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Maddy K, Kelley M, Burks SS. Commentary: Decellularized Graft for Repairing Severe Peripheral Nerve Injuries in Sheep. Neurosurgery 2023; 93:e149-e150. [PMID: 37409799 DOI: 10.1227/neu.0000000000002596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/14/2023] [Indexed: 07/07/2023] Open
Affiliation(s)
- Krisna Maddy
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami , Florida , USA
| | - Megan Kelley
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami , Florida , USA
| | - S Shelby Burks
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami , Florida , USA
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami , Florida , USA
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2
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Saffari S, Rademakers DJ, Pulos N, Shin AY. Dose-response analysis after administration of a human platelet-derived exosome product on neurite outgrowth in vitro. Biotechnol Bioeng 2023; 120:3191-3199. [PMID: 37539665 DOI: 10.1002/bit.28520] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/19/2023] [Accepted: 07/23/2023] [Indexed: 08/05/2023]
Abstract
Modulating the nerve's local microenvironment using exosomes is proposed to enhance nerve regeneration. This study aimed to determine the optimal dose of purified exosome product (PEP) required to exert maximal neurite extension. An in vitro dorsal root ganglion (DRG) neurite outgrowth assay was used to evaluate the effect of treatment with (i) 5% PEP, (ii) 10% PEP, (iii) 15% PEP, or (iv) 20% PEP on neurite extension (N = 9/group), compared to untreated controls. After 72 h, neurite extension was measured to quantify nerve regeneration. Live cell imaging was used to visualize neurite outgrowth during incubation. Treatment with 5% PEP resulted in the longest neurite extension and was superior to the untreated DRG (p = 0.003). Treatment with 10% PEP, 15% PEP, and 20% PEP was found to be comparable to controls (p = 0.12, p = 0.06, and p = 0.41, respectively) and each other. Live cell imaging suggested that PEP migrated towards the DRG neural regeneration site, compared to the persistent homogenous distribution of PEP in culture media alone. 5% PEP was found to be the optimal concentration for nerve regeneration based on this in vitro dose-response analysis.
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Affiliation(s)
- Sara Saffari
- Department of Orthopedic Surgery, Division of Hand and Microvascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Department of Plastic Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Daan J Rademakers
- Department of Orthopedic Surgery, Division of Hand and Microvascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Department of Plastic Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Nicholas Pulos
- Department of Orthopedic Surgery, Division of Hand and Microvascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Alexander Y Shin
- Department of Orthopedic Surgery, Division of Hand and Microvascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
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3
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Takeya H, Itai S, Kimura H, Kurashina Y, Amemiya T, Nagoshi N, Iwamoto T, Sato K, Shibata S, Matsumoto M, Onoe H, Nakamura M. Schwann cell-encapsulated chitosan-collagen hydrogel nerve conduit promotes peripheral nerve regeneration in rodent sciatic nerve defect models. Sci Rep 2023; 13:11932. [PMID: 37488180 PMCID: PMC10366170 DOI: 10.1038/s41598-023-39141-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/20/2023] [Indexed: 07/26/2023] Open
Abstract
Chitosan has various tissue regeneration effects. This study was designed to investigate the nerve regeneration effect of Schwann cell (SC)-encapsulated chitosan-collagen hydrogel nerve conduit (CCN) transplanted into a rat model of sciatic nerve defect. We prepared a CCN consisting of an outer layer of chitosan hydrogel and an inner layer of collagen hydrogel to encapsulate the intended cells. Rats with a 10-mm sciatic nerve defect were treated with SCs encapsulated in CCN (CCN+), CCN without SCs (CCN-), SC-encapsulated silicone tube (silicone+), and autologous nerve transplanting (auto). Behavioral and histological analyses indicated that motor functional recovery, axonal regrowth, and myelination of the CCN+ group were superior to those of the CCN- and silicone+ groups. Meanwhile, the CCN- and silicone+ groups showed no significant differences in the recovery of motor function and nerve histological restoration. In conclusion, SC-encapsulated CCN has a synergistic effect on peripheral nerve regeneration, especially axonal regrowth and remyelination of host SCs. In the early phase after transplantation, SC-encapsulated CCNs have a positive effect on recovery. Therefore, using SC-encapsulated CCNs may be a promising approach for massive peripheral nerve defects.
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Affiliation(s)
- Hiroaki Takeya
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Shun Itai
- Department of Mechanical Engineering, Faculty of Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-Ku, Yokohama-Shi, Kanagawa, 223-8522, Japan
- Division of Medical Science, Graduate School of Biomedical Engineering, Tohoku University, 1-1 Seiryomachi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroo Kimura
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjuku-Ku, Tokyo, 160-8582, Japan.
| | - Yuta Kurashina
- Division of Advanced Mechanical Systems Engineering, Institute of Engineering, Tokyo University of Agriculture and Technology, 2-24-16 Nakacho, Koganei-Shi, Tokyo, 184-8588, Japan
| | - Tsuyoshi Amemiya
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Takuji Iwamoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, 35 Shinanomachi Shinjuku-Ku, Tokyo, Japan
| | - Shinsuke Shibata
- Division of Microscopic Anatomy, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata, 951-8510, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Hiroaki Onoe
- Department of Mechanical Engineering, Faculty of Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-Ku, Yokohama-Shi, Kanagawa, 223-8522, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjuku-Ku, Tokyo, 160-8582, Japan
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4
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O'Brien AL, West JM, Saffari TM, Nguyen M, Moore AM. Promoting Nerve Regeneration: Electrical Stimulation, Gene Therapy, and Beyond. Physiology (Bethesda) 2022; 37:0. [PMID: 35820181 DOI: 10.1152/physiol.00008.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Peripheral nerve injuries often result in life-altering functional deficits even with optimal management. Unlike the central nervous system, peripheral nerves have the ability to regenerate lost axons after injury; however, axonal regeneration does not equate to full restoration of function. To overcome this physiological shortcoming, advances in nerve regeneration and repair are paramount, including electrical stimulation, gene therapy, and surgical technique advancements.
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Affiliation(s)
- Andrew L O'Brien
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Julie M West
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Tiam M Saffari
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Minh Nguyen
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Amy M Moore
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Bendale GS, Sonntag M, Clements IP, Isaacs JE. Biomechanical Testing of a Novel Device for Sutureless Nerve Repair. Tissue Eng Part C Methods 2022; 28:469-475. [PMID: 35850519 PMCID: PMC9526470 DOI: 10.1089/ten.tec.2022.0080] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/14/2022] [Indexed: 11/12/2022] Open
Abstract
Suboptimal nerve end alignment achieved with conventional nerve repair techniques may contribute to poor clinical outcomes. In this study, we introduce Nerve Tape®, a novel nerve repair device that integrates flexible columns of Nitinol microhooks within a biologic backing to entubulate, align, and secure approximated nerve ends. This study compares the repair strength of Nerve Tape with that of conventional microsuture repairs. Thirty small (2 mm) and 30 large (7 mm) diameter human cadaveric nerves were transected and repaired utilizing Nerve Tape or appropriate microsuture technique. Biomechanical testing was performed using a horizontal tensile tester. The repaired nerves were loaded until failure at a distraction rate of 40 mm/min, and the maximum failure load was determined. In the small nerve groups, the load-to-failure for Nerve Tape repairs (2.33 ± 0.66 N) was significantly higher than for suture repairs (1.22 ± 0.52 N; p < 0.05). In the large nerve groups, no significant difference in load-to-failure was found between Nerve Tape (7.45 ± 2.66 N) and suture repairs (5.82 ± 1.59 N: p = 0.12). Suture repairs tended to fail by rupture, whereas Nerve Tape failures resulted from microhook pullout. Nerve Tape is a novel nerve coaptation device that provides mechanical repair strength equal or greater to clinically relevant microsuture repairs.
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Affiliation(s)
- Geetanjali S. Bendale
- Department of Orthopedic Surgery, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | | | - Jonathan E. Isaacs
- Department of Orthopedic Surgery, Virginia Commonwealth University, Richmond, Virginia, USA
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Wolfe EM, Mathis SA, de la Olivo Muñoz N, Ovadia SA, Panthaki ZJ. Comparison of human amniotic membrane and collagen nerve wraps around sciatic nerve reverse autografts in a rat model. BIOMATERIALS AND BIOSYSTEMS 2022; 6:100048. [PMID: 36824162 PMCID: PMC9934491 DOI: 10.1016/j.bbiosy.2022.100048] [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] [Received: 12/13/2021] [Revised: 03/23/2022] [Accepted: 04/05/2022] [Indexed: 11/28/2022] Open
Abstract
Human amniotic membrane (hAM) and collagen nerve wraps are biomaterials that have been investigated as therapies for improving outcomes of peripheral nerve regeneration; however, their efficacy has not been compared. The purpose of this study is to compare the efficacy of collagen and human amniotic membrane nerve wraps in a rodent sciatic nerve reverse autograft model. Lewis rats (n = 29) underwent sciatic nerve injury and repair in which a 10-mm gap was bridged with reverse autograft combined with either no nerve wrap (control), collagen nerve wrap or hAM nerve wrap. Behavioral analyses were performed at baseline and 4, 8 and 12 weeks. Electrophysiological studies were conducted at 8, 10 and 12 weeks. Additional outcomes assessed included gastrocnemius muscle weights, nerve adhesions, axonal regeneration and scarring at 12 weeks. Application of both collagen and hAM nerve wraps resulted in improvement of functional and histologic outcomes when compared with controls, with a greater magnitude of improvement for the experimental group treated with hAM nerve wraps. hAM-treated animals had significantly higher numbers of axons compared to control animals (p < 0.05) and significantly less perineural fibrosis than both control and collagen treated nerves (p < 0.05). The ratio of experimental to control gastrocnemius weights was significantly greater in hAM compared to control samples (p < 0.05). We conclude that hAM nerve wraps are a promising biomaterial that is effective for improving outcomes of peripheral nerve regeneration, resulting in superior nerve regeneration and functional recovery compared to collagen nerve wraps and controls.
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Affiliation(s)
- Erin M. Wolfe
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida USA,Corresponding author.
| | - Sydney A. Mathis
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida USA
| | - Natalia de la Olivo Muñoz
- Department of Neurological Surgery, The Neuroscience Program, Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida USA
| | - Steven A. Ovadia
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida USA
| | - Zubin J. Panthaki
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida USA
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Towne J, Carter N, Neivandt DJ. COMSOL Multiphysics® modelling of oxygen diffusion through a cellulose nanofibril conduit employed for peripheral nerve repair. Biomed Eng Online 2021; 20:60. [PMID: 34130690 PMCID: PMC8204471 DOI: 10.1186/s12938-021-00897-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/09/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Peripheral nerve injury can cause significant impairment, and the current methods for facilitating repair, particularly over distances greater than approximately 1 mm, are not entirely effective. Allografts, autografts, and synthetic conduits are three of the most common surgical interventions for peripheral nerve repair; however, each has limitations including poor biocompatibility, adverse immune responses, and the need for successive surgeries. A potential new method for promoting peripheral nerve repair that addresses the shortcomings of current interventions is a biocompatible cellulose nanofibril (CNF) conduit that degrades in-vivo over time. Preliminary testing in multiple animal models has yielded positive results, but more information is needed regarding how the CNF conduit facilitates nutrient and gas flow. RESULTS The current work employs 3D modelling and analysis via COMSOL Multiphysics® to determine how the CNF conduit facilitates oxygen movement both radially through the conduit walls and axially along the length of the conduit. Various CNF wall permeabilities, conduit lengths, and nerve-to-conduit diameter ratios have been examined; all of which were shown to have an impact on the resultant oxygen profile within the conduit. When the walls of the CNF conduit were modeled to have significant oxygen permeability, oxygen diffusion across the conduit was shown to dominate relative to axial diffusion of oxygen along the length of the conduit, which was otherwise the controlling diffusion mechanism. CONCLUSIONS The results of this study suggest that there is a complex relationship between axial and radial diffusion as the properties of the conduit such as length, diameter, and permeability are altered and when investigating various locations within the model. At low wall permeabilities the axial diffusion is dominant for all configurations, while for higher wall permeabilities the radial diffusion became dominant for smaller diameters. The length of the conduit did not alter the mechanism of diffusion, but rather had an inverse relationship with the magnitude of the overall concentration profile. As such the modeling results may be employed to predict and control the amount and distribution of oxygenation throughout the conduit, and hence to guide experimental conduit design.
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Affiliation(s)
- Julia Towne
- Department of Chemical and Biomedical Engineering, University of Maine, Orono, ME, 04469, USA
| | - Nicklaus Carter
- Department of Chemical and Biomedical Engineering, University of Maine, Orono, ME, 04469, USA
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME, 04469, USA
| | - David J Neivandt
- Department of Chemical and Biomedical Engineering, University of Maine, Orono, ME, 04469, USA.
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME, 04469, USA.
- Forest Bioproduct Research Institute, University of Maine, Orono, ME, 04469, USA.
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8
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Bademoğlu G, Erdal N, Uzun C, Taşdelen B. The effects of pulsed electromagnetic field on experimentally induced sciatic nerve injury in rats. Electromagn Biol Med 2021; 40:408-419. [PMID: 33797305 DOI: 10.1080/15368378.2021.1907403] [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: 10/21/2022]
Abstract
Some experimental research indicates that low-frequency pulsed electromagnetic field (PEMF) stimulation may accelerate regeneration in sciatic nerve injury. However, little research has examined the electrophysiological and functional properties of regenerating peripheral nerves under PEMF. The main aim of the present study is to investigate the effects of PEMF on sciatic nerve regeneration in short- and long-term processes with electrophysiologically and functionally after crushing damage. Crush lesions were performed using jewelery forceps for 30 s. After crush injury of the sciatic nerves, 24 female Wistar-Albino rats were divided into 3 groups with 8 rats in each group: SH(Sham), SNI (Sciatic Nerve Injury), SNI+PEMF(Sciatic Nerve Injury+Pulsed Electromagnetic Field). SNI+PEMF group was exposed to PEMF (4 h/day, intensity; 0.3mT, low-frequency; 2 Hz) for 40-days. Electrophysiological records (at the beginning and 1st, 2nd, 4th and 6th weeks post-crush) and functional footprints (at 1st, 2nd, 3rd, 4th, 5th and 6th weeks post crush) were measured from all groups during the experiment. The results were compared to SNI and SNI+PEMF groups, it was found that amplitude and area parameters in the first-week were significantly higher and latency was lower in the SNI+PEMF group than in the SNI group (p < 0,05). However, the effect of PEMF was not significant in the 2nd, 4th, 6th weeks. In addition, in the 1st and 2nd weeks, the SSI parameters were significantly higher in SNI+PMF group than SNI group (p < .05). These results indicate that low-frequency PEMF is not effective for long-periods of application time while PEMF may be useful during the short-term recovery period.
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Affiliation(s)
- Gülten Bademoğlu
- Department of Biophysics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Nurten Erdal
- Department of Biophysics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Coşar Uzun
- Department of Biophysics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Bahar Taşdelen
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Mersin University, Mersin, Türkiye
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Zuo KJ, Shafa G, Chan K, Zhang J, Hawkins C, Tajdaran K, Gordon T, Borschel GH. Local FK506 drug delivery enhances nerve regeneration through fresh, unprocessed peripheral nerve allografts. Exp Neurol 2021; 341:113680. [PMID: 33675777 DOI: 10.1016/j.expneurol.2021.113680] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/29/2021] [Accepted: 02/26/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Nerve allografts offer many advantages in the reconstruction of peripheral nerve gaps: they retain their native microstructure, contain pro-regenerative Schwann cells, are widely available, and avoid donor site morbidity. Unfortunately, clinical use of nerve allografts is limited by the need for systemic immunosuppression and its adverse effects. To eliminate the toxicity of the systemic immunosuppressant FK506, we developed a local FK506 drug delivery system (DDS) to provide drug release over 28 days. The study objective was to investigate if the local FK506 DDS enhances nerve regeneration in a rodent model of nerve gap defect reconstruction with immunologically-disparate nerve allografts. METHODS In male Lewis rats, a common peroneal nerve gap defect was reconstructed with either a 20 mm nerve isograft from a donor Lewis rat or a 20 mm fresh, unprocessed nerve allograft from an immunologically incompatible donor ACI rat. After 4 weeks of survival, nerve regeneration was evaluated using retrograde neuronal labelling, quantitative histomorphometry, and serum cytokine profile. RESULTS Treatment with both systemic FK506 and the local FK506 DDS significantly improved motor and sensory neuronal regeneration, as well as histomorphometric indices including myelinated axon number. Rats with nerve allografts treated with either systemic or local FK506 had significantly reduced serum concentrations of the pro-inflammatory cytokine IL-12 compared to untreated vehicle control rats with nerve allografts. Serum FK506 levels were undetectable in rats with local FK506 DDS. INTERPRETATION The local FK506 DDS improved motor and sensory nerve regeneration through fresh nerve allografts to a level equal to that of either systemic FK506 or nerve isografting. This treatment may be clinically translatable in peripheral nerve reconstruction or vascularized composite allotransplantation.
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Affiliation(s)
- Kevin J Zuo
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada; Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Canada; Institute of Biomaterials and Biomedical Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, Canada.
| | - Golsa Shafa
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada.
| | - Katelyn Chan
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada; Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Canada.
| | - Jennifer Zhang
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada.
| | - Cynthia Hawkins
- Division of Pathology, The Hospital for Sick Children, Toronto, Canada; Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Canada.
| | - Kasra Tajdaran
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada.
| | - Tessa Gordon
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada; Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Canada; Program in Neuroscience, SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada.
| | - Gregory H Borschel
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada; Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Canada; Institute of Biomaterials and Biomedical Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, Canada; Program in Neuroscience, SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada.
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Xu Z, Chen Z, Feng W, Huang M, Yang X, Qi Z. Grafted muscle-derived stem cells promote the therapeutic efficiency of epimysium conduits in mice with peripheral nerve gap injury. Artif Organs 2019; 44:E214-E225. [PMID: 31792982 DOI: 10.1111/aor.13614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/25/2019] [Accepted: 11/29/2019] [Indexed: 12/24/2022]
Abstract
Our research aimed to build allogeneic artificial conduits with epimysium and muscle-derived stem cells (MDSCs) from the skeletal muscle of mice. We applied the conduit to repair peripheral nerve defects and estimated the effectiveness of the repair process. In the research, we prepared epimysium conduits with lumens to bridge repair a 5-mm-long sciatic nerve defect from C57 wild-type mice and then transplanted green fluorescent protein (GFP)-MDSCs and Matrigel suspensions into the conduit. Histological and functional assessments were performed 4 and 8 weeks after surgery. The tissue-engineered conduit from muscle effectively repaired the nerve defect, while the group with GFP-MDSCs showed improved histological examinations and functional assessments, and the newborn nerves highly expressed GFP. As the results suggested, autologous epimysium conduits represent a reliable method to repair peripheral nerve defects, and the addition of MDSCs promote the effectiveness of differentiating into multiple lineages. Our research simultaneously demonstrated the myogenic, neurogenic, and angiogenic potential of MDSCs in vivo for the first time.
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Affiliation(s)
- Zhuqiu Xu
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zixiang Chen
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weifeng Feng
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Minlu Huang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaonan Yang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zuoliang Qi
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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11
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Liu Y, Yu S, Gu X, Cao R, Cui S. Tissue-engineered nerve grafts using a scaffold-independent and injectable drug delivery system: a novel design with translational advantages. J Neural Eng 2019; 16:036030. [PMID: 30965290 DOI: 10.1088/1741-2552/ab17a0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Currently commercially available nerve conduits have demonstrated suboptimal clinical efficacy in repairing peripheral nerve defects. Although tissue-engineered nerve grafts (TENGs) with sustained release of neurotrophic factors (NTFs) are experimentally proved to be more effective than these blank conduits, there remains a lack of clinical translation. NTFs are typically immobilized onto scaffold materials of the conduit via adsorption, specific binding or other incorporation techniques. These scaffold-based delivery strategies increase complexity and cost of conduit fabrication and lack flexibility in choosing different drugs. Therefore, to facilitate clinical translation and commercialization, we construct a TENG using a scaffold-independent drug delivery system (DDS). APPROACH This study adopted a scaffold-independent DDS based on methoxy-poly (ethylene glycol)-b-poly(γ-ethyl-L-glutamate) (mPEG-PELG) thermosensitive hydrogels that undergo sol-to-gel transition at body temperature. In addition, TENG, a chitosan scaffold filled with nerve growth factor (NGF)-loaded mPEG-PELG that gel in the lumen upon injection during surgery and function as a drug-releasing conduit-filler, was designed. Subsequently, the efficacy of DDS and therapeutic effects of TENG were assessed. MAIN RESULTS The results demonstrated that NGF-loaded mPEG-PELG controllably and sustainably released bioactive NGF for 28 d. When bridging a 10 mm rat sciatic nerve gap, the morphological, electrophysiological, and functional analyses revealed that NGF-releasing TENG (Scaffold + NGF/mPEG-PELG) achieved superior regenerative outcomes compared to plain scaffolds and those combined with systemic delivery of NGF (daily intramuscular injection (IM)), and its effects were relatively similar to autografts. SIGNIFICANCE This study has proposed a TENG using thermosensitive hydrogels as an injectable implant to controllably release NGF, which has promising therapeutic potential and translatability. Such TENGs obviate the need for conduit modification, complex preloading or binding mediators, therefore they allow the ease of drug switching in clinical practice and greatly simplify the manufacturing process due to the independent preparation of drug delivery system.
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Affiliation(s)
- Yanxi Liu
- Department of Hand Surgery, China-Japan Union Hospital, Jilin University, Changchun, People's Republic of China
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12
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Lovati AB, D’Arrigo D, Odella S, Tos P, Geuna S, Raimondo S. Nerve Repair Using Decellularized Nerve Grafts in Rat Models. A Review of the Literature. Front Cell Neurosci 2018; 12:427. [PMID: 30510503 PMCID: PMC6254089 DOI: 10.3389/fncel.2018.00427] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/30/2018] [Indexed: 12/22/2022] Open
Abstract
Peripheral nerve regeneration after severe traumatic nerve injury is a relevant clinical problem. Several different strategies have been investigated to solve the problem of bridging the nerve gap. Among these, the use of decellularized nerve grafts has been proposed as an alternative to auto/isografts, which represent the current gold standard in the treatment of severe nerve injury. This study reports the results of a systematic review of the literature published between January 2007 and October 2017. The aim was to quantitatively analyze the effectiveness of decellularized nerve grafts in rat experimental models. The review included 33 studies in which eight different decellularization protocols were described. The decellularized nerve grafts were reported to be immunologically safe and able to support both functional and morphological regeneration after nerve injury. Chemical protocols were found to be superior to physical protocols. However, further research is needed to optimize preparation protocols, including recellularization, improve their effectiveness, and substitute the current gold standard, especially in the repair of long nerve defects.
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Affiliation(s)
- Arianna B. Lovati
- Cell and Tissue Engineering Laboratory, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Daniele D’Arrigo
- Cell and Tissue Engineering Laboratory, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Simonetta Odella
- UOC Hand Surgery and Reconstructive Microsurgery Unit, ASST G. Pini-CTO, Milan, Italy
| | - Pierluigi Tos
- UOC Hand Surgery and Reconstructive Microsurgery Unit, ASST G. Pini-CTO, Milan, Italy
| | - Stefano Geuna
- Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Stefania Raimondo
- Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
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13
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Yao R, Wang B, Wang G. [Research progress of graphene and its derivatives in repair of peripheral nerve defect]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2018; 32:1483-1487. [PMID: 30417629 DOI: 10.7507/1002-1892.201804096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective To review the research progress of graphene and its derivatives in repair of peripheral nerve defect. Methods The related literature of graphene and its derivatives in repair of peripheral nerve defect in recent years was extensively reviewed. Results It is confirmed by in vitro and in vivo experiments that graphene and its derivatives can promote cell adhesion, proliferation, differentiation and neurite growth effectively. They have good electrical conductivity, excellent mechanical properties, larger specific surface area, and other advantages when compared with traditional materials. The three-dimensional scaffold can improve the effect of nerve repair. Conclusion The metabolic pathways and long-term reaction of graphene and its derivatives in the body are unclear. How to regulate their biodegradation and explain the electric coupling reaction mechanism between cells and materials also need to be further explored.
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Affiliation(s)
- Ruzhan Yao
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Bingwu Wang
- Department of Spinal Surgery, Weifang People's Hospital, Weifang Shandong, 261000, P.R.China
| | - Guanglin Wang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,
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Vijayavenkataraman S, Zhang S, Thaharah S, Sriram G, Lu WF, Fuh JYH. Electrohydrodynamic Jet 3D Printed Nerve Guide Conduits (NGCs) for Peripheral Nerve Injury Repair. Polymers (Basel) 2018; 10:E753. [PMID: 30960678 PMCID: PMC6403768 DOI: 10.3390/polym10070753] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 12/31/2022] Open
Abstract
The prevalence of peripheral nerve injuries resulting in loss of motor function, sensory function, or both, is on the rise. Artificial Nerve Guide Conduits (NGCs) are considered an effective alternative treatment for autologous nerve grafts, which is the current gold-standard for treating peripheral nerve injuries. In this study, Polycaprolactone-based three-dimensional porous NGCs are fabricated using Electrohydrodynamic jet 3D printing (EHD-jetting) for the first time. The main advantage of this technique is that all the scaffold properties, namely fibre diameter, pore size, porosity, and fibre alignment, can be controlled by tuning the process parameters. In addition, EHD-jetting has the advantages of customizability, repeatability, and scalability. Scaffolds with five different pore sizes (125 to 550 μm) and porosities (65 to 88%) are fabricated and the effect of pore size on the mechanical properties is evaluated. In vitro degradation studies are carried out to investigate the degradation profile of the scaffolds and determine the influence of pore size on the degradation rate and mechanical properties at various degradation time points. Scaffolds with a pore size of 125 ± 15 μm meet the requirements of an optimal NGC structure with a porosity greater than 60%, mechanical properties closer to those of the native peripheral nerves, and an optimal degradation rate matching the nerve regeneration rate post-injury. The in vitro neural differentiation studies also corroborate the same results. Cell proliferation was highest in the scaffolds with a pore size of 125 ± 15 μm assessed by the PrestoBlue assay. The Reverse Transcription-Polymerase Chain Reaction (RT-PCR) results involving the three most important genes concerning neural differentiation, namely β3-tubulin, NF-H, and GAP-43, confirm that the scaffolds with a pore size of 125 ± 15 μm have the highest gene expression of all the other pore sizes and also outperform the electrospun Polycaprolactone (PCL) scaffold. The immunocytochemistry results, expressing the two important nerve proteins β3-tubulin and NF200, showed directional alignment of the neurite growth along the fibre direction in EHD-jet 3D printed scaffolds.
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Affiliation(s)
| | - Shuo Zhang
- Department of Mechanical Engineering, National University of Singapore (NUS), Singapore 117575, Singapore.
| | - Siti Thaharah
- Department of Mechanical Engineering, National University of Singapore (NUS), Singapore 117575, Singapore.
| | - Gopu Sriram
- Faculty of Dentistry, National University of Singapore, Singapore 119083, Singapore.
| | - Wen Feng Lu
- Department of Mechanical Engineering, National University of Singapore (NUS), Singapore 117575, Singapore.
| | - Jerry Ying Hsi Fuh
- Department of Mechanical Engineering, National University of Singapore (NUS), Singapore 117575, Singapore.
- NUS Research Institute, Suzhou Industry Park, Suzhou 215123, China.
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15
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Stem cells purified from human induced pluripotent stem cell-derived neural crest-like cells promote peripheral nerve regeneration. Sci Rep 2018; 8:10071. [PMID: 29968745 PMCID: PMC6030210 DOI: 10.1038/s41598-018-27952-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/13/2018] [Indexed: 12/12/2022] Open
Abstract
Strategies for therapeutic cell transplantation have been assessed for use in the treatment of massive peripheral nerve defects. To support safe and efficient cell transplantation, we have focused on the purification of cells using cell surface markers. Our group previously reported low-affinity nerve growth factor receptor (LNGFR)- and thymocyte antigen-1 (THY-1)-positive neural crest-like cells (LT-NCLCs), generated from human induced pluripotent stem cells (hiPSCs). In the present study, we investigated the efficacy of transplantation of hiPSC-derived LT-NCLCs in a murine massive peripheral nerve defect model. Animals with a sciatic nerve defect were treated with a bridging silicone tube prefilled with LT-NCLCs or medium in the transplantation (TP) and negative control (NC) groups, respectively. The grafted LT-NCLCs survived and enhanced myelination and angiogenesis, as compared to the NC group. Behavioral analysis indicated that motor functional recovery in the TP group was superior to that in the NC group, and similar to that in the autograft (Auto) group. LT-NCLCs promoted axonal regrowth and remyelination by Schwann cells. Transplantation of LT-NCLCs is a promising approach for nerve regeneration treatment of massive peripheral nerve defects.
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16
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A Systematic Review of Prognostic Factors for Sensory Recovery After Digital Nerve Reconstruction. Ann Plast Surg 2018; 80:S311-S316. [DOI: 10.1097/sap.0000000000001440] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Huang L, Zhu L, Shi X, Xia B, Liu Z, Zhu S, Yang Y, Ma T, Cheng P, Luo K, Huang J, Luo Z. A compound scaffold with uniform longitudinally oriented guidance cues and a porous sheath promotes peripheral nerve regeneration in vivo. Acta Biomater 2018; 68:223-236. [PMID: 29274478 DOI: 10.1016/j.actbio.2017.12.010] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 12/06/2017] [Accepted: 12/07/2017] [Indexed: 12/17/2022]
Abstract
Scaffolds with inner fillers that convey directional guidance cues represent promising candidates for nerve repair. However, incorrect positioning or non-uniform distribution of intraluminal fillers might result in regeneration failure. In addition, proper porosity (to enhance nutrient and oxygen exchange but prevent fibroblast infiltration) and mechanical properties (to ensure fixation and to protect regenerating axons from compression) of the outer sheath are also highly important for constructing advanced nerve scaffolds. In this study, we constructed a compound scaffold using a stage-wise strategy, including directionally freezing orientated collagen-chitosan (O-CCH) filler, electrospinning poly(ε-caprolactone) (PCL) sheaths and assembling O-CCH/PCL scaffolds. Based on scanning electron microscopy (SEM) and mechanical tests, a blend of collagen/chitosan (1:1) was selected for filler fabrication, and a wall thickness of 400 μm was selected for PCL sheath production. SEM and three-dimensional (3D) reconstruction further revealed that the O-CCH filler exhibited a uniform, longitudinally oriented microstructure (over 85% of pores were 20-50 μm in diameter). The electrospun PCL porous sheath with pore sizes of 6.5 ± 3.3 μm prevented fibroblast invasion. The PCL sheath exhibited comparable mechanical properties to commercially available nerve conduits, and the O-CCH filler showed a physiologically relevant substrate stiffness of 2.0 ± 0.4 kPa. The differential degradation time of the filler and sheath allows the O-CCH/PCL scaffold to protect regenerating axons from compression stress while providing enough space for regenerating nerves. In vitro and in vivo studies indicated that the O-CCH/PCL scaffolds could promote axonal regeneration and Schwann cell migration. More importantly, functional results indicated that the CCH/PCL compound scaffold induced comparable functional recovery to that of the autograft group at the end of the study. Our findings demonstrated that the O-CCH/PCL scaffold with uniform longitudinal guidance filler and a porous sheath exhibits favorable properties for clinical use and promotes nerve regeneration and functional recovery. The O-CCH/PCL scaffold provides a promising new path for developing an optimal therapeutic alternative for peripheral nerve reconstruction. STATEMENT OF SIGNIFICANCE Scaffolds with inner fillers displaying directional guidance cues represent a promising candidate for nerve repair. However, further clinical translation should pay attention to the problem of non-uniform distribution of inner fillers, the porosity and mechanical properties of the outer sheath and the morphological design facilitating operation. In this study, a stage-wise fabrication strategy was used, which made it possible to develop an O-CCH/PCL compound scaffold with a uniform longitudinally oriented inner filler and a porous outer sheath. The uniform distribution of the pores in the O-CCH/PCL scaffold provides a solution to resolve the problem of non-uniform distribution of inner fillers, which impede the clinical translation of scaffolds with longitudinal microstructured fillers, especially for aligned-fiber-based scaffolds. In vitro and in vivo studies indicated that the O-CCH/PCL scaffolds could provide topographical cues for axonal regeneration and SC migration, which were not found for random scaffolds (with random microstructure resemble sponge-based scaffolds). The electrospun porous PCL sheath of the O-CCH/PCL scaffold not only prevented fibroblast infiltration, but also satisfied the mechanical requirements for clinical use, paving the way for clinical translation. The differential degradation time of the O-CCH filler and the PCL sheath makes O-CCH/PCL scaffold able to provide long protection for regenerating axons from compression stress, but enough space for regenerating nerve. These findings highlight the possibility of developing an optimal therapeutic alternative for nerve defects using the O-CCH/PCL scaffold.
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Affiliation(s)
- Liangliang Huang
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Lei Zhu
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Xiaowei Shi
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Bing Xia
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Zhongyang Liu
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Shu Zhu
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Yafeng Yang
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Teng Ma
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Pengzhen Cheng
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Kai Luo
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Jinghui Huang
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China.
| | - Zhuojing Luo
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China.
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Huber JL, Maier C, Mainka T, Mannil L, Vollert J, Homann HH. Recovery of mechanical detection thresholds after direct digital nerve repair versus conduit implantation. J Hand Surg Eur Vol 2017; 42:720-730. [PMID: 28395576 DOI: 10.1177/1753193417699777] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED The purpose of this study was to assess sensory and functional nerve recovery after digital nerve injury in patients with an end-to-end suture (S) or with implantation of a collagen conduit (C) to bridge a nerve gap. Fifteen S and 11 C with a follow-up of 6-36 months and 28 healthy control participants were enrolled. Methods of assessments were quantitative sensory testing, the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), range of motion and the painDetect questionnaire. After both procedures, sensory profiles showed largely recovered function of C and Aδ fibres but severe loss of Aβ-fibre function leading to increased mechanical detection thresholds. There was only minimal allodynia. Severe pain was absent. Patients with conduits reported more functional impairment, especially in work performance, which correlated with the assessed loss of Aß-fibre function. LEVEL OF EVIDENCE III.
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Affiliation(s)
- J L Huber
- 1 Department of Pain Management, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - C Maier
- 1 Department of Pain Management, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - T Mainka
- 1 Department of Pain Management, BG-University Hospital Bergmannsheil, Bochum, Germany.,3 Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Mannil
- 2 Department of Plastic Surgery and Hand Surgery, Burn Center, BG Trauma Center Duisburg, Duisburg, Germany.,4 Division of Plastic and Hand Surgery, University Hospital Zurich, Switzerland
| | - J Vollert
- 1 Department of Pain Management, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - H-H Homann
- 2 Department of Plastic Surgery and Hand Surgery, Burn Center, BG Trauma Center Duisburg, Duisburg, Germany
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19
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Pollins AC, Kim JS, Boyer RB, Thayer WP. Mass spectrometry comparison of nerve allograft decellularization processes. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 28:20. [PMID: 28012154 DOI: 10.1007/s10856-016-5834-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 11/25/2016] [Indexed: 06/06/2023]
Abstract
Peripheral nerve repair using nerve grafts has been investigated for several decades using traditional techniques such as histology, immunohistochemistry, and electron microscopy. Recent advances in mass spectrometry techniques have made it possible to study the proteomes of complex tissues, including extracellular matrix rich tissues similar to peripheral nerves. The present study comparatively assessed three previously described processing methods for generating acellular nerve grafts by mass spectrometry. Acellular nerve grafts were additionally examined by F-actin staining and nuclear staining for debris clearance. Application of newer techniques allowed us to detect and highlight differences among the 3 treatments. Isolated proteins were separated by mass on polyacrylamide gels serving 2 purposes. This further illustrated that these treatments differ from one another and it allowed for selective protein extractions within specific bands/molecular weights. This approach resulted in small pools of proteins that could then be analyzed by mass spectrometry for content. In total, 543 proteins were identified, many of which corroborate previous findings for these processing methods. The remaining proteins are novel discoveries that expand the field. With this pilot study, we have proven that mass spectrometry techniques complement and add value to peripheral nerve repair studies.
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Affiliation(s)
- Alonda C Pollins
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Justine S Kim
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Richard B Boyer
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Wesley P Thayer
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
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20
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Mechanical properties and permeability of porous chitosan–poly(p-dioxanone)/silk fibroin conduits used for peripheral nerve repair. J Mech Behav Biomed Mater 2015; 50:192-205. [DOI: 10.1016/j.jmbbm.2015.06.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 06/14/2015] [Accepted: 06/15/2015] [Indexed: 12/11/2022]
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21
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Gao Y, Wang YL, Kong D, Qu B, Su XJ, Li H, Pi HY. Nerve autografts and tissue-engineered materials for the repair of peripheral nerve injuries: a 5-year bibliometric analysis. Neural Regen Res 2015. [PMID: 26199621 PMCID: PMC4498331 DOI: 10.4103/1673-5374.158369] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
With advances in biomedical methods, tissue-engineered materials have developed rapidly as an alternative to nerve autografts for the repair of peripheral nerve injuries. However, the materials selected for use in the repair of peripheral nerve injuries, in particular multiple injuries and large-gap defects, must be chosen carefully. Various methods and materials for protecting the healthy tissue and repairing peripheral nerve injuries have been described, and each method or material has advantages and disadvantages. Recently, a large amount of research has been focused on tissue-engineered materials for the repair of peripheral nerve injuries. Using the keywords “pe-ripheral nerve injury”, “autotransplant”, “nerve graft”, and “biomaterial”, we retrieved publications using tissue-engineered materials for the repair of peripheral nerve injuries appearing in the Web of Science from 2010 to 2014. The country with the most total publications was the USA. The institutions that were the most productive in this field include Hannover Medical School (Germany), Washington University (USA), and Nantong University (China). The total number of publications using tissue-engineered materials for the repair of peripheral nerve injuries grad-ually increased over time, as did the number of Chinese publications, suggesting that China has made many scientific contributions to this field of research.
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Affiliation(s)
- Yuan Gao
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Yu-Ling Wang
- Department of Nursing, Chinese PLA General Hospital, Beijing, China
| | - Dan Kong
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Bo Qu
- Clinic Division, Department of Surgery, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Jing Su
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Huan Li
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Hong-Ying Pi
- Department of Nursing, Chinese PLA General Hospital, Beijing, China
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22
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Sabongi RG, Fernandes M, Dos Santos JBG. Peripheral nerve regeneration with conduits: use of vein tubes. Neural Regen Res 2015; 10:529-33. [PMID: 26170802 PMCID: PMC4424734 DOI: 10.4103/1673-5374.155428] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2015] [Indexed: 12/17/2022] Open
Abstract
Treatment of peripheral nerve injuries remains a challenge to modern medicine due to the complexity of the neurobiological nerve regenerating process. There is a greater challenge when the transected nerve ends are not amenable to primary end-to-end tensionless neurorraphy. When facing a segmental nerve defect, great effort has been made to develop an alternative to the autologous nerve graft in order to circumvent morbidity at donor site, such as neuroma formation, scarring and permanent loss of function. Tubolization techniques have been developed to bridge nerve gaps and have been extensively studied in numerous experimental and clinical trials. The use of a conduit intends to act as a vehicle for moderation and modulation of the cellular and molecular ambience for nerve regeneration. Among several conduits, vein tubes were validated for clinical application with improving outcomes over the years. This article aims to address the investigation and treatment of segmental nerve injury and draw the current panorama on the use of vein tubes as an autogenous nerve conduit.
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Affiliation(s)
- Rodrigo Guerra Sabongi
- Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Marcela Fernandes
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, Brazil
| | - João Baptista Gomes Dos Santos
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, Brazil
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23
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Teuschl AH, Schuh C, Halbweis R, Pajer K, Márton G, Hopf R, Mosia S, Rünzler D, Redl H, Nógrádi A, Hausner T. A New Preparation Method for Anisotropic Silk Fibroin Nerve Guidance Conduits and Its Evaluation In Vitro and in a Rat Sciatic Nerve Defect Model. Tissue Eng Part C Methods 2015; 21:945-57. [PMID: 25819471 DOI: 10.1089/ten.tec.2014.0606] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Over the past decade, silk fibroin (SF) has been emergently used in peripheral nerve tissue engineering. Current approaches aiming at producing SF-based nerve guidance conduits (SF-NGCs) used dissolved silk based on either aqueous solutions or organic solvents. In this study, we describe a novel procedure to produce SF-NGCs: A braided tubular structure of raw Bombyx mori silk is subsequently processed with the ternary solvent CaCl2/H2O/ethanol, formic acid, and methanol to improve its mechanical and topographical characteristics. Topographically, the combination of the treatments results in a fusion of the outer single silk fibers to a closed layer with a thickness ranging from about 40 to 75 μm. In contrast to the outer wall, the inner lumen (not treated with processing solvents) still represents the braided structure of single fibers. Mechanical stability, elasticity, and kink characteristics were evaluated with a custom-made test system. The modification procedure described here drastically improved the elastic properties of our tubular raw scaffold, favoring its use as a NGC. A cell migration assay with NIH/3T3-fibroblasts revealed the impermeability of the SF-NGC wall for possible invading and scar-forming cells. Moreover, the potential of the SF-NGC to serve as a substratum for Schwann cells has been demonstrated by cytotoxicity tests and live-dead stainings of Schwann cells grown on the inner surface of the SF-NGC. In vivo, the SF-NGC was tested in a rat sciatic nerve injury model. In short-term in vivo studies, it was proved that SF-NGCs are not triggering host inflammatory reactions. After 12 weeks, we could demonstrate morphological and functional reinnervation of the distal targets. Filled with collagen, a higher number of axons could be found in the distal to the graft (1678±303), compared with the empty SF-NGC (1274±146). The novel SF-NGC presented here shows promising results for the treatment of peripheral nerve injuries. The modification of braided structures to adapt their mechanical and topographical characteristics may support the translation of SF-based scaffolds into the clinical setting. However, further improvements and the use of extracellular matrix molecules and Schwann cells are suggested to enable silk tube based conduits to bridge long-distance nerve gaps.
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Affiliation(s)
- Andreas Herbert Teuschl
- 1 Department of Biochemical Engineering, University of Applied Sciences Technikum Wien , Vienna, Austria
- 2 The Austrian Cluster for Tissue Regeneration, Vienna, Austria
- 3 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center , Vienna, Austria
| | - Christina Schuh
- 1 Department of Biochemical Engineering, University of Applied Sciences Technikum Wien , Vienna, Austria
- 2 The Austrian Cluster for Tissue Regeneration, Vienna, Austria
- 3 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center , Vienna, Austria
| | - Robert Halbweis
- 2 The Austrian Cluster for Tissue Regeneration, Vienna, Austria
- 3 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center , Vienna, Austria
| | - Krisztián Pajer
- 4 Department of Anatomy, Histology and Embryology, Faculty of Medicine, University of Szeged , Szeged, Hungary
| | - Gábor Márton
- 4 Department of Anatomy, Histology and Embryology, Faculty of Medicine, University of Szeged , Szeged, Hungary
| | - Rudolf Hopf
- 2 The Austrian Cluster for Tissue Regeneration, Vienna, Austria
- 3 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center , Vienna, Austria
| | - Shorena Mosia
- 2 The Austrian Cluster for Tissue Regeneration, Vienna, Austria
- 3 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center , Vienna, Austria
| | - Dominik Rünzler
- 1 Department of Biochemical Engineering, University of Applied Sciences Technikum Wien , Vienna, Austria
- 2 The Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Heinz Redl
- 2 The Austrian Cluster for Tissue Regeneration, Vienna, Austria
- 3 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center , Vienna, Austria
| | - Antal Nógrádi
- 2 The Austrian Cluster for Tissue Regeneration, Vienna, Austria
- 3 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center , Vienna, Austria
- 4 Department of Anatomy, Histology and Embryology, Faculty of Medicine, University of Szeged , Szeged, Hungary
| | - Thomas Hausner
- 2 The Austrian Cluster for Tissue Regeneration, Vienna, Austria
- 3 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology/AUVA Research Center , Vienna, Austria
- 5 Department of Traumatology, Lorenz Böhler Hospital , Austrian Workers' Compensation Board, Vienna, Austria
- 6 Department for Trauma Surgery and Sports Traumatology, Paracelsus Medical University , Salzburg, Austria
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