Design and evaluation of novel polyanhydride blends as nerve guidance conduits

Novel Bioinspired Nerve Scaffold with High Synchrony between Biodegradation and Nerve Regeneration for Repair of Peripheral Nerve Injury

The morphological structure reconstruction and functional recovery of long-distance peripheral nerve injury (PNI) are global medical challenges. Biodegradable nerve scaffolds that provide mechanical support for the growth and extension of neurites are a desired way to repair long-distance PNI. However, the synchrony of scaffold degradation and nerve regeneration is still challenging. Here, a novel bioinspired multichannel nerve guide conduit (MNGC) with topographical cues based on silk fibroin and ε-polylysine modification was constructed. This conduit (SF(A) + PLL MNGC) exhibited sufficient mechanical strength, excellent degradability, and favorable promotion of cell growth. Peripheral nerve repairing was evaluated by an in vivo 10 mm rat sciatic model. In vivo evidence demonstrated that SF(A) + PLL MNGC was completely biodegraded in the body within 4 weeks after providing sufficient physical support and guide for neurite extension, and a 10 mm sciatic nerve defect was effectively repaired without scar formation, indicating a high synchronous effect of scaffold biodegradation and nerve regeneration. More importantly, the regenerated nerve of the SF(A) + PLL MNGC group showed comparable morphological reconstruction and functional recovery to that of autologous nerve transplantation. This work proved that the designed SF(A) + PLL MNGC has potential for application in long-distance PNI repair in the clinic.

A rotary scanning method to evaluate grooves and porosity for nerve guide conduits based on ultrasound microscopy

Grooved nerve guide conduits (NGCs) have been effective in the clinical treatment of peripheral nerve injury. They are generally fabricated from a micro-structured spinneret using a spinning process, which easily can cause a variety of pores and morphological deviation. The topography of internal grooves as well as the porosity can greatly influence the therapeutic effect. Traditional optical or scanning electron microscopy (SEM) methods can be used to image the grooves; however, these methods are destructive and require slicing NGCs to prepare specimens suitable for imaging. Moreover, lengthy experiments and large batches of NGCs are required to ensure reliable results from both in vitro experiments and clinical studies. In this paper, a non-destructive method for evaluating the grooves and porosity of NGCs is proposed using ultrasonic imaging combined with rotary scanning and an image analysis algorithm. Two ultrasonic methods were used: a 25-MHz point-focus ultrasonic transducer applied to observe axial cross sections of the conduits and a 100-MHz point-focus ultrasonic transducer to detect large pores caused by defects. Furthermore, a theoretical algorithm for detecting the local porosity of a conduit based on density is proposed. Herein, the proposed acoustic method and traditional optical methods are evaluated and compared. A parameter representing the specific surface area of the internal grooves is introduced and computed for both the optical and acoustic methods, and the relative errors of the computed parameter values for three different NGCs were 7.0%, 7.9%, and 15.3%. The detected location and shape of pores were consistent between the acoustic and optical methods, and greater porosity was observed in the middle of the conduit wall. In this paper, the results of the acoustic and optical methods are presented and the errors relating to the acoustic factors, device characteristics, and image processing method are further analyzed.

Salicylic acid-based poly(anhydride-ester) nerve guidance conduits: Impact of localized drug release on nerve regeneration

Nerve guidance conduits (NGCs) can serve as physical scaffolds aligning and supporting regenerating cells while preventing scar tissue formation that often interferes with the regeneration process. Numerous studies have focused on functionalizing NGCs with neurotrophic factors, for example, to support nerve regeneration over longer gaps, but few directly incorporate therapeutic agents. Herein, we fabricated NGCs from a polyanhydride comprised of salicylic acid (SA), a nonsteroidal anti-inflammatory drug, then performed in vitro and in vivo assays. In vitro studies included cytotoxicity, anti-inflammatory response, and NGC porosity measurements. To prepare for implantation, type I collagen hydrogels were used as NGC luminal fillers to further enhance the axonal regeneration process. For the in vivo studies, SA-NGCs were implanted in femoral nerves of mice for 16 weeks and evaluated for functional recovery. The SA-based NGCs functioned as both a drug delivery vehicle capable of reducing inflammation and scar tissue formation because of SA release as well as a tissue scaffold that promotes peripheral nerve regeneration and functional recovery.

In Vitro Degradation of an Aromatic Polyanhydride with Enhanced Thermal Properties

Polyanhydrides have been studied as a drug delivery vehicles due to their surface-eroding behavior which results in zero-order release. However, many polyanhyrides have thermal and solubility properties that make them difficult to formulate for these applications. Poly[α,α'-bis(ortho-carboxyphenoxy)-para-xylene] (oCPX) is an aromatic polyanhydride that has thermal and solubility properties enabling facile processing. The polymer's in vitro degradation profile exhibited an induction period up to 10 days in which degradation product concentration in the media was minimal, followed by a period of stable release of the biocompatible degradation product. Scanning electron microscope images and molecular weight changes of the polymer matrices confirm that this polymer is primarily surface-eroding. The combination of thermal properties, solubility, polymer degradation time, and erosion mechanism indicate that poly(oCPX) is be a suitable matrix candidate for extended, controlled drug delivery.

A biomaterials approach to peripheral nerve regeneration: bridging the peripheral nerve gap and enhancing functional recovery

Microsurgical techniques for the treatment of large peripheral nerve injuries (such as the gold standard autograft) and its main clinically approved alternative--hollow nerve guidance conduits (NGCs)--have a number of limitations that need to be addressed. NGCs, in particular, are limited to treating a relatively short nerve gap (4 cm in length) and are often associated with poor functional recovery. Recent advances in biomaterials and tissue engineering approaches are seeking to overcome the limitations associated with these treatment methods. This review critically discusses the advances in biomaterial-based NGCs, their limitations and where future improvements may be required. Recent developments include the incorporation of topographical guidance features and/or intraluminal structures, which attempt to guide Schwann cell (SC) migration and axonal regrowth towards their distal targets. The use of such strategies requires consideration of the size and distribution of these topographical features, as well as a suitable surface for cell-material interactions. Likewise, cellular and molecular-based therapies are being considered for the creation of a more conductive nerve microenvironment. For example, hurdles associated with the short half-lives and low stability of molecular therapies are being surmounted through the use of controlled delivery systems. Similarly, cells (SCs, stem cells and genetically modified cells) are being delivered with biomaterial matrices in attempts to control their dispersion and to facilitate their incorporation within the host regeneration process. Despite recent advances in peripheral nerve repair, there are a number of key factors that need to be considered in order for these new technologies to reach the clinic.

Salicylic acid-derived poly(anhydride-ester) electrospun fibers designed for regenerating the peripheral nervous system

Continuous biomaterial advances and the regenerating potential of the adult human peripheral nervous system offer great promise for restoring full function to innervated tissue following traumatic injury via synthetic nerve guidance conduits (NGCs). To most effectively facilitate nerve regeneration, a tissue engineering scaffold within a conduit must be similar to the linear microenvironment of the healthy nerve. To mimic the native nerve structure, aligned poly(lactic-co-glycolic acid)/bioactive polyanhydride fibrous substrates were fabricated through optimized electrospinning parameters with diameters of 600 ± 200 nm. Scanning electron microscopy images show fibers with a high degree of alignment. Schwann cells and dissociated rat dorsal root ganglia demonstrated elongated and healthy proliferation in a direction parallel to orientated electrospun fibers with significantly longer Schwann cell process length and neurite outgrowth when compared to randomly orientated fibers. Results suggest that an aligned polyanhydride fiber mat holds tremendous promise as a supplement scaffold for the interior of a degradable polymer NGC. Bioactive salicylic acid-based polyanhydride fibers are not limited to nerve regeneration and offer exciting promise for a wide variety of biomedical applications.