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Redolfi Riva E, Özkan M, Contreras E, Pawar S, Zinno C, Escarda-Castro E, Kim J, Wieringa P, Stellacci F, Micera S, Navarro X. Beyond the limiting gap length: peripheral nerve regeneration through implantable nerve guidance conduits. Biomater Sci 2024; 12:1371-1404. [PMID: 38363090 DOI: 10.1039/d3bm01163a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Peripheral nerve damage results in the loss of sensorimotor and autonomic functions, which is a significant burden to patients. Furthermore, nerve injuries greater than the limiting gap length require surgical repair. Although autografts are the preferred clinical choice, their usage is impeded by their limited availability, dimensional mismatch, and the sacrifice of another functional donor nerve. Accordingly, nerve guidance conduits, which are tubular scaffolds engineered to provide a biomimetic environment for nerve regeneration, have emerged as alternatives to autografts. Consequently, a few nerve guidance conduits have received clinical approval for the repair of short-mid nerve gaps but failed to regenerate limiting gap damage, which represents the bottleneck of this technology. Thus, it is still necessary to optimize the morphology and constituent materials of conduits. This review summarizes the recent advances in nerve conduit technology. Several manufacturing techniques and conduit designs are discussed, with emphasis on the structural improvement of simple hollow tubes, additive manufacturing techniques, and decellularized grafts. The main objective of this review is to provide a critical overview of nerve guidance conduit technology to support regeneration in long nerve defects, promote future developments, and speed up its clinical translation as a reliable alternative to autografts.
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Affiliation(s)
- Eugenio Redolfi Riva
- The Biorobotic Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy
| | - Melis Özkan
- Institute of Materials, école Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
- Bertarelli Foundation Chair in Translational Neural Engineering, Center for Neuroprosthetics and Institute of Bioengineering, école Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Estefania Contreras
- Integral Service for Laboratory Animals (SIAL), Faculty of Veterinary, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Department of Cell Biology, Physiology and Immunology, Institute of Neurosciences, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra, Spain.
| | - Sujeet Pawar
- Institute of Materials, école Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - Ciro Zinno
- The Biorobotic Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy
| | - Enrique Escarda-Castro
- Complex Tissue Regeneration Department, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, The Netherlands
| | - Jaehyeon Kim
- Complex Tissue Regeneration Department, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, The Netherlands
| | - Paul Wieringa
- Complex Tissue Regeneration Department, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, The Netherlands
| | - Francesco Stellacci
- Institute of Materials, école Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
- Institute of Materials, Department of Bioengineering and Global Health Institute, École Polytechnique Fédérale de Lausanne (EPFL), Station 12, CH-1015 Lausanne, Switzerland
| | - Silvestro Micera
- The Biorobotic Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy
- Bertarelli Foundation Chair in Translational Neural Engineering, Center for Neuroprosthetics and Institute of Bioengineering, école Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Xavier Navarro
- Department of Cell Biology, Physiology and Immunology, Institute of Neurosciences, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra, Spain.
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain
- Institute Guttmann Foundation, Hospital of Neurorehabilitation, Badalona, Spain
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Zhang L, Zhang H, Wang H, Guo K, Zhu H, Li S, Gao F, Li S, Yang Z, Liu X, Zheng X. Fabrication of Multi-Channel Nerve Guidance Conduits Containing Schwann Cells Based on Multi-Material 3D Bioprinting. 3D PRINTING AND ADDITIVE MANUFACTURING 2023; 10:1046-1054. [PMID: 37886409 PMCID: PMC10599437 DOI: 10.1089/3dp.2021.0203] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Nerve guidance conduits (NGCs) are an essential solution for peripheral nerve repair and regeneration in tissue engineering and medicine. However, the ability of current NGCs is limited to repairing longer nerve gap (i.e., >20 mm) because it cannot meet the following two conditions simultaneously: (1) directional guidance of the axial high-density channels and (2) regenerative stimulation of the extracellular matrix secreted by Schwann cells (SCs). Therefore, we propose a multi-material 3D bioprinting process to fabricate multi-channel nerve guide conduits (MNGCs) containing SCs. In the article, cell-laden methacrylate gelatin (GelMA) was used as the bulk material of MNGCs. To improve the printing accuracy of the axial channels and the survival rate of SCs, we systematically optimized the printing temperature parameter based on hydrogel printability analysis. The multi-material bioprinting technology was used to realize the alternate printing of supporting gelatin and cell-laden GelMA. Then, the high-accuracy channels were fabricated through the UV cross-linking of GelMA and the dissolving technique of gelatin. The SCs distributed around the channels with a high survival rate, and the cell survival rate maintained above 90%. In general, the study on multi-material 3D printing was carried out from the fabricating technology and material analysis, which will provide a potential solution for the fabrication of MNGCs containing SCs.
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Affiliation(s)
- Liming Zhang
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
| | - Hui Zhang
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Heran Wang
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Kai Guo
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
| | - Huixuan Zhu
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Song Li
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
| | - Feiyang Gao
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
| | - Shijie Li
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
| | - Zhenda Yang
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
| | - Xin Liu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Xiongfei Zheng
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
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García-García ÓD, El Soury M, Campos F, Sánchez-Porras D, Geuna S, Alaminos M, Gambarotta G, Chato-Astrain J, Raimondo S, Carriel V. Comprehensive ex vivo and in vivo preclinical evaluation of novel chemo enzymatic decellularized peripheral nerve allografts. Front Bioeng Biotechnol 2023; 11:1162684. [PMID: 37082209 PMCID: PMC10111265 DOI: 10.3389/fbioe.2023.1162684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/22/2023] [Indexed: 04/07/2023] Open
Abstract
As a reliable alternative to autografts, decellularized peripheral nerve allografts (DPNAs) should mimic the complex microstructure of native nerves and be immunogenically compatible. Nevertheless, there is a current lack of decellularization methods able to remove peripheral nerve cells without significantly altering the nerve extracellular matrix (ECM). The aims of this study are firstly to characterize ex vivo, in a histological, biochemical, biomechanical and ultrastructural way, three novel chemical-enzymatic decellularization protocols (P1, P2 and P3) in rat sciatic nerves and compared with the Sondell classic decellularization method and then, to select the most promising DPNAs to be tested in vivo. All the DPNAs generated present an efficient removal of the cellular material and myelin, while preserving the laminin and collagen network of the ECM (except P3) and were free from any significant alterations in the biomechanical parameters and biocompatibility properties. Then, P1 and P2 were selected to evaluate their regenerative effectivity and were compared with Sondell and autograft techniques in an in vivo model of sciatic defect with a 10-mm gap, after 15 weeks of follow-up. All study groups showed a partial motor and sensory recovery that were in correlation with the histological, histomorphometrical and ultrastructural analyses of nerve regeneration, being P2 the protocol showing the most similar results to the autograft control group.
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Affiliation(s)
- Óscar Darío García-García
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Doctoral Program in Biomedicine, University of Granada, Granada, Spain
- Department of Clinical and Biological Sciences and Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Torino, Orbassano, Italy
| | - Marwa El Soury
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Clinical and Biological Sciences and Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Torino, Orbassano, Italy
| | - Fernando Campos
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - David Sánchez-Porras
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Stefano Geuna
- Department of Clinical and Biological Sciences and Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Torino, Orbassano, Italy
| | - Miguel Alaminos
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Giovanna Gambarotta
- Department of Clinical and Biological Sciences and Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Torino, Orbassano, Italy
| | - Jesús Chato-Astrain
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- *Correspondence: Jesús Chato-Astrain, ; Víctor Carriel,
| | - Stefania Raimondo
- Department of Clinical and Biological Sciences and Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Torino, Orbassano, Italy
| | - Víctor Carriel
- Tissue Engineering Group, Department of Histology, University of Granada and Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- *Correspondence: Jesús Chato-Astrain, ; Víctor Carriel,
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Yu T, Ao Q, Ao T, Ahmad MA, Wang A, Xu Y, Zhang Z, Zhou Q. Preparation and assessment of an optimized multichannel acellular nerve allograft for peripheral nerve regeneration. Bioeng Transl Med 2022. [DOI: 10.1002/btm2.10435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Tianhao Yu
- The VIP Department, School and Hospital of Stomatology China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases Shenyang China
| | - Qiang Ao
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education China Medical University Shenyang China
- NMPA Key Laboratory for Quality Research and Control of Tissue Regenerative Biomaterial, Institute of Regulatory Science for Medical Device, National Engineering Research Center for Biomaterials Sichuan University Chengdu Sichuan China
| | - Tianrang Ao
- Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | | | - Aijun Wang
- Department of Neurological Surgery University of California Davis Sacramento California USA
| | - Yingxi Xu
- Department of Clinical Nutrition Shengjing Hospital of China Medical University Shenyang China
| | - Zhongti Zhang
- The VIP Department, School and Hospital of Stomatology China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases Shenyang China
| | - Qing Zhou
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases Shenyang China
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Rao Z, Lin Z, Song P, Quan D, Bai Y. Biomaterial-Based Schwann Cell Transplantation and Schwann Cell-Derived Biomaterials for Nerve Regeneration. Front Cell Neurosci 2022; 16:926222. [PMID: 35836742 PMCID: PMC9273721 DOI: 10.3389/fncel.2022.926222] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/31/2022] [Indexed: 12/13/2022] Open
Abstract
Schwann cells (SCs) dominate the regenerative behaviors after peripheral nerve injury by supporting axonal regrowth and remyelination. Previous reports also demonstrated that the existence of SCs is beneficial for nerve regeneration after traumatic injuries in central nervous system. Therefore, the transplantation of SCs/SC-like cells serves as a feasible cell therapy to reconstruct the microenvironment and promote nerve functional recovery for both peripheral and central nerve injury repair. However, direct cell transplantation often leads to low efficacy, due to injection induced cell damage and rapid loss in the circulatory system. In recent years, biomaterials have received great attention as functional carriers for effective cell transplantation. To better mimic the extracellular matrix (ECM), many biodegradable materials have been engineered with compositional and/or topological cues to maintain the biological properties of the SCs/SCs-like cells. In addition, ECM components or factors secreted by SCs also actively contribute to nerve regeneration. Such cell-free transplantation approaches may provide great promise in clinical translation. In this review, we first present the current bio-scaffolds engineered for SC transplantation and their achievement in animal models and clinical applications. To this end, we focus on the physical and biological properties of different biomaterials and highlight how these properties affect the biological behaviors of the SCs/SC-like cells. Second, the SC-derived biomaterials are also reviewed and discussed. Finally, the relationship between SCs and functional biomaterials is summarized, and the trends of their future development are predicted toward clinical applications.
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Affiliation(s)
- Zilong Rao
- Guangdong Engineering Technology Research Centre for Functional Biomaterials, School of Materials Science and Engineering, Sun Yat-sen University, Guangzhou, China
| | - Zudong Lin
- PCFM Lab, GD HPPC Lab, School of Chemistry, Sun Yat-sen University, Guangzhou, China
| | - Panpan Song
- Guangdong Engineering Technology Research Centre for Functional Biomaterials, School of Materials Science and Engineering, Sun Yat-sen University, Guangzhou, China
| | - Daping Quan
- Guangdong Engineering Technology Research Centre for Functional Biomaterials, School of Materials Science and Engineering, Sun Yat-sen University, Guangzhou, China
| | - Ying Bai
- Guangdong Engineering Technology Research Centre for Functional Biomaterials, School of Materials Science and Engineering, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Ying Bai
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Gold nanorods decorated polycaprolactone/cellulose acetate hybrid scaffold for PC12 cells proliferation. Int J Biol Macromol 2022; 206:511-520. [PMID: 35240215 DOI: 10.1016/j.ijbiomac.2022.02.156] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/15/2022] [Accepted: 02/25/2022] [Indexed: 01/12/2023]
Abstract
Synthetic and natural polymers have recently received considerable attention due to the exclusive potential for supporting the regenerative cellular processes in peripheral nerve injuries (PNIs). Gold nanorods (GNRs) decorated polycaprolactone (PCL)/cellulose acetate (CA) nanocomposite (PCL/CA/GNR) were fabricated via electrospinning to improve PC12 cells attachment and growth or scaffold cues. Transmission electron microscopy (TEM) corroborated the GNR distribution (23 ± 2 nm length and 3/1 Aspect ratio) and suitable average dimension of 800 nm for the fibers; also, scanning electron microscopy (SEM) represented block-free and smooth fibers without perturbation. Because of gold nanorods incorporation, electrical conductivity of PCL/CA/GNR increased ~21%. Water contact angle data emphasized PCL/CA/GNR surface is more wettable that PCL/CA (<90° at 62 s). Real-time PCR technique (RT-PCR) demonstrated overexpression of β-tubulin and microtubule-associated protein 2 (MAP2) on PCL/CA/GNR compared to PCL/CA composite. Additionally, evaluated of the maturation and neurogenic differentiation of PC12 cells emphasized overexpression of nestin and β-tubulin by Immunocytochemistry staining onto PCL/CA/GNR in comparison to PCL/CA composite. Notably, these recently developed hybrid scaffolds could be considered for peripheral nerve injury (PNI) regeneration.
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Functional tissue-engineered microtissue formed by self-aggregation of cells for peripheral nerve regeneration. Stem Cell Res Ther 2022; 13:3. [PMID: 35012663 PMCID: PMC8744299 DOI: 10.1186/s13287-021-02676-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/11/2021] [Indexed: 02/06/2023] Open
Abstract
Background Peripheral nerve injury (PNI) is one of the essential causes of physical disability with a high incidence rate. The traditional tissue engineering strategy, Top-Down strategy, has some limitations. A new tissue-engineered strategy, Bottom-Up strategy (tissue-engineered microtissue strategy), has emerged and made significant research progress in recent years. However, to the best of our knowledge, microtissues are rarely used in neural tissue engineering; thus, we intended to use microtissues to repair PNI.
Methods We used a low-adhesion cell culture plate to construct adipose-derived mesenchymal stem cells (ASCs) into microtissues in vitro, explored the physicochemical properties and microtissues components, compared the expression of cytokines related to nerve regeneration between microtissues and the same amount of two-dimension (2D)-cultured cells, co-cultured directly microtissues with dorsal root ganglion (DRG) or Schwann cells (SCs) to observe the interaction between them using immunocytochemistry, quantitative reverse transcription polymerase chain reaction (qRT-PCR), enzyme-linked immunosorbent assay (ELISA). We used grafts constructed by microtissues and polycaprolactone (PCL) nerve conduit to repair sciatic nerve defects in rats. Results The present study results indicated that compared with the same number of 2D-cultured cells, microtissue could secrete more nerve regeneration related cytokines to promote SCs proliferation and axons growth. Moreover, in the direct co-culture system of microtissue and DRG or SCs, axons of DRG grown in the direction of microtissue, and there seems to be a cytoplasmic exchange between SCs and ASCs around microtissue. Furthermore, microtissues could repair sciatic nerve defects in rat models more effectively than traditional 2D-cultured ASCs. Conclusion Tissue-engineered microtissue is an effective strategy for stem cell culture and therapy in nerve tissue engineering. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-021-02676-0.
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Dervan A, Franchi A, Almeida-Gonzalez FR, Dowling JK, Kwakyi OB, McCoy CE, O’Brien FJ, Hibbitts A. Biomaterial and Therapeutic Approaches for the Manipulation of Macrophage Phenotype in Peripheral and Central Nerve Repair. Pharmaceutics 2021; 13:2161. [PMID: 34959446 PMCID: PMC8706646 DOI: 10.3390/pharmaceutics13122161] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 12/18/2022] Open
Abstract
Injury to the peripheral or central nervous systems often results in extensive loss of motor and sensory function that can greatly diminish quality of life. In both cases, macrophage infiltration into the injury site plays an integral role in the host tissue inflammatory response. In particular, the temporally related transition of macrophage phenotype between the M1/M2 inflammatory/repair states is critical for successful tissue repair. In recent years, biomaterial implants have emerged as a novel approach to bridge lesion sites and provide a growth-inductive environment for regenerating axons. This has more recently seen these two areas of research increasingly intersecting in the creation of 'immune-modulatory' biomaterials. These synthetic or naturally derived materials are fabricated to drive macrophages towards a pro-repair phenotype. This review considers the macrophage-mediated inflammatory events that occur following nervous tissue injury and outlines the latest developments in biomaterial-based strategies to influence macrophage phenotype and enhance repair.
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Affiliation(s)
- Adrian Dervan
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland; (A.D.); (A.F.); (F.R.A.-G.); (F.J.O.)
- Trinity Centre for Bioengineering, Trinity College Dublin, D02 R590 Dublin, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, D02 YN77 Dublin, Ireland
| | - Antonio Franchi
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland; (A.D.); (A.F.); (F.R.A.-G.); (F.J.O.)
- Trinity Centre for Bioengineering, Trinity College Dublin, D02 R590 Dublin, Ireland
| | - Francisco R. Almeida-Gonzalez
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland; (A.D.); (A.F.); (F.R.A.-G.); (F.J.O.)
- Trinity Centre for Bioengineering, Trinity College Dublin, D02 R590 Dublin, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, D02 YN77 Dublin, Ireland
| | - Jennifer K. Dowling
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland; (J.K.D.); (O.B.K.); (C.E.M.)
- FutureNeuro SFI Research Centre, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland
| | - Ohemaa B. Kwakyi
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland; (J.K.D.); (O.B.K.); (C.E.M.)
- School of Medicine, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland
| | - Claire E. McCoy
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland; (J.K.D.); (O.B.K.); (C.E.M.)
- FutureNeuro SFI Research Centre, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland
| | - Fergal J. O’Brien
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland; (A.D.); (A.F.); (F.R.A.-G.); (F.J.O.)
- Trinity Centre for Bioengineering, Trinity College Dublin, D02 R590 Dublin, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, D02 YN77 Dublin, Ireland
| | - Alan Hibbitts
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland; (A.D.); (A.F.); (F.R.A.-G.); (F.J.O.)
- Trinity Centre for Bioengineering, Trinity College Dublin, D02 R590 Dublin, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, D02 YN77 Dublin, Ireland
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Suss PH, Ribeiro VST, Motooka CE, de Melo LC, Tuon FF. Comparative study of decellularization techniques to obtain natural extracellular matrix scaffolds of human peripheral-nerve allografts. Cell Tissue Bank 2021; 23:511-520. [PMID: 34767141 DOI: 10.1007/s10561-021-09977-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 11/03/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND We hypothesize that adding sonication cycles to the process of decellularization of cadaveric human peripheral nerves will increase the removal of cell debris and myelin sheath, increasing their utility as allografts. METHODS Our aim of this study was to develop a decellularization protocol that allows the removal of cells and myelin sheath without detrimental effects on nerve architecture. Segments of ulnar and median nerves from human donors, isolated both before and after cardiac arrest, were subjected to two methods of decellularization: two-detergent-based (M1) and the same method with sonication added (M2). We evaluated the histology of unprocessed and decellularized nerves (n = 24 per group) for general morphology, presence of cell nuclei, nuclear remnants, collagen fibers, and myelin. We performed immunohistochemistry to verify the removal of Schwann cells associated with histomorphometry. We used scanning electron microscopy (EM) to evaluate the ultrastructure of both native and decellularized nerves. The efficacy of decellularization was assessed by analysis of genomic DNA. RESULTS Histology confirmed that both decellularization protocols were adequate and maintained natural nerve architecture. Scanning EM showed that 3D ultrastructural architecture also was maintained. Histomorphometric parameters showed a more complete removal of the myelin with the M2 protocol than with M1 (p = 0.009). Fiber diameter and density were not modified by decellularization methods. CONCLUSIONS Sonication can be a complementary method to decellularization of peripheral nerve allografts with sonication increasing the effectiveness of detergent-based protocols for the removal of unwanted cellular components from peripheral nerve allografts.
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Affiliation(s)
- Paula Hansen Suss
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil
| | - Victoria Stadler Tasca Ribeiro
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil
| | - Carlos Eduardo Motooka
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil
| | - Letícia Corso de Melo
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil
| | - Felipe Francisco Tuon
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil.
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Yang H, Li Q, Li L, Chen S, Zhao Y, Hu Y, Wang L, Lan X, Zhong L, Lu D. Gastrodin modified polyurethane conduit promotes nerve repair via optimizing Schwann cells function. Bioact Mater 2021; 8:355-367. [PMID: 34541406 PMCID: PMC8427216 DOI: 10.1016/j.bioactmat.2021.06.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/18/2021] [Accepted: 06/18/2021] [Indexed: 12/15/2022] Open
Abstract
Peripheral nerve regeneration and functional recovery remain a major clinical challenge. Nerve guidance conduit (NGC) that can regulate biological behavior of Schwann cells (SCs) and facilitate axonal regeneration through microenvironmental remodeling is beneficial for nerve regeneration and functional recovery. Gastrodin, a main constituent of a Chinese traditional herbal medicine, has been known to display several biological and pharmacological properties, especially antioxidative, anti‐inflammatory and nerve regeneration. Herein, polyurethane (PU) NGCs modified by different weight ratio of Gastrodin (0, 1 and 5 wt%) were designed for sequential and sustainable drug release, that created a favorable microenvironment for nerve regeneration. The scaffold showed suitable pore structure and biocompatibility in vitro, and evidently promoted morphological and functional recovery of regenerated sciatic nerves in vivo. Compared to the PU and 1%Gastrodin/PU scaffolds, the 5%Gastrodin/PU significantly enhanced the proliferation, migration and myelination of SCs and up-regulated expression of neurotrophic factors, as well as induction of the differentiation of PC12 cells. Interestingly, the obvious anti-inflammatory response was observed in 5%Gastrodin/PU by reduced expression of TNF-α and iNOS, which also evidenced by the few fibrous capsule formation in the subcutaneous implantation. Such a construct presented a similarity to autograft in vivo repairing a 10 mm sciatic nerve defects. It was able to not only boost the regenerated area of nerve and microvascular network, but also facilitate functional axons growth and remyelination, leading to highly improved functional restoration. These findings demonstrate that the 5%Gastrodin/PU NGC efficiently promotes nerve regeneration, indicating their potential for use in peripheral nerve regeneration applications. NGC with a sustained release of Gastrodin creates a favorable microenvironment. . Gastrodin/PU has superior anti-inflammatory effects. SCs-mediated tissue engineering strategies effectively drive myelination. 5Gastrodin/PU boosts nerve regeneration and functional restoration in vivo.
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Affiliation(s)
- Hongcai Yang
- Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Department of Neurology, The First Affiliated Hospital, Kunming Medical University, Kunming, 650500, China
| | - Qing Li
- Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Science and Technology Achievement Incubation Center, Kunming Medical University, Kunming, 650500, China
| | - Limei Li
- Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Science and Technology Achievement Incubation Center, Kunming Medical University, Kunming, 650500, China
| | - Shaochun Chen
- The School of Rehabilitation, Kunming Medical University, Kunming, 650500, China
| | - Yu Zhao
- Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Science and Technology Achievement Incubation Center, Kunming Medical University, Kunming, 650500, China
| | - Yingrui Hu
- Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Science and Technology Achievement Incubation Center, Kunming Medical University, Kunming, 650500, China
| | - Lu Wang
- Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Science and Technology Achievement Incubation Center, Kunming Medical University, Kunming, 650500, China
| | - Xiaoqian Lan
- Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Department of Neurology, The First Affiliated Hospital, Kunming Medical University, Kunming, 650500, China
| | - Lianmei Zhong
- Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Department of Neurology, The First Affiliated Hospital, Kunming Medical University, Kunming, 650500, China
| | - Di Lu
- Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Science and Technology Achievement Incubation Center, Kunming Medical University, Kunming, 650500, China
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11
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Capella-Monsonís H, Zeugolis DI. Decellularized xenografts in regenerative medicine: From processing to clinical application. Xenotransplantation 2021; 28:e12683. [PMID: 33709410 DOI: 10.1111/xen.12683] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/28/2021] [Accepted: 02/25/2021] [Indexed: 12/13/2022]
Abstract
Decellularized xenografts are an inherent component of regenerative medicine. Their preserved structure, mechanical integrity and biofunctional composition have well established them in reparative medicine for a diverse range of clinical indications. Nonetheless, their performance is highly influenced by their source (ie species, age, tissue) and processing (ie decellularization, crosslinking, sterilization and preservation), which govern their final characteristics and determine their success or failure for a specific clinical target. In this review, we provide an overview of the different sources and processing methods used in decellularized xenografts fabrication and discuss their effect on the clinical performance of commercially available decellularized xenografts.
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Affiliation(s)
- Héctor Capella-Monsonís
- 1Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland.,Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
| | - Dimitrios I Zeugolis
- 1Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland.,Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland.,Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
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12
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Amini S, Salehi H, Setayeshmehr M, Ghorbani M. Natural and synthetic polymeric scaffolds used in peripheral nerve tissue engineering: Advantages and disadvantages. POLYM ADVAN TECHNOL 2021. [DOI: 10.1002/pat.5263] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Shahram Amini
- Department of Anatomical Sciences and Molecular Biology, School of Medicine Isfahan University of Medical Sciences hezarjerib Isfahan Iran
- Student Research Committee Baqiyatallah University of Medical Sciences Tehran Iran
| | - Hossein Salehi
- Department of Anatomical Sciences and Molecular Biology, School of Medicine Isfahan University of Medical Sciences hezarjerib Isfahan Iran
| | - Mohsen Setayeshmehr
- Department of Biomaterials, Tissue Engineering and Nanotechnology, School of Advanced Technologies in Medicine Isfahan University of Medical Sciences Isfahan Iran
| | - Masoud Ghorbani
- Applied Biotechnology Research Center Baqiyatallah University of Medical Sciences Tehran Iran
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13
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Comparison of Decellularization Protocols to Generate Peripheral Nerve Grafts: A Study on Rat Sciatic Nerves. Int J Mol Sci 2021; 22:ijms22052389. [PMID: 33673602 PMCID: PMC7957587 DOI: 10.3390/ijms22052389] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 01/03/2023] Open
Abstract
In critical nerve gap repair, decellularized nerve allografts are considered a promising tissue engineering strategy that can provide superior regeneration results compared to nerve conduits. Decellularized nerves offer a well-conserved extracellular matrix component that has proven to play an important role in supporting axonal guiding and peripheral nerve regeneration. Up to now, the known decellularized techniques are time and effort consuming. The present study, performed on rat sciatic nerves, aims at investigating a novel nerve decellularization protocol able to combine an effective decellularization in short time with a good preservation of the extracellular matrix component. To do this, a decellularization protocol proven to be efficient for tendons (DN-P1) was compared with a decellularization protocol specifically developed for nerves (DN-P2). The outcomes of both the decellularization protocols were assessed by a series of in vitro evaluations, including qualitative and quantitative histological and immunohistochemical analyses, DNA quantification, SEM and TEM ultrastructural analyses, mechanical testing, and viability assay. The overall results showed that DN-P1 could provide promising results if tested in vivo, as the in vitro characterization demonstrated that DN-P1 conserved a better ultrastructure and ECM components compared to DN-P2. Most importantly, DN-P1 was shown to be highly biocompatible, supporting a greater number of viable metabolically active cells.
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14
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Tao M, Ao T, Mao X, Yan X, Javed R, Hou W, Wang Y, Sun C, Lin S, Yu T, Ao Q. Sterilization and disinfection methods for decellularized matrix materials: Review, consideration and proposal. Bioact Mater 2021; 6:2927-2945. [PMID: 33732964 PMCID: PMC7930362 DOI: 10.1016/j.bioactmat.2021.02.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 02/08/2023] Open
Abstract
Sterilization is the process of killing all microorganisms, while disinfection is the process of killing or removing all kinds of pathogenic microorganisms except bacterial spores. Biomaterials involved in cell experiments, animal experiments, and clinical applications need to be in the aseptic state, but their physical and chemical properties as well as biological activities can be affected by sterilization or disinfection. Decellularized matrix (dECM) is the low immunogenicity material obtained by removing cells from tissues, which retains many inherent components in tissues such as proteins and proteoglycans. But there are few studies concerning the effects of sterilization or disinfection on dECM, and the systematic introduction of sterilization or disinfection for dECM is even less. Therefore, this review systematically introduces and analyzes the mechanism, advantages, disadvantages, and applications of various sterilization and disinfection methods, discusses the factors influencing the selection of sterilization and disinfection methods, summarizes the sterilization and disinfection methods for various common dECM, and finally proposes a graphical route for selecting an appropriate sterilization or disinfection method for dECM and a technical route for validating the selected method, so as to provide the reference and basis for choosing more appropriate sterilization or disinfection methods of various dECM. Asepsis is the prerequisite for the experiment and application of biomaterials. Sterilization or disinfection affects physic-chemical properties of biomaterials. Mechanism, advantages and disadvantages of sterilization or disinfection methods. Factors influencing the selection of sterilization or disinfection methods. Selection of sterilization or disinfection methods for decellularized matrix.
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Affiliation(s)
- Meihan Tao
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Tianrang Ao
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoyan Mao
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Xinzhu Yan
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Rabia Javed
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Weijian Hou
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Yang Wang
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Cong Sun
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Shuang Lin
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Tianhao Yu
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Qiang Ao
- Department of Tissue Engineering, China Medical University, Shenyang, China.,Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China.,Institute of Regulatory Science for Medical Device, National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
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15
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Manoukian OS, Rudraiah S, Arul MR, Bartley JM, Baker JT, Yu X, Kumbar SG. Biopolymer-nanotube nerve guidance conduit drug delivery for peripheral nerve regeneration: In vivo structural and functional assessment. Bioact Mater 2021; 6:2881-2893. [PMID: 33718669 PMCID: PMC7907220 DOI: 10.1016/j.bioactmat.2021.02.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/12/2021] [Accepted: 02/12/2021] [Indexed: 01/01/2023] Open
Abstract
Peripheral nerve injuries account for roughly 3% of all trauma patients with over 900,000 repair procedures annually in the US. Of all extremity peripheral nerve injuries, 51% require nerve repair with a transected gap. The current gold-standard treatment for peripheral nerve injuries, autograft repair, has several shortcomings. Engineered constructs are currently only suitable for short gaps or small diameter nerves. Here, we investigate novel nerve guidance conduits with aligned microchannel porosity that deliver sustained-release of neurogenic 4-aminopyridine (4-AP) for peripheral nerve regeneration in a critical-size (15 mm) rat sciatic nerve transection model. The results of functional walking track analysis, morphometric evaluations of myelin development, and histological assessments of various markers confirmed the equivalency of our drug-conduit with autograft controls. Repaired nerves showed formation of thick myelin, presence of S100 and neurofilament markers, and promising functional recovery. The conduit's aligned microchannel architecture may play a vital role in physically guiding axons for distal target reinnervation, while the sustained release of 4-AP may increase nerve conduction, and in turn synaptic neurotransmitter release and upregulation of critical Schwann cell neurotrophic factors. Overall, our nerve construct design facilitates efficient and efficacious peripheral nerve regeneration via a drug delivery system that is feasible for clinical applications. Nerve guidance conduit platform with tunable scaffold properties for repair and regeneration of large-gap nerve injuries. Sustained 4-aminopyridine release amplifies neurotrophic factor release by Schwann cells to promote axon regeneration. Longitudinally aligned scaffold pores and controllable physicochemical properties provide guidance for axon regeneration. Critical-size rat sciatic nerve defect healing both structurally and functionally resembled autograft control treatment. Innovative and transformative scaffold technology imbued with structural and functional features for tissue regeneration. Scaffold enable tailorable release profiles for small molecules proteins and electrical stimulation for tissue regeneration.
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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
| | - 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
| | - Jenna M Bartley
- Department of Immunology, Center on Aging, University of Connecticut Health, Farmington, CT, USA
| | - Jiana T Baker
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, USA
| | - Xiaojun Yu
- Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, NJ, USA
| | - 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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16
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Yang CY, Huang WY, Chen LH, Liang NW, Wang HC, Lu J, Wang X, Wang TW. Neural tissue engineering: the influence of scaffold surface topography and extracellular matrix microenvironment. J Mater Chem B 2021; 9:567-584. [DOI: 10.1039/d0tb01605e] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Strategies using surface topography, contact guidance and biomechanical cues in the design of scaffolds as an ECM support for neural tissue engineering.
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Affiliation(s)
- Chun-Yi Yang
- Institute for Regenerative Medicine and Biomimetic Materials
- School of Materials Science and Engineering
- Tsinghua University
- Beijing
- China
| | - Wei-Yuan Huang
- Department of Materials Science and Engineering
- National Tsing Hua University
- Hsinchu
- Taiwan
| | - Liang-Hsin Chen
- Department of Materials Science and Engineering
- National Tsing Hua University
- Hsinchu
- Taiwan
| | - Nai-Wen Liang
- Department of Materials Science and Engineering
- National Tsing Hua University
- Hsinchu
- Taiwan
| | - Huan-Chih Wang
- Division of Neurosurgery
- Department of Surgery
- National Taiwan University Hospital
- Taipei
- Taiwan
| | - Jiaju Lu
- Institute for Regenerative Medicine and Biomimetic Materials
- School of Materials Science and Engineering
- Tsinghua University
- Beijing
- China
| | - Xiumei Wang
- Institute for Regenerative Medicine and Biomimetic Materials
- School of Materials Science and Engineering
- Tsinghua University
- Beijing
- China
| | - Tzu-Wei Wang
- Department of Materials Science and Engineering
- National Tsing Hua University
- Hsinchu
- Taiwan
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17
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Zaminy A, Sayad-Fathi S, Kasmaie FM, Jahromi Z, Zendedel A. Decellularized peripheral nerve grafts by a modified protocol for repair of rat sciatic nerve injury. Neural Regen Res 2021; 16:1086-1092. [PMID: 33269754 PMCID: PMC8224104 DOI: 10.4103/1673-5374.300449] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Studies have shown that acellular nerve xenografts do not require immunosuppression and use of acellular nerve xenografts for repair of peripheral nerve injury is safe and effective. However, there is currently no widely accepted standard chemical decellularization method. The purpose of this study is to investigate the efficiency of bovine-derived nerves decellularized by the modified Hudson’s protocol in the repair of rat sciatic nerve injury. In the modified Hudson’s protocol, Triton X-200 was replaced by Triton X-100, and DNase and RNase were used to prepare accelular nerve xenografts. The efficiency of bovine-derived nerves decellularized by the modified Hudson’s protocol was tested in vitro by hematoxylin & eosin, Alcian blue, Masson’s trichrome, and Luxol fast blue staining, immunohistochemistry, and biochemical assays. The decellularization approach excluded cells, myelin, and axons of nerve xenografts, without affecting the organization of nerve xenografts. The decellularized nerve xenograft was used to bridge a 7 mm-long sciatic nerve defect to evaluate its efficiency in the repair of peripheral nerve injury. At 8 weeks after transplantation, sciatic function index in rats subjected to transplantation of acellular nerve xenograft was similar to that in rats undergoing transplantation of nerve allograft. Morphological analysis revealed that there were a large amount of regenerated myelinated axons in acellular nerve xenograft; the number of Schwann cells in the acellular nerve xenograft was similar to that in the nerve allograft. These findings suggest that acellular nerve xenografts prepared by the modified Hudson’s protocol can be used for repair of peripheral nerve injury. This study was approved by the Research Ethics Committee, Research and Technology Chancellor of Guilan University of Medical Sciences, Iran (approval No. IR.GUMS.REC.1395.332) on February 11, 2017.
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Affiliation(s)
- Arash Zaminy
- Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Sara Sayad-Fathi
- Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Zohreh Jahromi
- Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Adib Zendedel
- Institute of Neuroanatomy, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
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18
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Bae JY, Park SY, Shin YH, Choi SW, Kim JK. Preparation of human decellularized peripheral nerve allograft using amphoteric detergent and nuclease. Neural Regen Res 2021; 16:1890-1896. [PMID: 33510098 PMCID: PMC8328754 DOI: 10.4103/1673-5374.306091] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Animal studies have shown that amphoteric detergent and nuclease (DNase I and ribonuclease A) is the most reliable decellularization method of the peripheral nerve. However, the optimal combination of chemical reagents for decellularization of human nerve allograft needs further investigation. To find the optimal protocol to remove the immunogenic cellular components of the nerve tissue and preserve the basal lamina and extracellular matrix and whether the optimal protocol can be applied to larger-diameter human peripheral nerves, in this study, we decellularized the median and sural nerves from the cadavers with two different methods: nonionic and anionic detergents (Triton X-100 and sodium deoxycholate) and amphoteric detergent and nuclease (3-[(3-cholamidopropyl)dimethylammonio]-1-propanesulfonate (CHAPS), deoxyribonuclease I, and ribonuclease A). All cellular components were successfully removed from the median and sural nerves by amphoteric detergent and nuclease. Not all cellular components were removed from the median nerve by nonionic and anionic detergent. Both median and sural nerves treated with amphoteric detergent and nuclease maintained a completely intact extracellular matrix. Treatment with nonionic and anionic detergent decreased collagen content in both median and sural nerves, while the amphoteric detergent and nuclease treatment did not reduce collagen content. In addition, a contact cytotoxicity assay revealed that the nerves decellularized by amphoteric detergent and nuclease was biocompatible. Strength failure testing demonstrated that the biomechanical properties of nerves decellularized with amphoteric detergent and nuclease were comparable to those of fresh controls. Decellularization with amphoteric detergent and nuclease better remove cellular components and better preserve extracellular matrix than decellularization with nonionic and anionic detergents, even in large-diameter human peripheral nerves. In Korea, cadaveric studies are not yet legally subject to Institutional Review Board review.
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Affiliation(s)
- Joo-Yul Bae
- Department of Orthopedic Surgery, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung-si, Korea
| | - Suk Young Park
- Department of Orthopedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Young Ho Shin
- Department of Orthopedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Shin Woo Choi
- Department of Orthopedic Surgery, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung-si, Korea
| | - Jae Kwang Kim
- Department of Orthopedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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19
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Rao Z, Lin T, Qiu S, Zhou J, Liu S, Chen S, Wang T, Liu X, Zhu Q, Bai Y, Quan D. Decellularized nerve matrix hydrogel scaffolds with longitudinally oriented and size-tunable microchannels for peripheral nerve regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 120:111791. [PMID: 33545917 DOI: 10.1016/j.msec.2020.111791] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/20/2020] [Accepted: 12/03/2020] [Indexed: 12/13/2022]
Abstract
The scaffolding biomaterials and their internal structures are crucial in constructing growth-permissive microenvironment for tissue regeneration. A functional bioscaffold not only requires sufficient extracellular matrix components, but also provides topological guidance by mimicry of the ultrastructure of the native tissue. In our laboratory, a decellularized nerve matrix hydrogel derived from porcine sciatic nerve (pDNM-G) is successfully prepared, which shows great promise for peripheral nerve regeneration. Herein, longitudinally oriented microchannel structures were introduced into pDNM-G bioscaffolds (A-pDNM-G) through controlled unidirectional freeze-drying. The axially aligned microchannels effectively directed and significantly promoted neurite extension and Schwann cell migration, assessed by culturing dorsal root ganglion explants on the longitudinal sections of A-pDNM-G scaffolds. Such regenerative cellular responses can be further optimized by tuning the channel sizes. In vivo studies confirmed that the implanted nerve guidance conduits containing A-pDNM-G scaffolds significantly facilitated axonal extension, myelination, and reached considerable functional recovery in 15-mm rat sciatic nerve defects. The incorporation of nerve growth factor further improved the overall performance in the grafted nerve. The bioactive pDNM-G enables controlled release of neurotrophic factor and easy integration of topological cue provided by the axially aligned microchannels into implantable bioscaffolds, which may serve in future clinical treatments of peripheral nerve injury.
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Affiliation(s)
- Zilong Rao
- PCFM Lab, GD HPPC Lab, School of Chemistry, Sun Yat-sen University, Guangzhou 510275, China; Guangdong Functional Biomaterials Engineering Technology Research Center, School of Materials Science and Engineering, Sun Yat-sen University, Guangzhou 510275, China
| | - Tao Lin
- Guangdong Peripheral Nerve Tissue Engineering and Technology Research Center, Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; Department of Orthopedics and Traumatology, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, China
| | - Shuai Qiu
- Guangdong Peripheral Nerve Tissue Engineering and Technology Research Center, Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Jing Zhou
- Guangdong Functional Biomaterials Engineering Technology Research Center, School of Materials Science and Engineering, Sun Yat-sen University, Guangzhou 510275, China
| | - Sheng Liu
- PCFM Lab, GD HPPC Lab, School of Chemistry, Sun Yat-sen University, Guangzhou 510275, China
| | - Shihao Chen
- PCFM Lab, GD HPPC Lab, School of Chemistry, Sun Yat-sen University, Guangzhou 510275, China
| | - Tao Wang
- Guangdong Peripheral Nerve Tissue Engineering and Technology Research Center, Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Soft Tissue Biofabrication Engineering Laboratory, Guangzhou 510080, China
| | - Xiaolin Liu
- Guangdong Peripheral Nerve Tissue Engineering and Technology Research Center, Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Qingtang Zhu
- Guangdong Peripheral Nerve Tissue Engineering and Technology Research Center, Department of Orthopedic and Microsurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Soft Tissue Biofabrication Engineering Laboratory, Guangzhou 510080, China.
| | - Ying Bai
- Guangdong Functional Biomaterials Engineering Technology Research Center, School of Materials Science and Engineering, Sun Yat-sen University, Guangzhou 510275, China; Guangdong Provincial Soft Tissue Biofabrication Engineering Laboratory, Guangzhou 510080, China.
| | - Daping Quan
- PCFM Lab, GD HPPC Lab, School of Chemistry, Sun Yat-sen University, Guangzhou 510275, China; Guangdong Functional Biomaterials Engineering Technology Research Center, School of Materials Science and Engineering, Sun Yat-sen University, Guangzhou 510275, China.
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20
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Yu T, Wen L, He J, Xu Y, Li T, Wang W, Ma Y, Ahmad MA, Tian X, Fan J, Wang X, Hagiwara H, Ao Q. Fabrication and evaluation of an optimized acellular nerve allograft with multiple axial channels. Acta Biomater 2020; 115:235-249. [PMID: 32771587 DOI: 10.1016/j.actbio.2020.07.059] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 12/19/2022]
Abstract
Acellular nerve allografts are promising alternatives to autologous nerve grafts, but still have many drawbacks which greatly limit their curative effects. Here, we developed an optimized acellular nerve allograft with multiple axial channels by a modified decellularization method. These allografts were confirmed to preserve more extracellular matrix components and factors, and remove cellular components effectively. Meanwhile, macrochannels and microchannels were introduced to optimize internal microstructure of allografts, which increases porosity and water absorption, without significant loss of mechanical strength. The in vitro experiments demonstrated that the multichannel allografts showed superior ability of facilitating proliferation and penetration of Schwann cells. Additionally, in the in vivo experiments, the multichannel allografts were used to bridge 10 mm rat sciatic nerve defects. They exhibited better capacity to guide regenerative nerve fibers through the defective segment and restore innervation of target organs, thus achieving better recovery of muscle and motor function, in comparison with conventional acellular allografts. These findings indicate that this multichannel acellular nerve allograft has great potential for clinical application and provides a new prospective for future investigations of nerve regeneration. STATEMENT OF SIGNIFICANCE: Acellular nerve allografts, with preservation of natural extracellular matrix, are officially approved to repair peripheral nerve injury in some countries. However, bioactive component loss and compact internal structure result in variable clinical effects of conventional acellular allografts. In the present study, we fabricated an optimized acellular nerve allograft with multiple axial channels, which could both enable decellularization to be easily accomplished and reduce the amount of detergents in the preparation process. Characterization of the multichannel acellular allografts was confirmed to have better preservation of ECM bioactive molecules and regenerative factors. Efficiency evaluation showed the multichannel allografts could facilitate Schwann cells to migrate inside them in vitro, and enhance regrowth and myelination of axons as well as recovery of muscle and motor function in vivo.
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21
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Qiu S, Rao Z, He F, Wang T, Xu Y, Du Z, Yao Z, Lin T, Yan L, Quan D, Zhu Q, Liu X. Decellularized nerve matrix hydrogel and glial-derived neurotrophic factor modifications assisted nerve repair with decellularized nerve matrix scaffolds. J Tissue Eng Regen Med 2020; 14:931-943. [PMID: 32336045 DOI: 10.1002/term.3050] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/11/2020] [Accepted: 04/20/2020] [Indexed: 12/28/2022]
Abstract
Nerve defects are challenging to address clinically without satisfactory treatments. As a reliable alternative to autografts, decellularized nerve matrix scaffolds (DNM-S) have been widely used in clinics for surgical nerve repair. However, DNM-S remain inferior to autografts in their ability to support nerve regeneration for long nerve defects. In this study, we systematically and clearly presented the nano-architecture of nerve-specific structures, including the endoneurium, basement membrane and perineurium/epineurium in DNM-S. Furthermore, we modified the DNM-S by supplementing decellularized nerve matrix hydrogel (DNMG) and glial-derived neurotrophic factor (GDNF) and then bridged a 50-mm sciatic nerve defect in a beagle model. Fifteen beagles were randomly divided into three groups (five per group): an autograft group, DNM-S group and GDNF-DNMG-modified DNM-S (DNM-S/GDNF@DNMG) group. DNM-S/GDNF@DNMG, as optimized nerve grafts, were used to bridge nerve defects in the same manner as in the DNM-S group. The repair outcome was evaluated by behavioural observations, electrophysiological assessments, regenerated nerve tissue histology and reinnervated target muscle examinations. Compared with the DNM-S group, limb function, electrophysiological responses and histological findings were improved in the DNM-S/GDNF@DNMG group 6 months after grafting, reflecting a narrower gap between the effects of DNM-S and autografts. In conclusion, modification of DNM-S with DNMG and GDNF enhanced nerve regeneration and functional recovery, indicating that noncellular modification of DNM-S is a promising method for treating long nerve defects.
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Affiliation(s)
- Shuai Qiu
- Department of Microsurgery, Orthopedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zilong Rao
- PCFM Lab, GD HPPC Lab, School of Chemistry, Sun Yat-sen University, Guangzhou, China
| | - Fulin He
- Department of Microsurgery, Orthopedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tao Wang
- Department of Microsurgery, Orthopedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yiwei Xu
- PCFM Lab, GD HPPC Lab, School of Chemistry, Sun Yat-sen University, Guangzhou, China
| | - Zhaoyi Du
- PCFM Lab, GD HPPC Lab, School of Chemistry, Sun Yat-sen University, Guangzhou, China
| | - Zhi Yao
- Department of Microsurgery, Orthopedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tao Lin
- Department of Microsurgery, Orthopedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Liwei Yan
- Department of Microsurgery, Orthopedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Daping Quan
- Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Peripheral Nerve Tissue-Engineering and Technology Research Center, Guangzhou, China.,GD Functional Biomaterials Engineering Technology Research Center, School of Materials Science and Engineering, Sun Yat-sen University, Guangzhou, China.,PCFM Lab, GD HPPC Lab, School of Chemistry, Sun Yat-sen University, Guangzhou, China
| | - Qingtang Zhu
- Department of Microsurgery, Orthopedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Peripheral Nerve Tissue-Engineering and Technology Research Center, Guangzhou, China
| | - Xiaolin Liu
- Department of Microsurgery, Orthopedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Peripheral Nerve Tissue-Engineering and Technology Research Center, Guangzhou, China
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22
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Li Q, Li L, Yu M, Zheng M, Li Y, Yang J, Dai M, Zhong L, Sun L, Lu D. Elastomeric polyurethane porous film functionalized with gastrodin for peripheral nerve regeneration. J Biomed Mater Res A 2020; 108:1713-1725. [PMID: 32196902 DOI: 10.1002/jbm.a.36937] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Qing Li
- Science and Technology Achievement Incubation CenterKunming Medical University Kunming China
| | - Limei Li
- Science and Technology Achievement Incubation CenterKunming Medical University Kunming China
| | - Mali Yu
- Science and Technology Achievement Incubation CenterKunming Medical University Kunming China
| | - Meng Zheng
- Science and Technology Achievement Incubation CenterKunming Medical University Kunming China
| | - Yao Li
- Department of StomatologyThe First People's Hospital of Yunnan Provience Kunming China
| | - Jian Yang
- Department of Biomedical EngineeringMaterials Research Institute, The Huck Institutes of The Life Sciences, The Pennsylvania State University University Park Pennsylvania USA
| | - Min Dai
- Department of Second CardiologyThe Third People's Hospital of Kunming Kunming China
| | - Lianmei Zhong
- Department of NeurologyThe First Affiliated Hospital, Kunming Medical University Kunming China
| | - Lin Sun
- Department of CardiologyThe Second Affiliated Hospital, Kunming Medical University Kunming China
| | - Di Lu
- Science and Technology Achievement Incubation CenterKunming Medical University Kunming China
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23
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Pedrini FA, Boriani F, Bolognesi F, Fazio N, Marchetti C, Baldini N. Cell-Enhanced Acellular Nerve Allografts for Peripheral Nerve Reconstruction: A Systematic Review and a Meta-Analysis of the Literature. Neurosurgery 2020; 85:575-604. [PMID: 30247648 DOI: 10.1093/neuros/nyy374] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 07/18/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Peripheral nerve reconstruction is a difficult problem to solve. Acellular nerve allografts (ANAs) have been widely tested and are a promising alternative to the autologous gold standard. However, current reconstructive methods still yield unpredictable and unsuccessful results. Consequently, numerous studies have been carried out studying alternatives to plain ANAs, but it is not clear if nerve regeneration potential exists between current biological, chemical, and physical enrichment modes. OBJECTIVE To systematically review the effects of cell-enhanced ANAs on regeneration of peripheral nerve injuries. METHODS PubMed, ScienceDirect, Medline, and Scopus databases were searched for related articles published from 2007 to 2017. Inclusion criteria of selected articles consisted of (1) articles written in English; (2) the topic being cell-enhanced ANAs in peripheral nerve regeneration; (3) an in vivo study design; and (4) postgrafting neuroregenerative assessment of results. Exclusion criteria included all articles that (1) discussed central nervous system ANAs; (2) consisted of xenografts as the main topic; and (3) consisted of case series, case reports or reviews. RESULTS Forty papers were selected, and categorization included the animal model; the enhancing cell types; the decellularization method; and the neuroregenerative test performed. The effects of using diverse cellular enhancements combined with ANAs are discussed and also compared with the other treatments such as autologous nerve graft, and plain ANAs. CONCLUSION ANAs cellular enhancement demonstrated positive effects on recovery of nerve function. Future research should include clinical translation, in order to increase the level of evidence available on peripheral nerve reconstruction.
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Affiliation(s)
- Francesca Alice Pedrini
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Filippo Boriani
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,Department of Plastic and Hand Surgery, Koelliker Hospital, Turin, Italy
| | - Federico Bolognesi
- Maxillofacial Surgery Unit, S. Orsola-Malpighi Hospital, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Nicola Fazio
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Claudio Marchetti
- Maxillofacial Surgery Unit, S. Orsola-Malpighi Hospital, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Nicola Baldini
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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24
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Jain D, Mattiassi S, Goh EL, Yim EKF. Extracellular matrix and biomimetic engineering microenvironment for neuronal differentiation. Neural Regen Res 2020; 15:573-585. [PMID: 31638079 PMCID: PMC6975142 DOI: 10.4103/1673-5374.266907] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Extracellular matrix (ECM) influences cell differentiation through its structural and biochemical properties. In nervous system, neuronal behavior is influenced by these ECMs structures which are present in a meshwork, fibrous, or tubular forms encompassing specific molecular compositions. In addition to contact guidance, ECM composition and structures also exert its effect on neuronal differentiation. This short report reviewed the native ECM structure and composition in central nervous system and peripheral nervous system, and their impact on neural regeneration and neuronal differentiation. Using topographies, stem cells have been differentiated to neurons. Further, focussing on engineered biomimicking topographies, we highlighted the role of anisotropic topographies in stem cell differentiation to neurons and its recent temporal application for efficient neuronal differentiation.
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Affiliation(s)
- Deepak Jain
- Department of Chemical Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Sabrina Mattiassi
- Department of Chemical Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Eyleen L Goh
- Neuroscience Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Evelyn K F Yim
- Department of Chemical Engineering, University of Waterloo, Waterloo, Ontario, Canada
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25
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Treatment of Neuroma-induced Chronic Pain and Management of Nerve Defects with Processed Nerve Allografts. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2467. [PMID: 32537284 PMCID: PMC7288900 DOI: 10.1097/gox.0000000000002467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 08/02/2019] [Indexed: 01/19/2023]
Abstract
Symptomatic neuromas can cause significant chronic pain and negatively impact quality of life. Symptoms often persist despite narcotics and nonoperative interventions, which are largely ineffective. With the opioid crisis, treatments for chronic pain that limit narcotics are needed. Traditional surgical options may result in neuroma recurrence. Autograft reconstruction often results in donor-site morbidity. Processed nerve allografts facilitate axonal growth, nerve regeneration, and eliminate donor-site morbidity. Methods A literature review was performed to identify studies in which chronic neuroma pain was treated with excision and processed nerve allograft reconstruction. PubMed was queried, and data from the studies were grouped into treatment effective and ineffective groups. Statistical analyses were performed on these groups, and further subgroup analysis was performed on overall change of preoperative and postoperative pain scores using a paired t test. Results Seven studies fulfilled inclusion criteria yielding 42 patients. Greater than 90% of patients had improvement of pain postoperatively. The preoperative and postoperative pain scores could be determined for 40 patients. The mean preoperative score was 7.9, and the mean postoperative score was 3.54. These results were statistically significant using a paired t test with a P value of <0.001. Conclusions Chronic pain resulting from symptomatic neuromas can be treated with neuroma excision and nerve stump reconstruction with processed nerve allograft. This obviates autograft-associated donor-site morbidity and provides a platform to potentially restore sensation to the involved nerve whenever a distal nerve end is available. Addressing the root cause is an important paradigm shift for treating symptomatic neuromas.
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26
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Philips C, Cornelissen M, Carriel V. Evaluation methods as quality control in the generation of decellularized peripheral nerve allografts. J Neural Eng 2019; 15:021003. [PMID: 29244032 DOI: 10.1088/1741-2552/aaa21a] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Nowadays, the high incidence of peripheral nerve injuries and the low success ratio of surgical treatments are driving research to the generation of novel alternatives to repair critical nerve defects. In this sense, tissue engineering has emerged as a possible alternative with special attention to decellularization techniques. Tissue decellularization offers the possibility to obtain a cell-free, natural extracellular matrix (ECM), characterized by an adequate 3D organization and proper molecular composition to repair different tissues or organs, including peripheral nerves. One major problem, however, is that there are no standard quality control methods to evaluate decellularized tissues. Therefore, in this review, a brief description of current strategies for peripheral nerve repair is given, followed by an overview of different decellularization methods used for peripheral nerves. Furthermore, we extensively discuss the available and currently used methods to demonstrate the success of tissue decellularization in terms of the cell removal, preservation of essential ECM molecules and maintenance or modification of biomechanical properties. Finally, orientative guidelines for the evaluation of decellularized peripheral nerve allografts are proposed.
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Affiliation(s)
- Charlot Philips
- Tissue Engineering and Biomaterials Group, Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, B-9000 Ghent, Belgium
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27
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Buckenmeyer MJ, Meder TJ, Prest TA, Brown BN. Decellularization techniques and their applications for the repair and regeneration of the nervous system. Methods 2019; 171:41-61. [PMID: 31398392 DOI: 10.1016/j.ymeth.2019.07.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/11/2019] [Accepted: 07/26/2019] [Indexed: 01/15/2023] Open
Abstract
A variety of surgical and non-surgical approaches have been used to address the impacts of nervous system injuries, which can lead to either impairment or a complete loss of function for affected patients. The inherent ability of nervous tissues to repair and/or regenerate is dampened due to irreversible changes that occur within the tissue remodeling microenvironment following injury. Specifically, dysregulation of the extracellular matrix (i.e., scarring) has been suggested as one of the major factors that can directly impair normal cell function and could significantly alter the regenerative potential of these tissues. A number of tissue engineering and regenerative medicine-based approaches have been suggested to intervene in the process of remodeling which occurs following injury. Decellularization has become an increasingly popular technique used to obtain acellular scaffolds, and their derivatives (hydrogels, etc.), which retain tissue-specific components, including critical structural and functional proteins. These advantageous characteristics make this approach an intriguing option for creating materials capable of stimulating the sensitive repair mechanisms associated with nervous system injuries. Over the past decade, several diverse decellularization methods have been implemented specifically for nervous system applications in an attempt to carefully remove cellular content while preserving tissue morphology and composition. Each application-based decellularized ECM product requires carefully designed treatments that preserve the unique biochemical signatures associated within each tissue type to stimulate the repair of brain, spinal cord, and peripheral nerve tissues. Herein, we review the decellularization techniques that have been applied to create biomaterials with the potential to promote the repair and regeneration of tissues within the central and peripheral nervous system.
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Affiliation(s)
- Michael J Buckenmeyer
- Department of Bioengineering, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, United States.
| | - Tyler J Meder
- Department of Bioengineering, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, United States.
| | - Travis A Prest
- Department of Bioengineering, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, United States.
| | - Bryan N Brown
- Department of Bioengineering, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, United States; McGowan Institute for Regenerative Medicine, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, United States; Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, United States.
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28
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Modulation of angiogenic potential of tissue-engineered peripheral nerve by covalent incorporation of heparin and loading with vascular endothelial growth factor. Neurosci Lett 2019; 705:259-264. [DOI: 10.1016/j.neulet.2019.01.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 12/15/2022]
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29
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Shin YH, Park SY, Kim JK. Comparison of systematically combined detergent and nuclease-based decellularization methods for acellular nerve graft: An ex vivo characterization and in vivo evaluation. J Tissue Eng Regen Med 2019; 13:1241-1252. [PMID: 31050871 DOI: 10.1002/term.2874] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 02/24/2019] [Accepted: 04/29/2019] [Indexed: 12/22/2022]
Abstract
Little consensus exists regarding which decellularization technique best removes the cellular components while maintaining structural integrity. We aimed to identify the most efficient and safest decellularization method by combining previously established chemical (detergent based) and biological (nuclease based) methods in a systematic manner. Sixty sciatic nerves were harvested from Sprague-Dawley rats and prepared in 120 nerve fragments with 1-cm length. Nerve fragments were randomly divided into six groups and decellularized with six different methods: A, nonionic detergent + amphoteric detergent; B, nonionic detergent + anionic detergent; C, anionic detergent + amphoteric detergent; D, nonionic detergent + nuclease; E, amphoteric detergent + nuclease; and F, anionic detergent + nuclease. The remaining cellular components were evaluated with H&E, DAPI, and S-100 immunohistochemical staining, and DNA content was measured in each sample. The remaining extracellular matrix (ECM) integrity was evaluated with H&E, Masson's trichrome, periodic acid-Schiff, Luxol fast blue, and laminin immunohistochemical staining, and collagen content was measured in each sample. The amphoteric detergent + nuclease method was the best protocol for both cell removal and ECM preservation. In the in vivo study, the nerve allograft that was decellularized with amphoteric detergent + nuclease showed an inferior recovery rate based on the tibialis anterior muscle weight to autograft, but considerable recovery was observed. In conclusion, among the possible systematic combinations of detergent- and nuclease-based methods, the combination of amphoteric detergent and nuclease is currently the most suitable for nerve decellularization in terms of adequate cell removal and sufficient preservation of the ECM.
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Affiliation(s)
- Young Ho Shin
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Suk Young Park
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae Kwang Kim
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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30
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Manoukian OS, Arul MR, Rudraiah S, Kalajzic I, Kumbar SG. Aligned microchannel polymer-nanotube composites for peripheral nerve regeneration: Small molecule drug delivery. J Control Release 2019; 296:54-67. [PMID: 30658124 PMCID: PMC6379151 DOI: 10.1016/j.jconrel.2019.01.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/03/2019] [Accepted: 01/14/2019] [Indexed: 12/18/2022]
Abstract
Peripheral nerve injury accounts for roughly 2.8% of all trauma patients with an annual cost of 7 billion USD in the U.S. alone. Current treatment options rely on surgical intervention with the use of an autograft, despite associated shortcomings. Engineered nerve guidance conduits, stem cell therapies, and transient electrical stimulation have reported to increase speeds of functional recovery. As an alternative to the conduction effects of electrical stimulation, we have designed and optimized a nerve guidance conduit with aligned microchannels for the sustained release of a small molecule drug that promotes nerve impulse conduction. A biodegradable chitosan structure reinforced with drug-loaded halloysite nanotubes (HNT) was formed into a foam-like conduit with interconnected, longitudinally-aligned pores with an average pore size of 59.3 ± 14.2 μm. The aligned composite with HNTs produced anisotropic mechanical behavior with a Young's modulus of 0.33 ± 0.1 MPa, very similar to that of native peripheral nerve. This manuscript reports on the sustained delivery of 4-Aminopyridine (4AP, molecular weight 94.1146 g/mol), a potassium-channel blocker as a growth factor alternative to enhance the rate of nerve regeneration. The conduit formulation released a total of 30 ± 2% of the encapsulated 4AP in the first 7 days. Human Schwann cells showed elevated expression of key proteins such as nerve growth factor, myelin protein zero, and brain derived neurotrophic factor in a 4AP dose dependent manner. Preliminary in vivo studies in a critical-sized sciatic nerve defect in Wistar rats confirmed conduit suturability and strength to withstand ambulatory forces over 4 weeks of their implantation. Histological evaluations suggest conduit biocompatibility and Schwann cell infiltration and organization within the conduit and lumen. These nerve guidance conduits and 4AP sustained delivery may serve as an attractive strategy for nerve repair and regeneration.
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Affiliation(s)
- Ohan S Manoukian
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA; Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT, USA
| | - Michael R Arul
- Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT, USA
| | - Swetha Rudraiah
- Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT, USA; Department of Pharmaceutical Sciences, University of Saint Joseph, Hartford, CT, USA
| | - Ivo Kalajzic
- Department of Reconstructive Sciences, University of Connecticut Health, Farmington, CT, USA
| | - Sangamesh G Kumbar
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA; Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT, USA.
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31
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Han GH, Peng J, Liu P, Ding X, Wei S, Lu S, Wang Y. Therapeutic strategies for peripheral nerve injury: decellularized nerve conduits and Schwann cell transplantation. Neural Regen Res 2019; 14:1343-1351. [PMID: 30964052 PMCID: PMC6524503 DOI: 10.4103/1673-5374.253511] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
In recent years, the use of Schwann cell transplantation to repair peripheral nerve injury has attracted much attention. Animal-based studies show that the transplantation of Schwann cells in combination with nerve scaffolds promotes the repair of injured peripheral nerves. Autologous Schwann cell transplantation in humans has been reported recently. This article reviews current methods for removing the extracellular matrix and analyzes its composition and function. The development and secretory products of Schwann cells are also reviewed. The methods for the repair of peripheral nerve injuries that use myelin and Schwann cell transplantation are assessed. This survey of the literature data shows that using a decellularized nerve conduit combined with Schwann cells represents an effective strategy for the treatment of peripheral nerve injury. This analysis provides a comprehensive basis on which to make clinical decisions for the repair of peripheral nerve injury.
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Affiliation(s)
- Gong-Hai Han
- Kunming Medical University, Kunming, Yunnan Province; Institute of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Jiang Peng
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Ping Liu
- Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Xiao Ding
- Shihezi University Medical College, Shihezi, Xinjiang Uygur Autonomous Region, China
| | - Shuai Wei
- Shihezi University Medical College, Shihezi, Xinjiang Uygur Autonomous Region, China
| | - Sheng Lu
- 920th Hospital of Joint Service Support Force, Kunming, Yunnan Province, China
| | - Yu Wang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing, China
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32
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Sarker M, Naghieh S, McInnes AD, Schreyer DJ, Chen X. Regeneration of peripheral nerves by nerve guidance conduits: Influence of design, biopolymers, cells, growth factors, and physical stimuli. Prog Neurobiol 2018; 171:125-150. [DOI: 10.1016/j.pneurobio.2018.07.002] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 07/24/2018] [Accepted: 07/26/2018] [Indexed: 01/10/2023]
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33
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Qiao W, Lu L, Wu G, An X, Li D, Guo J. DPSCs seeded in acellular nerve grafts processed by Myroilysin improve nerve regeneration. J Biomater Appl 2018; 33:819-833. [PMID: 30449254 DOI: 10.1177/0885328218812136] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Since synthetic nerve conduits do not exhibit ideal regeneration characteristics, they are generally inadequate substitutes for autologous nerve grafts in the repair of long peripheral nerve defects. To resolve this problem, in this study, a nerve regeneration acellular nerve graft (ANG) with homologous dental pulp stem cells (DPSCs) was constructed. Xenogeneic ANG was processed by Myroilysin to completely remove cells and myelin sheath, while preserving extracellular matrix (ECM) microstructure of the natural nerve. The study revealed that ANG could support cell attachment and proliferation and did not stimulate a vigorous host rejection response. After inoculation of rabbit DPSCs (r-DPSCs) onto ANG, cells were observed to align along the longitudinal axis of the acellular nerve matrix (ANM) and persistently express NGF and BDNF. Undifferentiated r-DPSCs also presented glial cell characteristics and promoted nerve regeneration after transplantation in vivo. We repaired 1 cm purebred New Zealand White Rabbits sciatic nerve defects using this nerve graft construction, and nerve gap regeneration was indicated by electrophysiological and histological analysis. Therefore, we conclude that the combination of an ANG processed by Myroilysin with DPSCs providing a microenvironment that increases nerve regeneration for repairing peripheral nerve defects.
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Affiliation(s)
- Wenlan Qiao
- Department of Orthodontics, School of Stomatology, Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Jinan, PR China
- Department of Stomatology, Qilu Hospital, and Institute of Stomatology, Shandong University, Jinan, PR China
| | - Lu Lu
- Department of Orthodontics, School of Stomatology, Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Jinan, PR China
| | - Guangxue Wu
- Department of Orthodontics, School of Stomatology, Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Jinan, PR China
| | - Xianglian An
- Department of Stomatology, Qilu Hospital, and Institute of Stomatology, Shandong University, Jinan, PR China
| | - Dong Li
- Department of Cryomedicine Lab, Qilu Hospital of Shandong University, Jinan, PR China
| | - Jing Guo
- Department of Orthodontics, School of Stomatology, Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Jinan, PR China
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34
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Boriani F, Fazio N, Bolognesi F, Pedrini FA, Marchetti C, Baldini N. Noncellular Modification of Acellular Nerve Allografts for Peripheral Nerve Reconstruction: A Systematic Critical Review of the Animal Literature. World Neurosurg 2018; 122:692-703.e2. [PMID: 30414518 DOI: 10.1016/j.wneu.2018.10.195] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/24/2018] [Accepted: 10/26/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Acellular nerve allografts (ANAs) have been established as promising alternatives to autologous nerve grafts, which represent the reference standard. Our research group recently performed a systematic review of reported cell-based-enriching methods for recellularization of ANAs. Recellularization results in consistent improvement of peripheral neuroregeneration compared with plain ANAs. We systematically reviewed the effects on nerve regeneration when ANA enrichment was obtained through biological, chemical, and physical modification instead of cells. METHODS The PubMed, ScienceDirect, Medline, and Scopus databases were searched for reports of noncellular modification of ANAs, reported from January 2007 to December 2017. The inclusion criteria were English language, noncellular enrichment of ANAs in peripheral nerve regeneration, an in vivo study design, and postgrafting neuroregenerative outcomes assessment. The exclusion criteria were the central nervous system as the site of ANA application, nerve conduits, xenografts, case series, case reports, and reviews. RESULTS Only animal studies were found to be eligible. We included 16 studies, which were analyzed regarding the animal model, decellularization method, graft-enriching mode, and neuroregenerative tests performed. CONCLUSIONS Noncellular-based stimulation of ANAs demonstrated positive effects on recovery of nerve function compared with nerve grafting compared with plain ANAs. The neuroregenerative effect of autografting still appeared superior to ANAs, even with noncellular enrichment of ANAs. However, we found that in a few studies, modified ANAs closely approached or even outperformed autografts. Future research should include more preclinical investigations of this promising tool and clinical translation to increase the level of evidence available in the challenging field of peripheral nerve reconstruction.
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Affiliation(s)
- Filippo Boriani
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Nicola Fazio
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli, IRCCS, Bologna, Italy
| | - Federico Bolognesi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Maxillofacial Surgery Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Francesca Alice Pedrini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli, IRCCS, Bologna, Italy
| | - Claudio Marchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Maxillofacial Surgery Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Nicola Baldini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli, IRCCS, Bologna, Italy
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Zhang Z, Zhang C, Li Z, Zhang S, Liu J, Bai Y, Pan J, Zhang C. Collagen/β‐TCP nerve guidance conduits promote facial nerve regeneration in mini‐swine and the underlying biological mechanism: A pilot in vivo study. J Biomed Mater Res B Appl Biomater 2018; 107:1122-1131. [PMID: 30261120 DOI: 10.1002/jbm.b.34205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 07/01/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Zhen Zhang
- Department of Oral and Maxillofacial‐Head & Neck OncologyShanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine Shanghai China
- School of StomatologyCapital Medical University Dongcheng China
| | - Chengyao Zhang
- Department of Oral and Maxillofacial‐Head & Neck OncologyShanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine Shanghai China
| | - Zheyi Li
- School of StomatologyCapital Medical University Dongcheng China
- Institute for Clinical Research and Application of Sunny DentalSunny Dental Clinic‐Shine Hills Beijing China
| | - Shijian Zhang
- Department of Oral and Maxillofacial‐Head & Neck OncologyShanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine Shanghai China
| | - Jiannan Liu
- Department of Oral and Maxillofacial‐Head & Neck OncologyShanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine Shanghai China
| | - Yuxing Bai
- School of StomatologyCapital Medical University Dongcheng China
| | - Juli Pan
- School of StomatologyCapital Medical University Dongcheng China
| | - Chenping Zhang
- Department of Oral and Maxillofacial‐Head & Neck OncologyShanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine Shanghai China
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Carvalho CR, Wrobel S, Meyer C, Brandenberger C, Cengiz IF, López-Cebral R, Silva-Correia J, Ronchi G, Reis RL, Grothe C, Oliveira JM, Haastert-Talini K. Gellan Gum-based luminal fillers for peripheral nerve regeneration: an in vivo study in the rat sciatic nerve repair model. Biomater Sci 2018; 6:1059-1075. [PMID: 29464240 DOI: 10.1039/c7bm01101f] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Peripheral nerve injuries (PNI) resulting in a gap to be bridged between the transected nerve ends are commonly reconstructed with autologous nerve tissue, but there is a need for valuable alternatives. This experimental work considers the innovative use of the biomaterial Gellan Gum (GG) as a luminal filler for nerve guidance channels made from chitosan with a 5% degree of acetylation. The engineered constructs should remodel the structural support given to regenerating axons by the so-called bands of Büngner. Four different GG formulations were produced by combining varying amounts of High-Acyl GG (HA-GG) and Methacrylated GG (MA-GG). The effective porosity of the freeze-dried networks was analysed by SEM and micro-CT 3D reconstructions, while the degradation and swelling abilities were characterized in vitro for up to 30 days. The metabolic activity and viability of immortalized Schwann cells seeded onto the freeze-dried networks were also evaluated. Finally, the developed hydrogel formulations were freeze-dried within the chitosan nerve guides and implanted in a 10 mm rat sciatic nerve defect. Functional and histomorphological analyses after 3, 6, and 12 weeks in vivo revealed that although it did not result in improved nerve regeneration, the NGC25:75 formulations could provide a basis for further development of GG scaffolds as luminal fillers for hollow nerve guidance channels.
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Affiliation(s)
- C R Carvalho
- 3B's Research Group - Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark - Parque de Ciência e Tecnologia, Zona Industrial de Gandra, 4805-017 Barco, Guimarães, Portugal.
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Development of an apoptosis-assisted decellularization method for maximal preservation of nerve tissue structure. Acta Biomater 2018; 77:116-126. [PMID: 29981947 DOI: 10.1016/j.actbio.2018.07.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/24/2018] [Accepted: 07/03/2018] [Indexed: 12/17/2022]
Abstract
Preservation of tissue structure is often a primary goal when optimizing tissue and organ decellularization methods. Many current protocols nonetheless rely on detergents that aid extraction of cellular components but also damage tissue architecture. It may be more beneficial to leverage an innate cellular process such as apoptosis and promote cell removal without the use of damaging reagents. During apoptosis, a cell detaches from the extracellular matrix, degrades its internal components, and fragments its contents for easier clearance. We have developed a method that leverages this process to achieve tissue decellularization using only mild wash buffers. We have demonstrated that treating peripheral nerve tissue with camptothecin induced both an early marker of apoptosis, cleaved caspase-3 expression, as well as a late stage marker, TUNEL+ DNA fragmentation. Clearance of the cellular components was then achieved in an apoptosis-dependent manner using a gentle wash in hypertonic phosphate buffered saline followed by DNase treatment. This wash paradigm did not significantly affect collagen or glycosaminoglycan content, but it was sufficient to remove any trace of the cytotoxic compound based on conditioned media experiments. The resulting acellular tissue graft was immunogenically tolerated in vivo and exhibited an intact basal lamina microarchitecture mimicking that of native, unprocessed nerve. Hence, ex vivo induction of apoptosis is a promising method to decellularize tissue without the use of harsh reagents while better preserving the benefits of native tissue such as tissue-specific composition and microarchitecture. STATEMENT OF SIGNIFICANCE Tissue decellularization has expanded the ability to generate non-immunogenic organ replacements for a broad range of health applications. Current technologies typically rely on the use of harsh agents for clearing cellular debris, altering the tissue structure and potentially diminishing the pro-regenerative effects. We have developed a method for effectively, yet gently, removing cellular components from peripheral nerve tissue while preserving the native tissue architecture. The novelty of this process is in the induction of programmed cell death - or apoptosis - via a general cytotoxin, thereby enabling antigen clearance using only hypertonic wash buffers. The resulting acellular nerve scaffolds are nearly identical to unprocessed tissue on a microscopic level and elicit low immune responses comparable to an isograft negative control in a model of subcutaneous implantation.
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Philips C, Campos F, Roosens A, Sánchez-Quevedo MDC, Declercq H, Carriel V. Qualitative and Quantitative Evaluation of a Novel Detergent-Based Method for Decellularization of Peripheral Nerves. Ann Biomed Eng 2018; 46:1921-1937. [PMID: 29987538 DOI: 10.1007/s10439-018-2082-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/22/2018] [Indexed: 01/02/2023]
Abstract
Tissue engineering is an emerging strategy for the development of nerve substitutes for peripheral nerve repair. Especially decellularized peripheral nerve allografts are interesting alternatives to replace the gold standard autografts. In this study, a novel decellularization protocol was qualitatively and quantitatively evaluated by histological, biochemical, ultrastructural and mechanical methods and compared to the protocol described by Sondell et al. and a modified version of the protocol described by Hudson et al. Decellularization by the method described by Sondell et al. resulted in a reduction of the cell content, but was accompanied by a loss of essential extracellular matrix (ECM) molecules such as laminin and glycosaminoglycans. This decellularization also caused disruption of the endoneurial tubes and an increased stiffness of the nerves. Decellularization by the adapted method of Hudson et al. did not alter the ECM composition of the nerves, but an efficient cell removal could not be obtained. Finally, decellularization by the method developed in our lab by Roosens et al. led to a successful removal of nuclear material, while maintaining the nerve ultrastructure and ECM composition. In addition, the resulting ECM scaffold was found to be cytocompatible, allowing attachment and proliferation of adipose-derived stem cells. These results show that our decellularization combining Triton X-100, DNase, RNase and trypsin created a promising scaffold for peripheral nerve regeneration.
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Affiliation(s)
- Charlot Philips
- Tissue Engineering and Biomaterials Group, Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, Building B3, 6th floor, 9000, Ghent, Belgium.
| | - Fernando Campos
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
| | - Annelies Roosens
- Tissue Engineering and Biomaterials Group, Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, Building B3, 6th floor, 9000, Ghent, Belgium
| | - María Del Carmen Sánchez-Quevedo
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
| | - Heidi Declercq
- Tissue Engineering and Biomaterials Group, Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, Building B3, 6th floor, 9000, Ghent, Belgium
| | - Víctor Carriel
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
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39
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Petcu EB, Midha R, McColl E, Popa-Wagner A, Chirila TV, Dalton PD. 3D printing strategies for peripheral nerve regeneration. Biofabrication 2018; 10:032001. [DOI: 10.1088/1758-5090/aaaf50] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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40
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Ko CH, Shie MY, Lin JH, Chen YW, Yao CH, Chen YS. Biodegradable Bisvinyl Sulfonemethyl-crosslinked Gelatin Conduit Promotes Regeneration after Peripheral Nerve Injury in Adult Rats. Sci Rep 2017; 7:17489. [PMID: 29235541 PMCID: PMC5727525 DOI: 10.1038/s41598-017-17792-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/30/2017] [Indexed: 12/20/2022] Open
Abstract
In our previous study, we found that gelatin-based materials exhibit good conductivity and are non-cytotoxic. In this study, gelatin was cross-linked with bisvinyl sulfonemethyl (BVSM) to fabricate a biodegradable conduit for peripheral nerve repair. First, BVSM on the prepared conduit was characterized to determine its mechanical properties and contact angle. The maximum tensile strength and water contact angle of the gelatin-BVSM conduits were 23 ± 4.8 MPa and 74.7 ± 9°, which provided sufficient mechanical strength to resist muscular contraction; additionally, the surface was hydrophilic. Cytotoxicity and apoptosis assays using Schwann cells demonstrated that the gelatin-BVSM conduits are non-cytotoxic. Next, we examined the neuronal electrophysiology, animal behavior, neuronal connectivity, macrophage infiltration, calcitonin gene-related peptide localization and expression, as well as the expression levels of nerve regeneration-related proteins. The number of fluorogold-labelled cells and histological analysis of the gelatin-BVSM nerve conduits was similar to that observed with the clinical use of silicone rubber conduits after 8 weeks of repair. Therefore, our results demonstrate that gelatin-BVSM conduits are promising substrates for application as bioengineered grafts for nerve tissue regeneration.
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Affiliation(s)
- Chien-Hsin Ko
- Graduate Institute of Basic Medical Sciences, China Medical University, Taichung, Taiwan
- Department of Traditional Chinese Medicine, Tzu Chi Hospital, Hualien, Taiwan
| | - Ming-You Shie
- School of Dentistry, China Medical University, Taichung, Taiwan
- 3D Printing Medical Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Jia-Horng Lin
- Department of Fiber and Composite Materials, Feng Chia University, Taichung, Taiwan
| | - Yi-Wen Chen
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
- 3D Printing Research Center, Asia University, Taichung, Taiwan
| | - Chun-Hsu Yao
- Biomaterials Translational Research Center, China Medical University Hospital, Taichung, Taiwan.
- Lab of Biomaterials, School of Chinese Medicine, China Medical University, Taichung, Taiwan.
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
| | - Yueh-Sheng Chen
- Biomaterials Translational Research Center, China Medical University Hospital, Taichung, Taiwan.
- Lab of Biomaterials, School of Chinese Medicine, China Medical University, Taichung, Taiwan.
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
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41
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Ryan AJ, Lackington WA, Hibbitts AJ, Matheson A, Alekseeva T, Stejskalova A, Roche P, O'Brien FJ. A Physicochemically Optimized and Neuroconductive Biphasic Nerve Guidance Conduit for Peripheral Nerve Repair. Adv Healthc Mater 2017; 6. [PMID: 28975768 DOI: 10.1002/adhm.201700954] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Indexed: 11/07/2022]
Abstract
Clinically available hollow nerve guidance conduits (NGCs) have had limited success in treating large peripheral nerve injuries. This study aims to develop a biphasic NGC combining a physicochemically optimized collagen outer conduit to bridge the transected nerve, and a neuroconductive hyaluronic acid-based luminal filler to support regeneration. The outer conduit is mechanically optimized by manipulating crosslinking and collagen density, allowing the engineering of a high wall permeability to mitigate the risk of neuroma formation, while also maintaining physiologically relevant stiffness and enzymatic degradation tuned to coincide with regeneration rates. Freeze-drying is used to seamlessly integrate the luminal filler into the conduit, creating a longitudinally aligned pore microarchitecture. The luminal stiffness is modulated to support Schwann cells, with laminin incorporation further enhancing bioactivity by improving cell attachment and metabolic activity. Additionally, this biphasic NGC is shown to support neurogenesis and gliogenesis of neural progenitor cells and axonal outgrowth from dorsal root ganglia. These findings highlight the paradigm that a successful NGC requires the concerted optimization of both a mechanical support phase capable of bridging a nerve defect and a neuroconductive phase with an architecture capable of supporting both Schwann cells and neurons in order to achieve functional regenerative outcome.
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Affiliation(s)
- Alan J. Ryan
- Tissue Engineering Research Group (TERG); Department of Anatomy; Royal College of Surgeons in Ireland; Dublin Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre; Trinity College Dublin; Dublin Ireland
- Trinity Centre for Bioengineering (TCBE); Trinity College Dublin; Dublin Ireland
| | - William A. Lackington
- Tissue Engineering Research Group (TERG); Department of Anatomy; Royal College of Surgeons in Ireland; Dublin Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre; Trinity College Dublin; Dublin Ireland
- Trinity Centre for Bioengineering (TCBE); Trinity College Dublin; Dublin Ireland
| | - Alan J. Hibbitts
- Tissue Engineering Research Group (TERG); Department of Anatomy; Royal College of Surgeons in Ireland; Dublin Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre; Trinity College Dublin; Dublin Ireland
- Trinity Centre for Bioengineering (TCBE); Trinity College Dublin; Dublin Ireland
| | - Austyn Matheson
- Tissue Engineering Research Group (TERG); Department of Anatomy; Royal College of Surgeons in Ireland; Dublin Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre; Trinity College Dublin; Dublin Ireland
- Trinity Centre for Bioengineering (TCBE); Trinity College Dublin; Dublin Ireland
| | - Tijna Alekseeva
- Tissue Engineering Research Group (TERG); Department of Anatomy; Royal College of Surgeons in Ireland; Dublin Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre; Trinity College Dublin; Dublin Ireland
- Trinity Centre for Bioengineering (TCBE); Trinity College Dublin; Dublin Ireland
| | - Anna Stejskalova
- Tissue Engineering Research Group (TERG); Department of Anatomy; Royal College of Surgeons in Ireland; Dublin Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre; Trinity College Dublin; Dublin Ireland
- Trinity Centre for Bioengineering (TCBE); Trinity College Dublin; Dublin Ireland
| | - Phoebe Roche
- Tissue Engineering Research Group (TERG); Department of Anatomy; Royal College of Surgeons in Ireland; Dublin Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre; Trinity College Dublin; Dublin Ireland
- Trinity Centre for Bioengineering (TCBE); Trinity College Dublin; Dublin Ireland
| | - Fergal J. O'Brien
- Tissue Engineering Research Group (TERG); Department of Anatomy; Royal College of Surgeons in Ireland; Dublin Ireland
- Advanced Materials and Bioengineering Research (AMBER) Centre; Trinity College Dublin; Dublin Ireland
- Trinity Centre for Bioengineering (TCBE); Trinity College Dublin; Dublin Ireland
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42
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López-Cebral R, Silva-Correia J, Reis RL, Silva TH, Oliveira JM. Peripheral Nerve Injury: Current Challenges, Conventional Treatment Approaches, and New Trends in Biomaterials-Based Regenerative Strategies. ACS Biomater Sci Eng 2017; 3:3098-3122. [DOI: 10.1021/acsbiomaterials.7b00655] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- R. López-Cebral
- 3Bs Research Group, 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
- ICVS/3Bs, PT Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
| | - J. Silva-Correia
- 3Bs Research Group, 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
- ICVS/3Bs, PT Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
| | - R. L. Reis
- 3Bs Research Group, 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
- ICVS/3Bs, PT Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
| | - T. H. Silva
- 3Bs Research Group, 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
- ICVS/3Bs, PT Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
| | - J. M. Oliveira
- 3Bs Research Group, 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
- ICVS/3Bs, PT Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
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43
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Boriani F, Fazio N, Fotia C, Savarino L, Nicoli Aldini N, Martini L, Zini N, Bernardini M, Baldini N. A novel technique for decellularization of allogenic nerves and in vivo
study of their use for peripheral nerve reconstruction. J Biomed Mater Res A 2017; 105:2228-2240. [DOI: 10.1002/jbm.a.36090] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 03/21/2017] [Accepted: 04/13/2017] [Indexed: 12/16/2022]
Affiliation(s)
- F. Boriani
- Laboratory for Orthopaedic Pathophysiology and Regenerative Medicine; Rizzoli Orthopaedic Institute; Bologna Italy
| | - N. Fazio
- Prometeo Laboratory; Rizzoli Orthopaedic Institute; Bologna Italy
| | - C. Fotia
- Laboratory for Orthopaedic Pathophysiology and Regenerative Medicine; Rizzoli Orthopaedic Institute; Bologna Italy
| | - L. Savarino
- Laboratory for Orthopaedic Pathophysiology and Regenerative Medicine; Rizzoli Orthopaedic Institute; Bologna Italy
| | - N. Nicoli Aldini
- Laboratory of Preclinical and Surgical Studies; Rizzoli Orthopaedic Institute; Bologna Italy
| | - L. Martini
- Laboratory of Preclinical and Surgical Studies; Rizzoli Orthopaedic Institute; Bologna Italy
| | - N. Zini
- CNR, National Research Council of Italy, Institute of Molecular Genetics; Bologna Italy
- Laboratory of Musculoskeletal Cell Biology; Rizzoli Orthopaedic Institute; Bologna Italy
| | - M. Bernardini
- Department of Animal Medicine; Production and Health, Padova University; Padua Italy
| | - N. Baldini
- Laboratory for Orthopaedic Pathophysiology and Regenerative Medicine; Rizzoli Orthopaedic Institute; Bologna Italy
- Department of Biomedical and Neuromotor Sciences; University of Bologna; Bologna Italy
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44
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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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