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Bordett R, Danazumi KB, Wijekoon S, Garcia CJ, Abdulmalik S, Kumbar SG. Advancements in stimulation therapies for peripheral nerve regeneration. Biomed Mater 2024; 19:052008. [PMID: 39025114 PMCID: PMC11425301 DOI: 10.1088/1748-605x/ad651d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/18/2024] [Indexed: 07/20/2024]
Abstract
Soft-tissue injuries affecting muscles, nerves, vasculature, tendons, and ligaments often diminish the quality of life due to pain, loss of function, and financial burdens. Both natural healing and surgical interventions can result in scarring, which potentially may impede functional recovery and lead to persistent pain. Scar tissue, characterized by a highly disorganized fibrotic extracellular matrix, may serve as a physical barrier to regeneration and drug delivery. While approaches such as drugs, biomaterials, cells, external stimulation, and other physical forces show promise in mitigating scarring and promoting regenerative healing, their implementation remains limited and challenging. Ultrasound, laser, electrical, and magnetic forms of external stimulation have been utilized to promote soft tissue as well as neural tissue regeneration. After stimulation, neural tissues experience increased proliferation of Schwann cells, secretion of neurotropic factors, production of myelin, and growth of vasculature, all aimed at supporting axon regeneration and innervation. Yet, the outcomes of healing vary depending on the pathophysiology of the damaged nerve, the timing of stimulation following injury, and the specific parameters of stimulation employed. Increased treatment intensity and duration have been noted to hinder the healing process by inducing tissue damage. These stimulation modalities, either alone or in combination with nerve guidance conduits and scaffolds, have been demonstrated to promote healing. However, the literature currently lacks a detailed understanding of the stimulation parameters used for nerve healing applications. In this article, we aim to address this gap by summarizing existing reports and providing an overview of stimulation parameters alongside their associated healing outcomes.
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Affiliation(s)
- Rosalie Bordett
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, United States of America
| | - Khadija B Danazumi
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, United States of America
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, United States of America
| | - Suranji Wijekoon
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, United States of America
| | - Christopher J Garcia
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, United States of America
| | - Sama Abdulmalik
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, United States of America
| | - Sangamesh G Kumbar
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, United States of America
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, United States of America
- Department of Materials Science and Engineering, University of Connecticut, Storrs, CT, United States of America
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Li X, Mao X, Tao M, Liang F, Tian X, Fan J, Wang X, Yu T, Ao Q. Enhancing neuroinduction activity of PLCL-based nerve conduits through native epineurium integration. BIOMATERIALS ADVANCES 2024; 159:213803. [PMID: 38447384 DOI: 10.1016/j.bioadv.2024.213803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/23/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
Autologous nerve grafts have been considered the gold standard for peripheral nerve grafts. However, due to drawbacks such as functional loss in the donor area and a shortage of donor sources, nerve conduits are increasingly being considered as an alternative approach. Polymer materials have been widely studied as nerve repair materials due to their excellent processing performance. However, their limited biocompatibility has restricted further clinical applications. The epineurium is a natural extra-neural wrapping structure. After undergoing decellularization, the epineurium not only reduces immune rejection but also retains certain bioactive components. In this study, decellularized epineurium (DEP) derived from the sciatic nerve of mammals was prepared, and a bilayer nerve conduit was created by electrospinning a poly (l-lactide-co-ε-caprolactone) (PLCL) membrane layer onto the outer surface of the DEP. Components of the DEP were examined; the physical properties and biosafety of the bilayer nerve conduit were evaluated; and the functionality of the nerve conduit was evaluated in rats. The results demonstrate that the developed bilayer nerve conduit exhibits excellent biocompatibility and mechanical properties. Furthermore, this bilayer nerve conduit shows significantly superior therapeutic effects for sciatic nerve defects in rats compared to the pure PLCL nerve conduit. In conclusion, this research provides a novel strategy for the design of nerve regeneration materials and holds promising potential for further clinical translation.
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Affiliation(s)
- Xiao Li
- Department of Tissue Engineering, School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, China
| | - Xiaoyan Mao
- Department of Tissue Engineering, School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, China
| | - Meihan Tao
- Department of Tissue Engineering, School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, China
| | - Fang Liang
- Department of Tissue Engineering, School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, China
| | - Xiaohong Tian
- Department of Tissue Engineering, School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, China
| | - Jun Fan
- Department of Tissue Engineering, School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, China
| | - Xiaohong Wang
- Department of Tissue Engineering, School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, 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, School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, 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 610064, China..
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Wang S, Wang Y, Chen B, Zhao M, Song G, Wang J, Xu J. Preparation and performance study of multichannel PLA artificial nerve conduits. Biomed Mater 2023; 18:065001. [PMID: 37582380 DOI: 10.1088/1748-605x/acf0ae] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/15/2023] [Indexed: 08/17/2023]
Abstract
Compared with single-channel nerve conduits, multichannel artificial nerve conduits are more beneficial for repairing damaged peripheral nerves of long-distance nerve defects. Multichannel nerve conduits can be fabricated by the mold method and the electrospinning method but with disadvantages such as low strength and large differences in batches, while the braiding method can solve this problem. In this study, polylactic acid yarns were used as the braiding yarn, and the number of spindles during braiding was varied to achieve 4, 5, 6, 7 and 8 multichannel artificial nerve conduits. A mathematical model of the number of braiding yarn spindles required to meet certain size specification parameters of the multichannel conduit was established. The cross-sectional morphology and mechanical properties of the conduits were characterized by scanning electron microscopy observation and mechanical testing; the results showed that the multichannel structure was well constructed; the tensile strength of the multichannel conduit was more than 30 times that of the rabbit tibial nerve. The biocompatibility of the conduit was tested; thein vitrocell culture results proved that the braided multichannel nerve conduits were nontoxic to Schwann cells, and the cell adhesion and proliferation were optimal in the 4-channel conduit among the multichannel conduits, which was close to the single-channel conduit.
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Affiliation(s)
- Shanlong Wang
- College of Textile and Clothing Engineering, Soochow University, Suzhou 215021, People's Republic of China
| | - Yuyu Wang
- College of Textile and Clothing Engineering, Soochow University, Suzhou 215021, People's Republic of China
| | - Biling Chen
- College of Textile and Clothing Engineering, Soochow University, Suzhou 215021, People's Republic of China
| | - Mingda Zhao
- College of Textile and Clothing Engineering, Soochow University, Suzhou 215021, People's Republic of China
| | - Gongji Song
- College of Textile and Clothing Engineering, Soochow University, Suzhou 215021, People's Republic of China
| | - Jiannan Wang
- College of Textile and Clothing Engineering, Soochow University, Suzhou 215021, People's Republic of China
- Key Laboratory of Textile Industry for Silk Products in Medical and Health Use, Soochow University, Suzhou 215127, People's Republic of China
| | - Jianmei Xu
- College of Textile and Clothing Engineering, Soochow University, Suzhou 215021, People's Republic of China
- Key Laboratory of Textile Industry for Silk Products in Medical and Health Use, Soochow University, Suzhou 215127, People's Republic of China
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Fregnan F, Muratori L, Bassani GA, Crosio A, Biagiotti M, Vincoli V, Carta G, Pierimarchi P, Geuna S, Alessandrino A, Freddi G, Ronchi G. Preclinical Validation of SilkBridge TM for Peripheral Nerve Regeneration. Front Bioeng Biotechnol 2020; 8:835. [PMID: 32850714 PMCID: PMC7426473 DOI: 10.3389/fbioe.2020.00835] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/29/2020] [Indexed: 12/19/2022] Open
Abstract
Silk fibroin (Bombyx mori) was used to manufacture a nerve conduit (SilkBridgeTM) characterized by a novel 3D architecture. The wall of the conduit consists of two electrospun layers (inner and outer) and one textile layer (middle), perfectly integrated at the structural and functional level. The manufacturing technology conferred high compression strength on the device, thus meeting clinical requirements for physiological and pathological compressive stresses. As demonstrated in a previous work, the silk material has proven to be able to provide a valid substrate for cells to grow on, differentiate and start the fundamental cellular regenerative activities in vitro and, in vivo, at the short time point of 2 weeks, to allow the starting of regenerative processes in terms of good integration with the surrounding tissues and colonization of the wall layers and of the lumen with several cell types. In the present study, a 10 mm long gap in the median nerve was repaired with 12 mm SilkBridgeTM conduit and evaluated at middle (4 weeks) and at longer time points (12 and 24 weeks). The SilkBridgeTM conduit led to a very good functional and morphological recovery of the median nerve, similar to that observed with the reference autograft nerve reconstruction procedure. Taken together, all these results demonstrated that SilkBridgeTM has an optimized balance of biomechanical and biological properties, which allowed proceeding with a first-in-human clinical study aimed at evaluating safety and effectiveness of using the device for the reconstruction of digital nerve defects in humans.
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Affiliation(s)
- Federica Fregnan
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Neuroscience Institute Cavalieri Ottolenghi, University of Turin, Turin, Italy
| | - Luisa Muratori
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Neuroscience Institute Cavalieri Ottolenghi, University of Turin, Turin, Italy
| | | | - Alessandro Crosio
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Department of Orthopaedics and Traumatology for Hand, ASST Gaetano Pini, Milan, Italy
| | | | | | - Giacomo Carta
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Neuroscience Institute Cavalieri Ottolenghi, University of Turin, Turin, Italy
| | | | - Stefano Geuna
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Neuroscience Institute Cavalieri Ottolenghi, University of Turin, Turin, Italy
| | | | | | - Giulia Ronchi
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Neuroscience Institute Cavalieri Ottolenghi, University of Turin, Turin, Italy
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Wang Z, Lin J, Zhang D, Xun B, Yin J, Qian J, Dai G, Zhang N, Wen X, Huang Y, Fu J. Porous morphology and mechanical properties of poly(lactide-co-glycolide) hollow fiber membranes governed by ternary-phase inversion. J Memb Sci 2019. [DOI: 10.1016/j.memsci.2019.02.065] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zhang PX, Han N, Kou YH, Zhu QT, Liu XL, Quan DP, Chen JG, Jiang BG. Tissue engineering for the repair of peripheral nerve injury. Neural Regen Res 2019; 14:51-58. [PMID: 30531070 PMCID: PMC6263012 DOI: 10.4103/1673-5374.243701] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Peripheral nerve injury is a common clinical problem and affects the quality of life of patients. Traditional restoration methods are not satisfactory. Researchers increasingly focus on the field of tissue engineering. The three key points in establishing a tissue engineering material are the biological scaffold material, the seed cells and various growth factors. Understanding the type of nerve injury, the construction of scaffold and the process of repair are necessary to solve peripheral nerve injury and promote its regeneration. This review describes the categories of peripheral nerve injury, fundamental research of peripheral nervous tissue engineering and clinical research on peripheral nerve scaffold material, and paves a way for related research and the use of conduits in clinical practice.
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Affiliation(s)
| | - Na Han
- Peking University People's Hospital, Beijing, China
| | - Yu-Hui Kou
- Peking University People's Hospital, Beijing, China
| | - Qing-Tang Zhu
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Xiao-Lin Liu
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Da-Ping Quan
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Jian-Guo Chen
- School of Life Science, Peking University, Beijing, China
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Ozer H, Bozkurt H, Bozkurt G, Demirbilek M. Regenerative potential of chitosan-coated poly-3-hydroxybutyrate conduits seeded with mesenchymal stem cells in a rat sciatic nerve injury model. Int J Neurosci 2018; 128:828-834. [PMID: 29384433 DOI: 10.1080/00207454.2018.1435536] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES A number of chemical and biological factors, including mesenchymal stem cells (MSCs), have been developed to enhance nerve regeneration by introduction through a variety of nerve conduits. This study was designed to assess the efficacy of using chitosan-coated poly-3-hydroxybutyrate (PHB) nerve conduits seeded with human bone marrow-derived MSCs (hMSC-bm) to augment repair in an experimental rat model of sciatic nerve injury. METHODS A total of 30 rats were randomly assigned to one of three groups (n = 10). In each rat, a 10 mm segment of the sciatic nerve was removed and was replaced by a chitosan-coated PHB conduit seeded with hMSC-bm (PHB/chitosan-hMSC-bm group), a chitosan-coated PHB conduit (PHB/chitosan group), or an autograft (autograft group) as the control. The results were evaluated 8 weeks postoperatively by observation, electromyography and histologic examination with light microscopy and immunostaining. RESULTS Histologic examination showed that both PHB/chitosan-hMSC-bm conduits and PHB/chitosan conduits led the damaged axons through the injured area. When the effects were compared, the results with the PHB/chitosan-hMSC-bm conduits were superior to those with the PHB/chitosan conduits (p < 0.05) but not as successful as with the autologous nerve grafts (p < 0.05). CONCLUSION PHB/chitosan-hMSC-bm nerve conduits may be a useful artificial guide for nerve regeneration.
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Affiliation(s)
- Hidir Ozer
- a Department of Neurosurgery , Hacettepe University Faculty of Medicine , Ankara , Turkey
| | - Huseyin Bozkurt
- b Department of Neurosurgery , Cumhuriyet University Faculty of Medicine , Sivas , Turkey
| | - Gokhan Bozkurt
- c Department of Neurosurgery , Memorial Private Hospital , Ankara , Turkey
| | - Murat Demirbilek
- d Advanced Technologies Application and Research Center , Hacettepe University , Ankara , Turkey
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Perruisseau-Carrier A, Bahlouli N, Po C, Vernet P, Facca S, Liverneaux P. Analysis of the modifications of MRI signal of the brachial plexus of rats: Comparative study before and after freezing/thawing. ANN CHIR PLAST ESTH 2017; 62:322-326. [PMID: 28129915 DOI: 10.1016/j.anplas.2016.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 12/27/2016] [Indexed: 10/20/2022]
Abstract
The aim of this study was to compare the MRI signal of the brachial plexus and surrounding muscles before and after freezing/thawing on a murine model. A first MRI going through the brachial plexuses of 5 healthy Wistar rats was performed immediately post-mortem. A second MRI was performed after freezing at -30°C and then thawing at 20°C for 24hours. All MRI images were segmented to make nerve and muscular structures appear and calculate the average intensity of the MRI signal using the program ImageJ. The average nerve and muscular MRI signals were compared before and after freezing/thawing and rated in grayscale units between 0 and 255. The average intensity of the MRI signal of nerve structures was 40.315 grayscale units before freezing and 31.943 after freezing/thawing. The average intensity of the MRI signal of muscular structures was 25.44 grayscale units before freezing and 35.710 after freezing/thawing. Our results have shown that the intensity of the MRI signal of the brachial plexus was higher before freezing/thawing. The intensity of the MRI signal of muscles was lower than the intensity of the brachial plexus before freezing/thawing and higher after freezing/thawing in muscles than in brachial plexus. The MRI could be used in clinical practice to monitor the reinnervation after frozen nerve allografts.
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Affiliation(s)
- A Perruisseau-Carrier
- Department of hand surgery, SOS main, Icube CNRS 7357, CCOM, university hospital of Strasbourg, FMTS, university of Strasbourg, 10, avenue Baumann, 67400 Illkirch cedex, France
| | - N Bahlouli
- Department of mechanics, CNRS, ICUBE, university of Strasbourg, 2, rue Boussingault, 67000 Strasbourg, France
| | - C Po
- Department of mechanics, CNRS, ICUBE, university of Strasbourg, 2, rue Boussingault, 67000 Strasbourg, France
| | - P Vernet
- Department of hand surgery, SOS main, Icube CNRS 7357, CCOM, university hospital of Strasbourg, FMTS, university of Strasbourg, 10, avenue Baumann, 67400 Illkirch cedex, France
| | - S Facca
- Department of hand surgery, SOS main, Icube CNRS 7357, CCOM, university hospital of Strasbourg, FMTS, university of Strasbourg, 10, avenue Baumann, 67400 Illkirch cedex, France
| | - P Liverneaux
- Department of hand surgery, SOS main, Icube CNRS 7357, CCOM, university hospital of Strasbourg, FMTS, university of Strasbourg, 10, avenue Baumann, 67400 Illkirch cedex, France.
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