. In rodents, a great deal is known about the molecules that control this process, such as the transcription factors c-Jun and early growth response protein 2 (EGR2/KROX20), or mark the cells and cellular changes involved, including SOX10 and P75 neurotrophin receptor (p75NTR). However, ethical and practical challenges associated with studying human nerve injury have meant that little is known about human nerve regeneration.The present study addresses this issue, analysing 34 denervated and five healthy nerve samples from 27 patients retrieved during reconstructive nerve procedures. Using immunohistochemistry and Real-Time quantitative Polymerase Chain Reaction (RT-qPCR), the expression of SOX10, c-Jun, p75NTR and EGR2 was assessed in denervated samples and compared to healthy nerve. Nonparametric smoothing linear regression was implemented to better visualise trends in the expression of these markers across denervated samples.It was found, first, that two major genes associated with repair Schwann cells in rodents, c-Jun and p75NTR, are also up-regulated in acutely injured human nerves, while the myelin associated transcription factor EGR2 is down-regulated, observations that encourage the view that rodent models are relevant for learning about human nerve injury. Second, as in rodents, the expression of c-Jun and p75NTR declines during long-term denervation. In rodents, diminishing c-Jun and p75NTR levels mark the general deterioration of repair cells during chronic denervation, a process thought to be a major obstacle to effective nerve repair. The down-regulation of c-Jun and p75NTR reported here provides the first molecular evidence that also in humans, repair cells deteriorate during chronic denervation.
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Affiliation(s)
- Matthew B. Wilcox
- Peripheral Nerve Injury Research Unit, Royal National Orthopaedic Hospital, Stanmore, UK
- Department of Pharmacology, UCL School of Pharmacy, University College London, London, WC1N 1AX UK
- UCL Centre for Nerve Engineering, University College London, London, UK
| | - Simão G Laranjeira
- UCL Centre for Nerve Engineering, University College London, London, UK
- Department of Mechanical Engineering, University College London, London, UK
| | - Tuula M. Eriksson
- Department of Biomaterials and Tissue Engineering, Eastman Dental Institute, University College London, London, UK
| | - Kristjan R. Jessen
- UCL Centre for Nerve Engineering, University College London, London, UK
- Department of Cell and Developmental Biology, University College London, London, UK
| | - Rhona Mirsky
- UCL Centre for Nerve Engineering, University College London, London, UK
- Department of Cell and Developmental Biology, University College London, London, UK
| | - Tom J. Quick
- Peripheral Nerve Injury Research Unit, Royal National Orthopaedic Hospital, Stanmore, UK
- UCL Centre for Nerve Engineering, University College London, London, UK
| | - James B. Phillips
- Department of Pharmacology, UCL School of Pharmacy, University College London, London, WC1N 1AX UK
- UCL Centre for Nerve Engineering, University College London, London, UK
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Bonnet M, Guiraudie-Capraz G, Marqueste T, Garcia S, Jaloux C, Decherchi P, Féron F. Immediate or Delayed Transplantation of a Vein Conduit Filled with Nasal Olfactory Stem Cells Improves Locomotion and Axogenesis in Rats after a Peroneal Nerve Loss of Substance. Int J Mol Sci 2020; 21:E2670. [PMID: 32290426 PMCID: PMC7215801 DOI: 10.3390/ijms21082670] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/24/2020] [Accepted: 04/07/2020] [Indexed: 02/02/2023] Open
Abstract
Over the recent years, several methods have been experienced to repair injured peripheral nerves. Among investigated strategies, the use of natural or synthetic conduits was validated for clinical application. In this study, we assessed the therapeutic potential of vein guides, transplanted immediately or two weeks after a peroneal nerve injury and filled with olfactory ecto-mesenchymal stem cells (OEMSC). Rats were randomly allocated to five groups. A3 mm peroneal nerve loss was bridged, acutely or chronically, with a 1 cm long femoral vein and with/without OEMSCs. These four groups were compared to unoperated rats (Control group). OEMSCs were purified from male olfactory mucosae and grafted into female hosts. Three months after surgery, nerve repair was analyzed by measuring locomotor function, mechanical muscle properties, muscle mass, axon number, and myelination. We observed that stem cells significantly (i) increased locomotor recovery, (ii) partially maintained the contractile phenotype of the target muscle, and (iii) augmented the number of growing axons. OEMSCs remained in the nerve and did not migrate in other organs. These results open the way for a phase I/IIa clinical trial based on the autologous engraftment of OEMSCs in patients with a nerve injury, especially those with neglected wounds.
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Affiliation(s)
- Maxime Bonnet
- Aix Marseille Univ, CNRS, ISM, UMR 7287, Institut des Sciences du Mouvement: Etienne-Jules MAREY, Equipe Plasticité des Systèmes Nerveux et Musculaire (PSNM), Parc Scientifique et Technologique de Luminy, Faculté des Sciences du Sport de Marseille, CEDEX 09, F-13288 Marseille, France; (M.B.); (T.M.); (P.D.)
- Aix Marseille Univ, CNRS, INP, UMR 7051, Institut de Neuropathophysiologie, Equipe Nasal Olfactory Stemness and Epigenesis (NOSE), CEDEX 15, F-13344 Marseille, France; (G.G.-C.); (C.J.)
| | - Gaëlle Guiraudie-Capraz
- Aix Marseille Univ, CNRS, INP, UMR 7051, Institut de Neuropathophysiologie, Equipe Nasal Olfactory Stemness and Epigenesis (NOSE), CEDEX 15, F-13344 Marseille, France; (G.G.-C.); (C.J.)
| | - Tanguy Marqueste
- Aix Marseille Univ, CNRS, ISM, UMR 7287, Institut des Sciences du Mouvement: Etienne-Jules MAREY, Equipe Plasticité des Systèmes Nerveux et Musculaire (PSNM), Parc Scientifique et Technologique de Luminy, Faculté des Sciences du Sport de Marseille, CEDEX 09, F-13288 Marseille, France; (M.B.); (T.M.); (P.D.)
| | - Stéphane Garcia
- APHM, Laboratoire d’Anatomie Pathologique, Hôpital Nord, Chemin des Bourrely, CEDEX 20, F-13915 Marseille, France;
| | - Charlotte Jaloux
- Aix Marseille Univ, CNRS, INP, UMR 7051, Institut de Neuropathophysiologie, Equipe Nasal Olfactory Stemness and Epigenesis (NOSE), CEDEX 15, F-13344 Marseille, France; (G.G.-C.); (C.J.)
- APHM, Unité de Culture et Thérapie Cellulaire, Hôpital de la Conception, F-13006 Marseille, France
| | - Patrick Decherchi
- Aix Marseille Univ, CNRS, ISM, UMR 7287, Institut des Sciences du Mouvement: Etienne-Jules MAREY, Equipe Plasticité des Systèmes Nerveux et Musculaire (PSNM), Parc Scientifique et Technologique de Luminy, Faculté des Sciences du Sport de Marseille, CEDEX 09, F-13288 Marseille, France; (M.B.); (T.M.); (P.D.)
| | - François Féron
- Aix Marseille Univ, CNRS, INP, UMR 7051, Institut de Neuropathophysiologie, Equipe Nasal Olfactory Stemness and Epigenesis (NOSE), CEDEX 15, F-13344 Marseille, France; (G.G.-C.); (C.J.)
- APHM, Unité de Culture et Thérapie Cellulaire, Hôpital de la Conception, F-13006 Marseille, France
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Bergmeister KD, Große-Hartlage L, Daeschler SC, Rhodius P, Böcker A, Beyersdorff M, Kern AO, Kneser U, Harhaus L. Acute and long-term costs of 268 peripheral nerve injuries in the upper extremity. PLoS One 2020; 15:e0229530. [PMID: 32251479 PMCID: PMC7135060 DOI: 10.1371/journal.pone.0229530] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 02/07/2020] [Indexed: 11/18/2022] Open
Abstract
Background Peripheral nerve injury in the upper extremity is linked to high socioeconomic burden, yet cost-analyses are rare and from small cohorts. The objective of this study was to determine the costs and long-term socioeconomic effects of peripheral nerve injuries in the upper extremity in Germany. Methods We analyzed data of 250 patients with 268 work-related upper extremity nerve injuries from acute treatment to long-term follow-up on rehabilitation, sick-leave and disability-pension. Results Patients were on average 39.9±14.2 years old, male (85%) and mean inpatient treatment was 7±6 days. Location of nerve was 8% (N = 19) proximal to the wrist, 26% (N = 65) at the wrist and metacarpus, and 66% (N = 166) at phalangeal level. Acute in-patient treatment for (single) median nerve injury accounted for 66% with hospital reimbursement of 3.570€, ulnar nerve injury for 24% and 2.650€ and radial nerve injury for 10% and 3.166€, all including finger nerve injuries. The remaining were combined nerve injuries, with significantly higher costs, especially if combined with tendon 5.086€ or vascular injury 4.886€. Based on location, nerve injuries proximal to the wrist averaged 5.360±6.429€, at the wrist and metacarpus 3.534±2.710€ and at the phalangeal level 3.418±3.330€. 16% required rehabilitation with average costs of 5.842€ and stay of 41±21 days. Sick leave was between 11–1109 days with an average of 147 days with socioeconomic costs of 197€/day, equaling on average 17.640€. 30% received a mean yearly disability pension of 3.187€, that would account to 102.167€ per lifetime. Conclusion This large German patient sample indicates that nerve injury has a major impact on function and employment, resulting in significant health care costs. Both proximal and distal nerve injuries led to long-term disability, subsequent sick-leave and in 30% to permanent disability pension. These data are determined to support future studies and health economical work on prevention, treatment and rehabilitation of these often small injuries with great consequences.
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Affiliation(s)
- Konstantin D. Bergmeister
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Heidelberg, Germany
- Department of Surgery, Clinical Laboratory for the Restoration of Extremity Function, Medical University of Vienna, Vienna, Austria
- Department of Plastic, Aesthetic and Reconstructive Surgery, University Hospital St. Poelten, Poelten, Austria
| | - Luisa Große-Hartlage
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Heidelberg, Germany
| | - Simeon C. Daeschler
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Heidelberg, Germany
| | - Patrick Rhodius
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Heidelberg, Germany
| | - Arne Böcker
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Heidelberg, Germany
| | - Marius Beyersdorff
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Heidelberg, Germany
| | - Axel Olaf Kern
- Faculty of Social Work, Health, and Nursing, Hochschule Ravensburg-Weingarten, Weingarten, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Heidelberg, Germany
| | - Leila Harhaus
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg, Heidelberg, Germany
- * E-mail:
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180
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Omejec G, Podnar S. Contribution of ultrasonography in evaluating traumatic lesions of the peripheral nerves. Neurophysiol Clin 2020; 50:93-101. [DOI: 10.1016/j.neucli.2020.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/31/2020] [Accepted: 01/31/2020] [Indexed: 01/09/2023] Open
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181
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Carvalho CR, Costa JB, Costa L, Silva-Correia J, Moay ZK, Ng KW, Reis RL, Oliveira JM. Enhanced performance of chitosan/keratin membranes with potential application in peripheral nerve repair. Biomater Sci 2020; 7:5451-5466. [PMID: 31642822 DOI: 10.1039/c9bm01098j] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although surgical management of peripheral nerve injuries (PNIs) has improved over time, autografts are still the current "gold standard" treatment for PNIs, which presents numerous limitations. In an attempt to improve natural biomaterial-based nerve guidance conduits (NGCs), chitosan (CHT), a derivative of the naturally occurring biopolymer chitin, has been explored for peripheral nerve regeneration (PNR). In addition to CHT, keratin has gained enormous attention as a biomaterial and tissue engineering scaffolding. In this study, biomimetic CHT/keratin membranes were produced using a solvent casting technique. These membranes were broadly characterized in terms of their surface topography and physicochemical properties, with techniques such as Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC), contact angle, weight loss and water uptake measurements, Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM). Biological in vitro assays were also performed, where a preliminary cytotoxicity screening with the L929 fibroblast cell line revealed that the membranes and respective materials are suitable for cell culture. In addition, Schwann cells, fibroblasts and endothelial cells were directly seeded in the membranes. Quantitative and qualitative assays revealed that the addition of keratin enhanced cell viablity and adhesion. Based on the encouraging in vitro results, the in vivo angiogenic/antiangiogenic potential of CHT and CHT/keratin membranes was assessed, using an optimized chick embryo chorioallantoic membrane assay, where higher angiogenic responses were seen in keratin-enriched materials. Overall, the obtained results indicate the higher potential of CHT/keratin membranes for guided tissue regeneration applications in the field of PNR.
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Affiliation(s)
- Cristiana R Carvalho
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, Avepark - Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal.
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Romeo-Guitart D, Casas C. NeuroHeal Treatment Alleviates Neuropathic Pain and Enhances Sensory Axon Regeneration. Cells 2020; 9:E808. [PMID: 32230770 PMCID: PMC7226810 DOI: 10.3390/cells9040808] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/16/2020] [Accepted: 03/24/2020] [Indexed: 01/06/2023] Open
Abstract
Peripheral nerve injury (PNI) leads to the loss of motor, sensory, and autonomic functions, and often triggers neuropathic pain. During the last years, many efforts have focused on finding new therapies to increase axonal regeneration or to alleviate painful conditions. Still only a few of them have targeted both phenomena. Incipient or aberrant sensory axon regeneration is related to abnormal unpleasant sensations, such as hyperalgesia or allodynia. We recently have discovered NeuroHeal, a combination of two repurposed drugs; Acamprosate and Ribavirin. NeuroHeal is a neuroprotective agent that also enhances motor axon regeneration after PNI. In this work, we investigated its effect on sensory fiber regeneration and PNI-induced painful sensations in a rat model of spare nerve injury and nerve crush. The follow up of the animals showed that NeuroHeal treatment reduced the signs of neuropathic pain in both models. Besides, the treatment favored sensory axon regeneration, as observed in dorsal root ganglion explants. Mechanistically, the effects observed in vivo may improve the resolution of cell-protective autophagy. Additionally, NeuroHeal treatment modulated the P2X4-BDNF-KCC2 axis, which is an essential driver of neuropathic pain. These data open a new therapeutic avenue based on autophagic modulation to foster endogenous regenerative mechanisms and reduce the appearance of neuropathic pain in PNI.
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Affiliation(s)
- David Romeo-Guitart
- Institut de Neurociències (INc) and Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra, Barcelona, Spain;
- Institut Necker Enfants-Malades (INEM), INSERM U1151, Laboratory “Hormonal regulation of brain development and functions”—Team 8, Université Paris Descartes, Sorbonne Paris Cité, 75015 Paris, France
| | - Caty Casas
- Institut de Neurociències (INc) and Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra, Barcelona, Spain;
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Foster CH, Karsy M, Jensen MR, Guan J, Eli I, Mahan MA. Trends and Cost-Analysis of Lower Extremity Nerve Injury Using the National Inpatient Sample. Neurosurgery 2020; 85:250-256. [PMID: 29889258 DOI: 10.1093/neuros/nyy265] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/18/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Peripheral nerve injuries (PNIs) of the lower extremities have been assessed in small cohort studies; however, the actual incidence, national trends, comorbidities, and cost of care in lower extremity PNI are not defined. Lack of sufficient data limits discussion on national policies, payors, and other aspects fundamental to the delivery of care in the US. OBJECTIVE To establish estimates of lower extremity PNIs incidence, associated diagnoses, and cost in the US using a comprehensive database with a minimum of a decade of data. METHODS The National Inpatient Sample was utilized to evaluate International Classification of Disease codes for specific lower extremity PNIs (9560-9568) between 2001 and 2013. RESULTS Lower extremity PNIs occurred with a mean incidence of 13.3 cases per million population annually, which declined minimally from 2001 to 2013. The mean ± SEM age was 41.6 ± 0.1 yr; 61.1% of patients were males. Most were admitted via the emergency department (56.0%). PNIs occurred to the sciatic (16.6%), femoral (10.7%), tibial (6.0%), peroneal (33.4%), multiple nerves (1.3%), and other (32.0%). Associated diagnoses included lower extremity fracture (13.4%), complications of care (11.2%), open wounds (10.3%), crush injury (9.7%), and other (7.2%). Associated procedures included tibial fixation (23.3%), closure of skin (20.1%), debridement of open fractures (15.4%), fixation of other bones (13.5%), and wound debridement (14.5%). The mean annual unadjusted compounded growth rate of charges was 8.8%. The mean ± SEM annual charge over the time period was $64 031.20 ± $421.10, which was associated with the number of procedure codes (β = 0.2), length of stay (β = 0.6), and year (β = 0.1) in a multivariable analysis (P = .0001). CONCLUSION These data describe associations in the treatment of lower extremity PNIs, which are important for considering national policies, costs, research and the delivery of care.
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Affiliation(s)
- Chase H Foster
- Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, Texas
| | - Michael Karsy
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah
| | - Michael R Jensen
- Department of Neurosurgery, Stanford Neurosciences Health Center, Stanford, Palo Alto, California
| | - Jian Guan
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah
| | - Ilyas Eli
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah
| | - Mark A Mahan
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah
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Liu GB, Pan YM, Liu YS, Hu JH, Zhang XD, Zhang DW, Wang Y, Feng YK, Yu JB, Cheng YX. Ghrelin promotes neural differentiation of adipose tissue-derived mesenchymal stem cell via AKT/mTOR and β-catenin signaling pathways. Kaohsiung J Med Sci 2020; 36:405-416. [PMID: 32003536 DOI: 10.1002/kjm2.12188] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 01/07/2020] [Indexed: 02/04/2023] Open
Abstract
Adipose tissue-derived mesenchymal stem cells (ADSCs) are multipotent cells that can differentiate into various cell types. This study aimed to investigate the effect of ghrelin on the neural differentiation of rat ADSCs and underlying molecular mechanisms. Rat ADSCs were isolated and third-passage ADSCs were used in this study. The isolated ADSCs were characterized by flow cytometry analysis for MSCs' surface expression markers as evidenced by positive for CD90, CD44, and CD29 and negative for CD34, CD45, and CD11b/2f/c. The multilineage differentiation of ADSCs was confirmed by adipogenic, osteogenic, and neural differentiation. After induction of neurogenesis, the differentiated cells were identified by development of neuron-like morphology and expression of neural markers including glial fibrillary acidic protein, Nestin, MAP2, and β-Tubulin III using immunofluorescence and western blot. Ghrelin concentration dependently elevated the proportion of neural-like cells and branching dendrites, as well as upregulated the expression of neural markers. Further, the expression of nuclear β-catenin, p-GSK-3β, p-AKT, and p-mTOR was increased by ghrelin, indicating an activation of β-catenin and AKT/mTOR signaling after the ghrelin treatment. Importantly, inhibition of β-catenin or AKT/mTOR signaling suppressed ghrelin-induced neurogenesis. Therefore, we demonstrate that ghrelin promotes neural differentiation of ADSCs through the activation of β-catenin and AKT/mTOR signaling pathways.
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Affiliation(s)
- Gui-Bo Liu
- Department of Anatomy, School of Basic Medical Sciences, Mudanjiang Medical College, Mudanjiang, People's Republic of China.,Institute of Neural Tissue Engineering, Mudanjiang Medical College, Mudanjiang, People's Republic of China
| | - Yan-Ming Pan
- Department of Anatomy, School of Basic Medical Sciences, Mudanjiang Medical College, Mudanjiang, People's Republic of China.,Key Laboratory of Cancer Prevention and Treatment of Heilongjiang Province, Mudanjiang Medical College, Mudanjiang, People's Republic of China
| | - Yun-Shuang Liu
- Department of Medical Imaging, Hongqi Hospital of Mudanjiang Medical College, Mudanjiang, People's Republic of China
| | - Jia-Hang Hu
- Department of Medical Imaging, Hongqi Hospital of Mudanjiang Medical College, Mudanjiang, People's Republic of China
| | - Xiao-Dong Zhang
- Department of Infectious Diseases, Hongqi Hospital of Mudanjiang Medical College, Mudanjiang, People's Republic of China
| | - Da-Wei Zhang
- Department of Anatomy, School of Basic Medical Sciences, Mudanjiang Medical College, Mudanjiang, People's Republic of China
| | - Ying Wang
- Department of Anatomy, School of Basic Medical Sciences, Mudanjiang Medical College, Mudanjiang, People's Republic of China.,Institute of Neural Tissue Engineering, Mudanjiang Medical College, Mudanjiang, People's Republic of China
| | - Yu-Kuan Feng
- Department of Anatomy, School of Basic Medical Sciences, Mudanjiang Medical College, Mudanjiang, People's Republic of China
| | - Jian-Bo Yu
- Key Laboratory of Cancer Prevention and Treatment of Heilongjiang Province, Mudanjiang Medical College, Mudanjiang, People's Republic of China.,Pathology Diagnosis Center, The First Clinical Medical School of Mudanjiang Medical College, Mudanjiang, People's Republic of China
| | - Yong-Xia Cheng
- Key Laboratory of Cancer Prevention and Treatment of Heilongjiang Province, Mudanjiang Medical College, Mudanjiang, People's Republic of China.,Pathology Diagnosis Center, The First Clinical Medical School of Mudanjiang Medical College, Mudanjiang, People's Republic of China.,Institute of Stem Cells, Mudanjiang Medical College, Mudanjiang, People's Republic of China
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185
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Oliveira MA, Heimfarth L, Passos FRS, Miguel-Dos-Santos R, Mingori MR, Moreira JCF, Lauton SS, Barreto RSS, Araújo AAS, Oliveira AP, Oliveira JT, Baptista AF, Martinez AMB, Quintans-Júnior LJ, Quintans JSS. Naringenin complexed with hydroxypropyl-β-cyclodextrin improves the sciatic nerve regeneration through inhibition of p75 NTR and JNK pathway. Life Sci 2020; 241:117102. [PMID: 31790691 DOI: 10.1016/j.lfs.2019.117102] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 11/19/2019] [Accepted: 11/22/2019] [Indexed: 11/17/2022]
Abstract
Peripheral nerve injuries are common conditions that often lead to dysfunctions. Although much knowledge exists on the several factors that mediate the complex biological process involved in peripheral nerve regeneration, there is a lack of effective treatments that ensure full functional recovery. Naringenin (NA) is the most abundant flavanone found in citrus fruits and it has promising neuroprotective, anti-inflammatory and antioxidant effects. This study aimed to enhance peripheral nerve regeneration using an inclusion complex containing NA and hydroxypropyl-β-cyclodextrin (HPβCD), named NA/HPβCD. A mouse sciatic nerve crush model was used to evaluate the effects of NA/HPβCD on nerve regeneration. Sensory and motor parameters, hyperalgesic behavior and the sciatic functional index (SFI), respectively, improved with NA treatment. Western blot analysis revealed that the levels of p75NTR ICD and p75NTR full length as well phospho-JNK/total JNK ratios were preserved by NA treatment. In addition, NA treatment was able to decrease levels of caspase 3. The concentrations of TNF-α and IL-1β were decreased in the lumbar spine, on the other hand there was an increase in IL-10. NA/HPβCD presented a better overall morphological profile but it was not able to increase the number of myelinated fibers. Thus, NA was able to enhance nerve regeneration, and NA/HPβCD decreased effective drug doses while maintaining the effect of the pure drug, demonstrating the advantage of using the complex over the pure compound.
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Affiliation(s)
- Marlange A Oliveira
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil
| | - Luana Heimfarth
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil
| | - Fabiolla Rocha Santos Passos
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil
| | - Rodrigo Miguel-Dos-Santos
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil
| | - Moara R Mingori
- Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - José Cláudio F Moreira
- Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Sandra S Lauton
- Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil
| | - Rosana S S Barreto
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil
| | - Adriano A S Araújo
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Aldeidia P Oliveira
- Medicinal Plants Research Center, Federal University of Piauí, Teresina, PI 64.049-550, Brazil
| | - Júlia T Oliveira
- Department of Pathology, Medical School - HUCFF - Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Ana Maria B Martinez
- Department of Pathology, Medical School - HUCFF - Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Lucindo J Quintans-Júnior
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil.
| | - Jullyana S S Quintans
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil.
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186
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Pan D, Mackinnon SE, Wood MD. Advances in the repair of segmental nerve injuries and trends in reconstruction. Muscle Nerve 2020; 61:726-739. [PMID: 31883129 DOI: 10.1002/mus.26797] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 12/18/2022]
Abstract
Despite advances in surgery, the reconstruction of segmental nerve injuries continues to pose challenges. In this review, current neurobiology regarding regeneration across a nerve defect is discussed in detail. Recent findings include the complex roles of nonneuronal cells in nerve defect regeneration, such as the role of the innate immune system in angiogenesis and how Schwann cells migrate within the defect. Clinically, the repair of nerve defects is still best served by using nerve autografts with the exception of small, noncritical sensory nerve defects, which can be repaired using autograft alternatives, such as processed or acellular nerve allografts. Given current clinical limits for when alternatives can be used, advanced solutions to repair nerve defects demonstrated in animals are highlighted. These highlights include alternatives designed with novel topology and materials, delivery of drugs specifically known to accelerate axon growth, and greater attention to the role of the immune system.
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Affiliation(s)
- Deng Pan
- Division of Plastic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Susan E Mackinnon
- Division of Plastic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Matthew D Wood
- Division of Plastic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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187
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Loke G, Yan W, Khudiyev T, Noel G, Fink Y. Recent Progress and Perspectives of Thermally Drawn Multimaterial Fiber Electronics. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2020; 32:e1904911. [PMID: 31657053 DOI: 10.1002/adma.201904911] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/06/2019] [Indexed: 05/08/2023]
Abstract
Fibers are the building blocks of a broad spectrum of products from textiles to composites, and waveguides to wound dressings. While ubiquitous, the capabilities of fibers have not rapidly increased compared to semiconductor chip technology, for example. Recognizing that fibers lack the composition, geometry, and feature sizes for more functions, exploration of the boundaries of fiber functionality began some years ago. The approach focuses on a particular form of fiber production, thermal-drawing from a preform. This process has been used for producing single material fibers, but by combining metals, insulators, and semiconductors all within a single strand of fiber, an entire world of functionality in fibers has emerged. Fibers with optical, electrical, acoustic, or optoelectronic functionalities can be produced at scale from relatively easy-to-assemble macroscopic preforms. Two significant opportunities now present themselves. First, can one expect that fiber functions escalate in a predictable manner, creating the context for a "Moore's Law" analog in fibers? Second, as fabrics occupy an enormous surface around the body, could fabrics offer a valuable service to augment the human body? Toward answering these questions, the materials, performance, and limitations of thermally drawn fibers in different electronic applications are detailed and their potential in new fields is envisioned.
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Affiliation(s)
- Gabriel Loke
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Institute of Soldier Nanotechnology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Wei Yan
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Tural Khudiyev
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Grace Noel
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Yoel Fink
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Institute of Soldier Nanotechnology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Advanced Functional Fabrics of America (AFFOA), Cambridge, MA, 02139, USA
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188
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Seven F, Gölcez T, Yaralı ZB, Onak G, Karaman O, Şen M. Guiding neural extensions of PC12 cells on carbon nanotube tracks dielectrophoretically formed in poly(ethylene glycol) dimethacrylate. RSC Adv 2020; 10:26120-26125. [PMID: 35519760 PMCID: PMC9055325 DOI: 10.1039/d0ra04496b] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/04/2020] [Indexed: 11/21/2022] Open
Abstract
The PC12 cell line has been widely used as an in vitro model for studying neuronal differentiation and identifying the factors affecting the process. It has the ability to differentiate in the presence of nerve growth factor (NGF), resulting in neural extensions called dendrites and axons. In this study, first the impact of randomly distributed multi-walled carbon nanotubes (MWCNTs) in poly(ethylene glycol) dimethacrylate (PEGDMA) on PC12 cell differentiation was investigated in terms of neurite length, number of neurite per cell and differentiation marker gene expression profile. Then, dielectrophoretically aligned MWCNTs in PEGDMA was used to guide and support the neuronal differentiation of PC12 cells in the presence of NGF. The method is expected to be useful in revealing the nanotopographical role in fundamental studies and understanding of nanotopographical effects for biomedical applications on nerve regeneration. A schematic illustration of the strategy used to create a microenvironment consisting of micropatterns and CNT tracks. The new microenvironment allowed roughly positioning of PC12 cells and guidance of neural extensions.![]()
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Affiliation(s)
- Fikri Seven
- Izmir Katip Celebi University
- Graduate School of Natural and Applied Sciences
- Department of Biomedical Technologies/Master of Science
- Izmir
- Turkey
| | - Tansu Gölcez
- Izmir Katip Celebi University
- Graduate School of Natural and Applied Sciences
- Department of Biomedical Technologies/Master of Science
- Izmir
- Turkey
| | - Ziyşan Buse Yaralı
- Izmir Katip Celebi University
- Graduate School of Natural and Applied Sciences
- Biomedical Test, Calibration
- Application and Research Center
- Izmir
| | - Günnur Onak
- Izmir Katip Celebi University
- Graduate School of Natural and Applied Sciences
- Biomedical Test, Calibration
- Application and Research Center
- Izmir
| | - Ozan Karaman
- Izmir Katip Celebi University
- Faculty of Engineering and Architecture
- Biomedical Engineering
- Izmir
- Turkey
| | - Mustafa Şen
- Izmir Katip Celebi University
- Faculty of Engineering and Architecture
- Biomedical Engineering
- Izmir
- Turkey
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189
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Li T, Sui Z, Matsuno A, Ten H, Oyama K, Ito A, Jiang H, Ren X, Javed R, Zhang L, Ao Q. Fabrication and Evaluation of a Xenogeneic Decellularized Nerve-Derived Material: Preclinical Studies of a New Strategy for Nerve Repair. Neurotherapeutics 2020; 17:356-370. [PMID: 31758411 PMCID: PMC7007487 DOI: 10.1007/s13311-019-00794-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The repair and regeneration of transected peripheral nerves is an important area of clinical research, and the adhesion of anastomosis sites to surrounding tissues is a vital factor affecting the quality of nerve recovery after nerve anastomosis. This study involves the generation of a novel nerve repair membrane derived from decellularized porcine nerves using a unique, innovative technique. The decellularized nerve matrix was verified to be effective in eliminating cellular components, and it still retained some neural extracellular matrix components and bioactive molecules (collagens, glycosaminoglycans, laminin, fibronectin, TGF-β, etc.), which were mainly determined by proteomic analysis, histochemistry, immunohistochemistry, and enzyme-linked immunosorbent assay. Cytotoxicity, intracutaneous reactivity, hemolysis, and cell affinity analyses were conducted to confirm the biosecurity of the nerve repair membrane. The in vivo functionality was assessed in a rat sciatic nerve transection model, and indices of functional nerve recovery, including the measurement of the claw-spread reflex, nerve anastomosis site adhesion, electrophysiological properties, and the number of regenerated nerve fibers, were evaluated. The results indicated that the nerve repair membrane could effectively prevent adhesion between the nerve anastomosis sites and the surrounding tissues and enhance nerve regeneration, which could be attributed to its various bioactive components. In conclusion, the novel nerve repair membrane derived from xenogeneic decellularized nerves described in this study shows great potential auxiliary clinical treatment for peripheral nerve injuries.
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Affiliation(s)
- Ting Li
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Zhigang Sui
- Key Laboratory of Separation Science for Analytical Chemistry, National Chromatographic Research and Analysis Center, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
| | - Akira Matsuno
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Hirotomo Ten
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
- Department of Judo Physical Therapy, Faculty of Health, Teikyo Heisei University, Tokyo, Japan
| | - Kenichi Oyama
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Akihiro Ito
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Hong Jiang
- Shandong Junxiu Biotechnology Company, Limited, Yantai, China
| | - Xiaomin Ren
- Shandong Junxiu Biotechnology Company, Limited, Yantai, China
| | - Rabia Javed
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Lihua Zhang
- Key Laboratory of Separation Science for Analytical Chemistry, National Chromatographic Research and Analysis Center, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China.
| | - Qiang Ao
- Department of Tissue Engineering, China Medical University, Shenyang, China.
- Institute of Regulatory Science for Medical Devices, Engineering Research Center in Biomaterials, Sichuan University, Chengdu, China.
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190
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Dietzmeyer N, Huang Z, Schüning T, Rochkind S, Almog M, Nevo Z, Lieke T, Kankowski S, Haastert-Talini K. In Vivo and In Vitro Evaluation of a Novel Hyaluronic Acid-Laminin Hydrogel as Luminal Filler and Carrier System for Genetically Engineered Schwann Cells in Critical Gap Length Tubular Peripheral Nerve Graft in Rats. Cell Transplant 2020; 29:963689720910095. [PMID: 32174148 PMCID: PMC7444218 DOI: 10.1177/0963689720910095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/04/2020] [Accepted: 02/10/2020] [Indexed: 12/22/2022] Open
Abstract
In the current study we investigated the suitability of a novel hyaluronic acid-laminin hydrogel (HAL) as luminal filler and carrier system for co-transplanted cells within a composite chitosan-based nerve graft (CNG) in a rat critical nerve defect model. The HAL was meant to improve the performance of our artificial nerve guides by giving additional structural and molecular support to regrowing axons. We filled hollow CNGs or two-chambered nerve guides with an inserted longitudinal chitosan film (CNG[F]s), with cell-free HAL or cell-free HA or additionally suspended either naïve Schwann cells (SCs) or fibroblast growth factor 2-overexpressing Schwann cells (FGF2-SCs) within the gels. We subjected female Lewis rats to immediate 15 mm sciatic nerve gap reconstruction and comprehensively compared axonal and functional regeneration parameters with the gold standard autologous nerve graft (ANG) repair. Motor recovery was surveyed by means of electrodiagnostic measurements at 60, 90, and 120 days post-reconstruction. Upon explantation after 120 days, lower limb target muscles were harvested for calculation of muscle-weight ratios. Semi-thin cross-sections of nerve segments distal to the grafts were evaluated histomorphometrically. After 120 days of recovery, only ANG treatment led to full motor recovery. Surprisingly, regeneration outcomes revealed no regeneration-supportive effect of HAL alone and even an impairment of peripheral nerve regeneration when combined with SCs and FGF2-SCs. Furthermore, complementary in vitro studies, conducted to elucidate the reason for this unexpected negative result, revealed that SCs and FGF2-SCs suspended within the hydrogel relatively downregulated gene expression of regeneration-supporting neurotrophic factors. In conclusion, cell-free HAL in its current formulation did not qualify for optimizing regeneration outcome through CNG[F]s. In addition, we demonstrate that our HAL, when used as a carrier system for co-transplanted SCs, changed their gene expression profile and deteriorated the pro-regenerative milieu within the nerve guides.
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Affiliation(s)
- Nina Dietzmeyer
- Institute of Neuroanatomy and Cell Biology, Hannover Medical School,
Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | - Zhong Huang
- Institute of Neuroanatomy and Cell Biology, Hannover Medical School,
Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | - Tobias Schüning
- Institute of Neuroanatomy and Cell Biology, Hannover Medical School,
Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | - Shimon Rochkind
- Research Center for Nerve Reconstruction, Department of
Neurosurgery, Tel-Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv,
Israel
| | - Mara Almog
- Research Center for Nerve Reconstruction, Department of
Neurosurgery, Tel-Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv,
Israel
| | - Zvi Nevo
- Department of Human Molecular Genetics and Biochemistry, Sackler
School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Prof. Nevo passed away
| | - Thorsten Lieke
- Transplant Laboratory, Department of General-, Visceral-, and
Transplantation Surgery, Hannover Medical School, Hannover, Germany
| | - Svenja Kankowski
- Institute of Neuroanatomy and Cell Biology, Hannover Medical School,
Hannover, Germany
| | - Kirsten Haastert-Talini
- Institute of Neuroanatomy and Cell Biology, Hannover Medical School,
Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
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191
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Hussain G, Wang J, Rasul A, Anwar H, Qasim M, Zafar S, Aziz N, Razzaq A, Hussain R, de Aguilar JLG, Sun T. Current Status of Therapeutic Approaches against Peripheral Nerve Injuries: A Detailed Story from Injury to Recovery. Int J Biol Sci 2020; 16:116-134. [PMID: 31892850 PMCID: PMC6930373 DOI: 10.7150/ijbs.35653] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 06/22/2019] [Indexed: 12/14/2022] Open
Abstract
Peripheral nerve injury is a complex condition with a variety of signs and symptoms such as numbness, tingling, jabbing, throbbing, burning or sharp pain. Peripheral nerves are fragile in nature and can easily get damaged due to acute compression or trauma which may lead to the sensory and motor functions deficits and even lifelong disability. After lesion, the neuronal cell body becomes disconnected from the axon's distal portion to the injury site leading to the axonal degeneration and dismantlement of neuromuscular junctions of targeted muscles. In spite of extensive research on this aspect, complete functional recovery still remains a challenge to be resolved. This review highlights detailed pathophysiological events after an injury to a peripheral nerve and the associated factors that can either hinder or promote the regenerative machinery. In addition, it throws light on the available therapeutic strategies including supporting therapies, surgical and non-surgical interventions to ameliorate the axonal regeneration, neuronal survival, and reinnervation of peripheral targets. Despite the availability of various treatment options, we are still lacking the optimal treatments for a perfect and complete functional regain. The need for the present age is to discover or design such potent compounds that would be able to execute the complete functional retrieval. In this regard, plant-derived compounds are getting more attention and several recent reports validate their remedial effects. A plethora of plants and plant-derived phytochemicals have been suggested with curative effects against a number of diseases in general and neuronal injury in particular. They can be a ray of hope for the suffering individuals.
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Affiliation(s)
- Ghulam Hussain
- Neurochemicalbiology and Genetics Laboratory (NGL), Department of Physiology, Faculty of Life Sciences, Government College University, Faisalabad, 38000 Pakistan
| | - Jing Wang
- Center for Precision Medicine, School of Medicine and School of Biomedical Sciences, Huaqiao University, Xiamen, Fujian Province, 361021 China
| | - Azhar Rasul
- Department of Zoology, Faculty of Life Sciences, Government College University, Faisalabad, 38000 Pakistan
| | - Haseeb Anwar
- Neurochemicalbiology and Genetics Laboratory (NGL), Department of Physiology, Faculty of Life Sciences, Government College University, Faisalabad, 38000 Pakistan
| | - Muhammad Qasim
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, 38000 Pakistan
| | - Shamaila Zafar
- Neurochemicalbiology and Genetics Laboratory (NGL), Department of Physiology, Faculty of Life Sciences, Government College University, Faisalabad, 38000 Pakistan
| | - Nimra Aziz
- Neurochemicalbiology and Genetics Laboratory (NGL), Department of Physiology, Faculty of Life Sciences, Government College University, Faisalabad, 38000 Pakistan
| | - Aroona Razzaq
- Neurochemicalbiology and Genetics Laboratory (NGL), Department of Physiology, Faculty of Life Sciences, Government College University, Faisalabad, 38000 Pakistan
| | - Rashad Hussain
- Department of Neurosurgery, Center for Translational Neuromedicine (SMD), School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 645, Rochester, NY 14642, USA
| | - Jose-Luis Gonzalez de Aguilar
- Université de Strasbourg, UMR_S 1118, Strasbourg, France
- INSERM, U1118, Mécanismes Centraux et Péripheriques de la Neurodégénérescence, Strasbourg, France
| | - Tao Sun
- Center for Precision Medicine, School of Medicine and School of Biomedical Sciences, Huaqiao University, Xiamen, Fujian Province, 361021 China
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192
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Jablonka-Shariff A, Lu CY, Campbell K, Monk KR, Snyder-Warwick AK. Gpr126/Adgrg6 contributes to the terminal Schwann cell response at the neuromuscular junction following peripheral nerve injury. Glia 2019; 68:1182-1200. [PMID: 31873966 DOI: 10.1002/glia.23769] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 12/03/2019] [Accepted: 12/10/2019] [Indexed: 12/12/2022]
Abstract
Gpr126/Adgrg6 is an adhesion G protein-coupled receptor essential for Schwann cell (SC) myelination with important contributions to repair after nerve crush injury. Despite critical functions in myelinating SCs, the role of Gpr126 within nonmyelinating terminal Schwann cells (tSCs) at the neuromuscular junction (NMJ), is not known. tSCs have important functions in synaptic maintenance and reinnervation, and after injury tSCs extend cytoplasmic processes to guide regenerating axons to the denervated NMJ. In this study, we show that Gpr126 is expressed in tSCs, and that absence of Gpr126 in SCs (SC-specific Gpr126 knockout, cGpr126) results in a NMJ maintenance defect in the hindlimbs of aged mice, but not in young adult mice. After nerve transection and repair, cGpr126 mice display delayed NMJ reinnervation, altered tSC morphology with decreased S100β expression, and reduced tSC cytoplasmic process extensions. The immune response promoting reinnervation at the NMJ following nerve injury is also altered with decreased macrophage infiltration, Tnfα, and anomalous cytokine expression compared to NMJs of control mice. In addition, Vegfa expression is decreased in muscle, suggesting that cGpr126 non-cell autonomously modulates angiogenesis after nerve injury. In sum, cGpr126 mice demonstrated delayed NMJ reinnervation and decreased muscle mass following nerve transection and repair compared to control littermates. The integral function of Gpr126 in tSCs at the NMJ provides the framework for new therapeutic targets for neuromuscular disease.
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Affiliation(s)
- Albina Jablonka-Shariff
- Division of Plastic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Chuieng-Yi Lu
- Division of Plastic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.,Division of Reconstructive Microsurgery, Department of Plastic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Katherine Campbell
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Kelly R Monk
- Department of Developmental Biology, Washington University School of Medicine, St. Louis, Missouri.,Vollum Institute, Oregon Health & Science University, Portland, Oregon
| | - Alison K Snyder-Warwick
- Division of Plastic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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193
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Kubiak CA, Grochmal J, Kung TA, Cederna PS, Midha R, Kemp SWP. Stem-cell-based therapies to enhance peripheral nerve regeneration. Muscle Nerve 2019; 61:449-459. [PMID: 31725911 DOI: 10.1002/mus.26760] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 10/31/2019] [Accepted: 11/12/2019] [Indexed: 12/13/2022]
Abstract
Peripheral nerve injury remains a major cause of morbidity in trauma patients. Despite advances in microsurgical techniques and improved understanding of nerve regeneration, obtaining satisfactory outcomes after peripheral nerve injury remains a difficult clinical problem. There is a growing body of evidence in preclinical animal studies demonstrating the supportive role of stem cells in peripheral nerve regeneration after injury. The characteristics of both mesoderm-derived and ectoderm-derived stem cell types and their role in peripheral nerve regeneration are discussed, specifically focusing on the presentation of both foundational laboratory studies and translational applications. The current state of clinical translation is presented, with an emphasis on both ethical considerations of using stems cells in humans and current governmental regulatory policies. Current advancements in cell-based therapies represent a promising future with regard to supporting nerve regeneration and achieving significant functional recovery after debilitating nerve injuries.
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Affiliation(s)
- Carrie A Kubiak
- Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, Michigan
| | - Joey Grochmal
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Theodore A Kung
- Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, Michigan
| | - Paul S Cederna
- Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, Michigan.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
| | - Rajiv Midha
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Stephen W P Kemp
- Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, Michigan.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
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194
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Stratton JA, Holmes A, Rosin NL, Sinha S, Vohra M, Burma NE, Trang T, Midha R, Biernaskie J. Macrophages Regulate Schwann Cell Maturation after Nerve Injury. Cell Rep 2019; 24:2561-2572.e6. [PMID: 30184491 DOI: 10.1016/j.celrep.2018.08.004] [Citation(s) in RCA: 122] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 04/15/2018] [Accepted: 07/29/2018] [Indexed: 12/26/2022] Open
Abstract
Pro-regenerative macrophages are well known for their role in promoting tissue repair; however, their specific roles in promoting regeneration of the injured nerve are not well defined. Specifically, how macrophages interact with Schwann cells following injury during remyelination has been largely unexplored. We demonstrate that after injury, including in humans, macrophages function to clear debris and persist within the nerve microenvironment. Macrophage ablation immediately preceding remyelination results in an increase in immature Schwann cell density, a reduction in remyelination, and long-term deficits in conduction velocity. Targeted RNA-seq of macrophages from injured nerve identified Gas6 as one of several candidate factors involved in regulating Schwann cell dynamics. Functional studies show that the absence of Gas6 within monocyte lineage cells impairs Schwann cell remyelination within the injured nerve. These results demonstrate a role for macrophages in regulating Schwann cell function during nerve regeneration and highlight a molecular mechanism by which this occurs.
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Affiliation(s)
- Jo Anne Stratton
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada; Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Alexandra Holmes
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada; Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Nicole L Rosin
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Sarthak Sinha
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Mohit Vohra
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Nicole E Burma
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada; Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Tuan Trang
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada; Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Rajiv Midha
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Jeff Biernaskie
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada; Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB T2N 4N1, Canada.
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195
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Carvalho CR, Oliveira JM, Reis RL. Modern Trends for Peripheral Nerve Repair and Regeneration: Beyond the Hollow Nerve Guidance Conduit. Front Bioeng Biotechnol 2019; 7:337. [PMID: 31824934 PMCID: PMC6882937 DOI: 10.3389/fbioe.2019.00337] [Citation(s) in RCA: 159] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 10/30/2019] [Indexed: 12/13/2022] Open
Abstract
Peripheral nerve repair and regeneration remains among the greatest challenges in tissue engineering and regenerative medicine. Even though peripheral nerve injuries (PNIs) are capable of some degree of regeneration, frail recovery is seen even when the best microsurgical technique is applied. PNIs are known to be very incapacitating for the patient, due to the deprivation of motor and sensory abilities. Since there is no optimal solution for tackling this problem up to this day, the evolution in the field is constant, with innovative designs of advanced nerve guidance conduits (NGCs) being reported every day. As a basic concept, a NGC should act as a physical barrier from the external environment, concomitantly acting as physical guidance for the regenerative axons across the gap lesion. NGCs should also be able to retain the naturally released nerve growth factors secreted by the damaged nerve stumps, as well as reducing the invasion of scar tissue-forming fibroblasts to the injury site. Based on the neurobiological knowledge related to the events that succeed after a nerve injury, neuronal subsistence is subjected to the existence of an ideal environment of growth factors, hormones, cytokines, and extracellular matrix (ECM) factors. Therefore, it is known that multifunctional NGCs fabricated through combinatorial approaches are needed to improve the functional and clinical outcomes after PNIs. The present work overviews the current reports dealing with the several features that can be used to improve peripheral nerve regeneration (PNR), ranging from the simple use of hollow NGCs to tissue engineered intraluminal fillers, or to even more advanced strategies, comprising the molecular and gene therapies as well as cell-based therapies.
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Affiliation(s)
- Cristiana R. Carvalho
- 3B's Research Group, I3Bs – Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
- The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Guimarães, Portugal
| | - Joaquim M. Oliveira
- 3B's Research Group, I3Bs – Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
- The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Guimarães, Portugal
| | - Rui L. Reis
- 3B's Research Group, I3Bs – Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
- The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Guimarães, Portugal
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196
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Manoukian OS, Baker JT, Rudraiah S, Arul MR, Vella AT, Domb AJ, Kumbar SG. Functional polymeric nerve guidance conduits and drug delivery strategies for peripheral nerve repair and regeneration. J Control Release 2019; 317:78-95. [PMID: 31756394 DOI: 10.1016/j.jconrel.2019.11.021] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 10/16/2019] [Accepted: 11/18/2019] [Indexed: 12/25/2022]
Abstract
Peripheral nerve injuries can be extremely debilitating, resulting in sensory and motor loss-of-function. Endogenous repair is limited to non-severe injuries in which transection of nerves necessitates surgical intervention. Traditional treatment approaches include the use of biological grafts and alternative engineering approaches have made progress. The current article serves as a comprehensive, in-depth perspective on peripheral nerve regeneration, particularly nerve guidance conduits and drug delivery strategies. A detailed background of peripheral nerve injury and repair pathology, and an in-depth look into augmented nerve regeneration, nerve guidance conduits, and drug delivery strategies provide a state-of-the-art perspective on the field.
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Affiliation(s)
- Ohan S Manoukian
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA; Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, USA
| | - Jiana T Baker
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, USA
| | - Swetha Rudraiah
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, USA; Department of Pharmaceutical Sciences, University of Saint Joseph, Hartford, CT, USA
| | - Michael R Arul
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, USA
| | - Anthony T Vella
- Department of Department of Immunology, University of Connecticut Health, Farmington, CT, USA
| | - Abraham J Domb
- Institute of Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Sangamesh G Kumbar
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA; Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, USA.
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197
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Yi-Zhen L, Run-Pei M, Tian-Yuan Y, Wan-Zhu B, Jing-Jing C, Meng-Qian L, Yi S, Yu-Ting L, Shuai S, Yu-Mo Z, Yan-Jun M, Tao-Tao L, Guo-Yong C. Mild Mechanic Stimulate on Acupoints Regulation of CGRP-Positive Cells and Microglia Morphology in Spinal Cord of Sciatic Nerve Injured Rats. Front Integr Neurosci 2019; 13:58. [PMID: 31803029 PMCID: PMC6869816 DOI: 10.3389/fnint.2019.00058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 09/24/2019] [Indexed: 11/26/2022] Open
Abstract
Objective The objective of this study is to observe the effects of mild mechanical stimulation on acupuncture points of spinal motor neurons and active substances of sciatic nerve injury in rats, and to explore the morphological basis for the recovery of motor function in rats with sciatic nerve injury, using mild acupuncture. Acupuncture in the local area of injury may cause further damage to the peripheral nerve injury. We believe that mild mechanical stimulation on the surface, using some specific acupuncture points can also have a positive effect on nerve repair. This method, called Chinese tuina, has existed for more than 2,000 years in China. Methods This study establishes a rat model using sciatic nerve crush injury. Rats received Chinese tuina in accordance with the principle of the three methods and three points, once a day, for 20 days. The rats’ status of hindlimb recovery was detected by a sciatic functional index. The labeled neuronal cell body was used to evaluate the fiber recovery after the rats’ sciatic nerve injury, using a neural tracing technique. Our team studied motor neuronal cell bodies, CGRP-positive cells, and the microglia of damaged sciatic nerves which were stained with fluorescent triple staining, adopting a confocal multi-layer scanning technique, and then the changes in neuronal activity distribution and expression, and changes of time and treatment were described, using the method of morphological description. Results Sciatic nerve injury decreased the survival rate of motor neurons, affected CGRP-positive cells, and activated microglia in the ventral horn of the spinal cord. Compared with the model group, the survival of spinal ventral horn motor neurons was increased through tuina intervention. The swelling of CGRP-positive cells was alleviated, and the degree of microglia activation was less than that of the model group. Conclusion This study used visual morphological findings to assess changes in neurons and active substances with time after injury of the peripheral nerve, and demonstrated that peripheral mild acupuncture intervention improved the capacity of neurofibrillary axoplasmic transport, regulated microglia activation, and significantly promoted the recovery of sciatic nerve injury.
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Affiliation(s)
- Li Yi-Zhen
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Miao Run-Pei
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Tian-Yuan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Bai Wan-Zhu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Cui Jing-Jing
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lu Meng-Qian
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shen Yi
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Luo Yu-Ting
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shao Shuai
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Zhang Yu-Mo
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Mo Yan-Jun
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Lv Tao-Tao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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198
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Lee TH, Yen CT, Hsu SH. Preparation of Polyurethane-Graphene Nanocomposite and Evaluation of Neurovascular Regeneration. ACS Biomater Sci Eng 2019; 6:597-609. [DOI: 10.1021/acsbiomaterials.9b01473] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Tsung-Han Lee
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Chen-Tung Yen
- Department of Life Science, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Shan-hui Hsu
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei, Taiwan, Republic of China
- Research and Development Center for Medical Devices, National Taiwan University, Taipei, Taiwan, Republic of China
- Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan, Taiwan, Republic of China
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199
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Improved Motor Nerve Regeneration by SIRT1/Hif1a-Mediated Autophagy. Cells 2019; 8:cells8111354. [PMID: 31671642 PMCID: PMC6912449 DOI: 10.3390/cells8111354] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/12/2019] [Accepted: 10/29/2019] [Indexed: 02/06/2023] Open
Abstract
Complete restoring of functional connectivity between neurons or target tissue after traumatic lesions is still an unmet medical need. Using models of nerve axotomy and compression, we investigated the effect of autophagy induction by genetic and pharmacological manipulation on motor nerve regeneration. ATG5 or NAD+-dependent deacetylase sirtuin-1 (SIRT1) overexpression on spinal motoneurons stimulates mTOR-independent autophagy and facilitates a growth-competent state improving motor axonal regeneration with better electromyographic records after nerve transection and suture. In agreement with this, using organotypic spinal cord cultures and the human cell line SH-SY5Y, we observed that the activation of SIRT1 and autophagy by NeuroHeal increased neurite outgrowth and length extension and that this was mediated by downstream HIF1a. To conclude, SIRT1/Hifα-dependent autophagy confers a more pro-regenerative phenotype to motoneurons after peripheral nerve injury. Altogether, we provide evidence showing that autophagy induction by SIRT1/Hifα activation or NeuroHeal treatment is a novel therapeutic option for improving motor nerve regeneration and functional recovery after injury.
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200
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Abstract
Magnetic resonance imaging (MRI) has been used extensively in revealing pathological changes in the central nervous system. However, to date, MRI is very much underutilized in evaluating the peripheral nervous system (PNS). This underutilization is generally due to two perceived weaknesses in MRI: first, the need for very high resolution to image the small structures within the peripheral nerves to visualize morphological changes; second, the lack of normative data in MRI of the PNS and this makes reliable interpretation of the data difficult. This article reviews current state-of-the-art capabilities in
in vivo MRI of human peripheral nerves. It aims to identify areas where progress has been made and those that still require further improvement. In particular, with many new therapies on the horizon, this review addresses how MRI can be used to provide non-invasive and objective biomarkers in the evaluation of peripheral neuropathies. Although a number of techniques are available in diagnosing and tracking pathologies in the PNS, those techniques typically target the distal peripheral nerves, and distal nerves may be completely degenerated during the patient’s first clinic visit. These techniques may also not be able to access the proximal nerves deeply embedded in the tissue. Peripheral nerve MRI would be an alternative to circumvent these problems. In order to address the pressing clinical needs, this review closes with a clinical protocol at 3T that will allow high-resolution, high-contrast, quantitative MRI of the proximal peripheral nerves.
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Affiliation(s)
- Yongsheng Chen
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - E Mark Haacke
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Jun Li
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, 48201, USA.,Center for Molecular Medicine & Genetics, Wayne State University School of Medicine, Detroit, MI, 48201, USA.,Department of Biochemistry, Microbiology and Immunology, Wayne State University School of Medicine, Detroit, MI, 48201, USA.,John D. Dingell VA Medical Center, Detroit, MI, 48201, USA
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