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Rochkind S, Sirota S, Kushnir A. Nerve Reconstruction Using ActiGraft Blood Clot in Rabbit Acute Peripheral Injury Model: Preliminary Study. Bioengineering (Basel) 2024; 11:298. [PMID: 38671720 PMCID: PMC11047591 DOI: 10.3390/bioengineering11040298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/16/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
This preliminary study aimed to investigate an ActiGraft blood clot implant (RedDress Ltd., Pardes-Hanna, Israel) attempting to treat and induce the regeneration of a completely injured peripheral nerve with a massive loss defect. The tibial portion of the sciatic nerve in 11 rabbits was transected, and a 25 mm nerve gap was reconnected using a collagen tube. A comparison was performed between the treatment group (eight rabbits; reconnection using a tube filled with ActiGraft blood clot) and the control group (three rabbits; gap reconnection using an empty tube). The post-operative follow-up period lasted 18 weeks and included electrophysiological and histochemical assessments. The pathological severity score was high in the tube cross sections of the control group (1.33) compared to the ActiGraft blood clot treatment group (0.63). Morphometric analysis showed a higher percentage of the positive myelin basic protein (MBP) stained area in the ActiGraft blood clot group (19.57%) versus the control group (3.67%). These differences were not statistically significant due to the small group sizes and the large intra-group variability. The results of this preliminary study suggest that the application of an ActiGraft blood clot (into the collagen tube) can enable nerve recovery. However, a future study using a larger animal group is required to achieve objective statistical results.
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Affiliation(s)
- Shimon Rochkind
- Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Sharon Sirota
- RedDress Ltd., Pardes Hana 3701142, Israel; (S.S.); (A.K.)
| | - Alon Kushnir
- RedDress Ltd., Pardes Hana 3701142, Israel; (S.S.); (A.K.)
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Zhang D, Jin C, Han T, Chen J, Ali Raza M, Li B, Wang L, Yan H. Sinomenine promotes flap survival by upregulating eNOS and eNOS-mediated autophagy via PI3K/AKT pathway. Int Immunopharmacol 2023; 116:109752. [PMID: 36739833 DOI: 10.1016/j.intimp.2023.109752] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/05/2023] [Accepted: 01/15/2023] [Indexed: 02/05/2023]
Abstract
Large skin defects and surgical tissue reconstructions are frequently covered utilizing random flaps. The flap has the advantage of being designed according to the size and shape of a surgical wound. However, the necrosis of the distal part of the flap restricts the clinical application of flaps. Sinomenine (SIN) is the major active component of sinomenium acutum. SIN has been demonstrated to inhibit oxidative stress and stimulate autophagy in a cell, animal, and clinical studies. The protective and proliferative effects of sinomenium on HUVECs were evaluated by scratched test, CCK-8, and EDU assays. For the flap survival, we established a mouse random pattern flap model and observed the effects of SIN injected intraperitoneally. The survival area and blood flow intensity of the flap in sinomenium group were significantly increased compared to the control group. Our results demonstrate that SIN promotes flap survival. Sinomenium enhances eNOS expression in the flap and reduces the level of oxidative stress, promotes autophagy flux increase, reduces apoptosis, and promotes angiogenesis. Having a therapeutic benefit of SIN, Autophagy inhibitor 3-MA shows its critical role by reversing the beneficial effects of SIN, and the nitric oxide synthase inhibitor l-NAME both stimulated HUVECs that explore the relationship between autophagy flux and nitric oxide synthase. Furthermore, the mechanism in our study reveals the changes in the signal pathway of PI3K/AKT, the protective effect of SIN during antioxidant activity, the activation of eNOS through PI3K/AKT signaling pathway affects autophagy through the eNOS system, and promote the random flap survival.
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Affiliation(s)
- Dupiao Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthpaedics, Wenzhou, Zhejiang Province, China; The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Chen Jin
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthpaedics, Wenzhou, Zhejiang Province, China; The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Tao Han
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthpaedics, Wenzhou, Zhejiang Province, China; The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Jianpeng Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthpaedics, Wenzhou, Zhejiang Province, China; The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Mazhar Ali Raza
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthpaedics, Wenzhou, Zhejiang Province, China; The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Baolong Li
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthpaedics, Wenzhou, Zhejiang Province, China; The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Liang Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthpaedics, Wenzhou, Zhejiang Province, China; The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Hede Yan
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthpaedics, Wenzhou, Zhejiang Province, China.
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Kong Y, Xu J, Han Q, Zheng T, Wu L, Li G, Yang Y. Electrospinning porcine decellularized nerve matrix scaffold for peripheral nerve regeneration. Int J Biol Macromol 2022; 209:1867-1881. [PMID: 35489621 DOI: 10.1016/j.ijbiomac.2022.04.161] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/09/2022] [Accepted: 04/21/2022] [Indexed: 12/27/2022]
Abstract
The composition and spatial structure of bioscaffold materials are essential for constructing tissue regeneration microenvironments. In this study, by using an electrospinning technique without any other additives, we successfully developed pure porcine decellularized nerve matrix (xDNME) conduits. The developed xDNME was composed of an obvious decellularized matrix fiber structure and effectively retained the natural components in the decellularized matrix of the nerve tissue. The xDNME conduit exhibited superior biocompatibility and the ability to overcome inter-species barriers. In vivo, after 12 weeks of implantation, xDNME significantly promoted the regeneration of rat sciatic nerve. The regenerated nerve fibers completely connected the two ends of the nerve defect, which were about 8 mm apart. The xDNME and xDNME-OPC groups showed myelin structures in the regenerated nerve fibers. In the xDNME group, the average thickness of the regenerated myelin sheath was 0.640 ± 0.013 μm, which was almost comparable to that in the autologous nerve group (0.646 ± 0.017 μm). Electrophysiological experiments revealed that both of the regenerated nerve fibers in the xDNME and xDNME-OPC groups had excellent abilities to transmit electrical signals. Respectively, the average conduction velocities of xDNME and xDNME-OPC were 8.86 ± 3.57 m/s and 6.99 ± 3.43 m/s. In conclusion, the xDNME conduits have a great potential for clinical treatment of peripheral nerve injuries, which may clinically transform peripheral nerve related regenerative medicine.
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Affiliation(s)
- Yan Kong
- Key Laboratory of Eco-Textiles, Ministry of Education, College of Textile Science and Engineering, Jiangnan University, Wuxi, Jiangsu 214122, PR China
| | - Jiawei Xu
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, Nantong, Jiangsu 226001, PR China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu 226001, PR China
| | - Qi Han
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, Nantong, Jiangsu 226001, PR China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu 226001, PR China
| | - Tiantian Zheng
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, Nantong, Jiangsu 226001, PR China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu 226001, PR China
| | - Linliang Wu
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, Nantong, Jiangsu 226001, PR China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu 226001, PR China
| | - Guicai Li
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, Nantong, Jiangsu 226001, PR China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu 226001, PR China
| | - Yumin Yang
- Key Laboratory of Eco-Textiles, Ministry of Education, College of Textile Science and Engineering, Jiangnan University, Wuxi, Jiangsu 214122, PR China; Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, Nantong, Jiangsu 226001, PR China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu 226001, PR China.
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Rochkind S, Almog M, Meilin S, Nevo Z. Reviving Matrix for Nerve Reconstruction in Rabbit Model of Chronic Peripheral Nerve Injury With Massive Loss Defect. Front Surg 2021; 7:609638. [PMID: 33521046 PMCID: PMC7844361 DOI: 10.3389/fsurg.2020.609638] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/24/2020] [Indexed: 01/09/2023] Open
Abstract
Background and Aims: The aim of this study was to investigate the innovative guiding regenerative gel (GRG) and antigliotic GRG (AGRG) fillings for nerve conduits, prepared with Food and Drug Administration (FDA)-approved agents and expected to provide an alternative to autologous nerve graft and to enable reconnection of massive nerve gaps in a rabbit model of chronic peripheral nerve injury with massive loss defect that simulates the human condition of chronic injury with a large gap. Methods: The components and dosimetry for GRG and AGRG formulations were investigated in vitro on nerve cell culture and in vivo on 10-mm reconstructed sciatic nerves of 72 rats using different concentrations of agents and completed on a rabbit model of delayed (chronic) complete peripheral nerve injury with a 25-mm gap. Forty rabbits underwent delayed (9 weeks after complete injury of the tibial portion of the sciatic nerve) nerve tube reconstruction of a gap that is 25 mm long. GRG and AGRG groups were compared with autologous and empty tube reconstructed groups. Rats and rabbits underwent electrophysiological and histochemical assessments (19 weeks for rats and 40 weeks for rabbits). Results: Application of AGRG showed a significant increase of about 78% in neurite length per cell and was shown to have the most promising effect on neuronal outgrowth, with total number of neurites increasing by 4-fold. The electrophysiological follow-up showed that AGRG treatment is most promising for the reconstruction of the tibial portion of the sciatic nerve with a critical gap of 25 mm. The beneficial effect of AGRG was found when compared with the autologous nerve graft reconstruction. Thirty-one weeks post the second surgery (delayed reconstruction), histochemical observation showed significant regeneration after using AGRG neurogel, compared with the empty tube, and succeeded in significantly regenerating the nerve, as well as the autologous nerve graft, which was almost similar to a healthy nerve. Conclusion: We demonstrate that in the model of delayed peripheral nerve repair with massive loss defect, the application of AGRG led to a stronger nerve recovery and can be an alternative to autologous nerve graft.
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Affiliation(s)
- Shimon Rochkind
- Research Center for Nerve Reconstruction, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mara Almog
- Research Center for Nerve Reconstruction, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sigal Meilin
- Neurology R&D Division, MD Biosciences, Ness Ziona, Israel
| | - Zvi Nevo
- Department of Human Molecular Genetics and Biochemistry, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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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: 41] [Impact Index Per Article: 10.3] [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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Cidade MT, Ramos DJ, Santos J, Carrelo H, Calero N, Borges JP. Injectable Hydrogels Based on Pluronic/Water Systems Filled with Alginate Microparticles for Biomedical Applications. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E1083. [PMID: 30986948 PMCID: PMC6479463 DOI: 10.3390/ma12071083] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/26/2019] [Accepted: 03/28/2019] [Indexed: 01/03/2023]
Abstract
A (model) composite system for drug delivery was developed based on a thermoresponsive hydrogel loaded with microparticles. We used Pluronic F127 hydrogel as the continuous phase and alginate microparticles as the dispersed phase of this composite system. It is well known that Pluronic F127 forms a gel when added to water in an appropriate concentration and in a certain temperature range. Pluronic F127 hydrogel may be loaded with drug and injected, in its sol state, to act as a drug delivery system in physiological environment. A rheological characterization allowed the most appropriate concentration of Pluronic F127 (15.5 wt%) and appropriate alginate microparticles contents (5 and 10 wt%) to be determined. Methylene blue (MB) was used as model drug to perform drug release studies in MB loaded Pluronic hydrogel and in MB loaded alginate microparticles/Pluronic hydrogel composite system. The latter showed a significantly slower MB release than the former (10 times), suggesting its potential in the development of dual cargo release systems either for drug delivery or tissue engineering.
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Affiliation(s)
- M T Cidade
- i3N/CENIMAT, Department of Materials Science, Faculty of Sciences and Technology, Universidade, NOVA de Lisboa, Campus de Caparica, 2829-516 Caparica, Portugal.
| | - D J Ramos
- i3N/CENIMAT, Department of Materials Science, Faculty of Sciences and Technology, Universidade, NOVA de Lisboa, Campus de Caparica, 2829-516 Caparica, Portugal.
| | - J Santos
- Applied Rheology, Colloid Technology, Chemical Engineering Department, University of Sevilla, c/ P. García González, 1, E41012 Sevilla, Spain.
| | - H Carrelo
- i3N/CENIMAT, Department of Materials Science, Faculty of Sciences and Technology, Universidade, NOVA de Lisboa, Campus de Caparica, 2829-516 Caparica, Portugal.
| | - N Calero
- Applied Rheology, Colloid Technology, Chemical Engineering Department, University of Sevilla, c/ P. García González, 1, E41012 Sevilla, Spain.
| | - J P Borges
- i3N/CENIMAT, Department of Materials Science, Faculty of Sciences and Technology, Universidade, NOVA de Lisboa, Campus de Caparica, 2829-516 Caparica, Portugal.
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Dixon AR, Jariwala SH, Bilis Z, Loverde JR, Pasquina PF, Alvarez LM. Bridging the gap in peripheral nerve repair with 3D printed and bioprinted conduits. Biomaterials 2018; 186:44-63. [DOI: 10.1016/j.biomaterials.2018.09.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/06/2018] [Accepted: 09/07/2018] [Indexed: 01/14/2023]
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Panagopoulos GN, Megaloikonomos PD, Mavrogenis AF. The Present and Future for Peripheral Nerve Regeneration. Orthopedics 2017; 40:e141-e156. [PMID: 27783836 DOI: 10.3928/01477447-20161019-01] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 08/23/2016] [Indexed: 02/03/2023]
Abstract
Peripheral nerve injury can have a potentially devastating impact on a patient's quality of life, resulting in severe disability with substantial social and personal cost. Refined microsurgical techniques, advances in peripheral nerve topography, and a better understanding of the pathophysiology and molecular basis of nerve injury have all led to a decisive leap forward in the field of translational neurophysiology. Nerve repair, nerve grafting, and nerve transfers have improved significantly with consistently better functional outcomes. Direct nerve repair with epineural microsutures is still the surgical treatment of choice when a tension-free coaptation in a well-vascularized bed can be achieved. In the presence of a significant gap (>2-3 cm) between the proximal and distal nerve stumps, primary end-to-end nerve repair often is not possible; in these cases, nerve grafting is the treatment of choice. Indications for nerve transfer include brachial plexus injuries, especially avulsion type, with long distance from target motor end plates, delayed presentation, segmental loss of nerve function, and broad zone of injury with dense scarring. Current experimental research in peripheral nerve regeneration aims to accelerate the process of regeneration using pharmacologic agents, bioengineering of sophisticated nerve conduits, pluripotent stem cells, and gene therapy. Several small molecules, peptides, hormones, neurotoxins, and growth factors have been studied to improve and accelerate nerve repair and regeneration by reducing neuronal death and promoting axonal outgrowth. Targeting specific steps in molecular pathways also allows for purposeful pharmacologic intervention, potentially leading to a better functional recovery after nerve injury. This article summarizes the principles of nerve repair and the current concepts of peripheral nerve regeneration research, as well as future perspectives. [Orthopedics. 2017; 40(1):e141-e156.].
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Önger ME, Delibaş B, Türkmen AP, Erener E, Altunkaynak BZ, Kaplan S. The role of growth factors in nerve regeneration. Drug Discov Ther 2016; 10:285-291. [PMID: 27746416 DOI: 10.5582/ddt.2016.01058] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Nerve injuries result in functional loss in the innervated organ or body parts, and recovery is difficult unless surgical treatment has been done. Different surgical treatments have been suggested for nerve repair. Tissue engineering related to growth factors has arisen as an alternative approach for triggering and improving nerve regeneration. Therefore, the aim of this review is to provide a comprehensive analysis related to growth factors as tools for optimizing the regeneration process. Studies and reviews on the use of growth factors for nerve regeneration were compiled over the course of the review. According to literature review, it may be concluded that growth factors from different sources present promising treatment related to nerve regeneration involved in neuronal differentiation, greater myelination and axonal growth and proliferation of specific cells for nerve repair.
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Affiliation(s)
- Mehmet Emin Önger
- Department of Histology and Embryology, Faculty of Medicine, Ondokuz Mayis University
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Sweet L, Kang Y, Czisch C, Witek L, Shi Y, Smay J, Plant GW, Yang Y. Geometrical versus Random β-TCP Scaffolds: Exploring the Effects on Schwann Cell Growth and Behavior. PLoS One 2015; 10:e0139820. [PMID: 26444999 PMCID: PMC4596809 DOI: 10.1371/journal.pone.0139820] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 09/17/2015] [Indexed: 12/22/2022] Open
Abstract
Numerous studies have demonstrated that Schwann cells (SCs) play a role in nerve regeneration; however, their role in innervating a bioceramic scaffold for potential application in bone regeneration is still unknown. Here we report the cell growth and functional behavior of SCs on β-tricalcium phosphate (β-TCP) scaffolds arranged in 3D printed-lattice (P-β-TCP) and randomly-porous, template-casted (N-β-TCP) structures. Our results indicate that SCs proliferated well and expressed the phenotypic markers p75LNGFR and the S100-β subunit of SCs as well as displayed growth morphology on both scaffolds, but SCs showed spindle-shaped morphology with a significant degree of SCs alignment on the P-β-TCP scaffolds, seen to a lesser degree in the N-β-TCP scaffold. The gene expressions of nerve growth factor (β-ngf), neutrophin–3 (nt–3), platelet-derived growth factor (pdgf-bb), and vascular endothelial growth factor (vegf-a) were higher at day 7 than at day 14. While no significant differences in protein secretion were measured between these last two time points, the scaffolds promoted the protein secretion at day 3 compared to that on the cell culture plates. These results together imply that the β-TCP scaffolds can support SC cell growth and that the 3D-printed scaffold appeared to significantly promote the alignment of SCs along the struts. Further studies are needed to investigate the early and late stage relationship between gene expression and protein secretion of SCs on the scaffolds with refined characteristics, thus better exploring the potential of SCs to support vascularization and innervation in synthetic bone grafts.
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Affiliation(s)
- Lauren Sweet
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, United States of America
- Department of Biology, Stanford University, Stanford, California, United States of America
| | - Yunqing Kang
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, United States of America
- Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, Florida, United States of America
| | - Christopher Czisch
- Department of Neurosurgery, Stanford University, Stanford, California, United States of America
| | - Lukasz Witek
- School of Chemical Engineering, Oklahoma State University, Stillwater, Oklahoma, United States of America
| | - Yang Shi
- School of Chemical Engineering, Oklahoma State University, Stillwater, Oklahoma, United States of America
| | - Jim Smay
- School of Chemical Engineering, Oklahoma State University, Stillwater, Oklahoma, United States of America
| | - Giles W. Plant
- Department of Neurosurgery, Stanford University, Stanford, California, United States of America
| | - Yunzhi Yang
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, United States of America
- Department of Materials Science and Engineering, Stanford University, Stanford, California, United States of America
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
- * E-mail:
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12
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3D multi-channel bi-functionalized silk electrospun conduits for peripheral nerve regeneration. J Mech Behav Biomed Mater 2015; 41:43-55. [DOI: 10.1016/j.jmbbm.2014.09.029] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 09/25/2014] [Accepted: 09/30/2014] [Indexed: 12/21/2022]
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Kim DY, Choi YS, Kim SE, Lee JH, Kim SM, Kim YJ, Rhie JW, Jun YJ. In vivo effects of adipose-derived stem cells in inducing neuronal regeneration in Sprague-Dawley rats undergoing nerve defect bridged with polycaprolactone nanotubes. J Korean Med Sci 2014; 29 Suppl 3:S183-92. [PMID: 25473208 PMCID: PMC4248004 DOI: 10.3346/jkms.2014.29.s3.s183] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 08/12/2014] [Indexed: 11/25/2022] Open
Abstract
There have been many attempts for regeneration of peripheral nerve injury. In this study, we examined the in vivo effects of non-differentiated and neuronal differentiated adipose-derived stem cells (ADSCs) in inducing the neuronal regeneration in the Sprague-Dawley (SD) rats undergoing nerve defect bridged with the PCL nanotubes. Then, we performed immunohistochemical and histopathologic examinations, as well as the electromyography, in three groups: the control group (14 sciatic nerves transplanted with the PCL nanotube scaffold), the experimental group I (14 sciatic nerves with the non-differentiated ADSCs at a density of 7×10(5) cells/0.1 mL) and the experimental group II (14 sciatic nerves with the neuronal differentiated ADSCs at 7×10(5) cells/0.1 mL). Six weeks postoperatively, the degree of the neuronal induction and that of immunoreactivity to nestin, MAP-2 and GFAP was significantly higher in the experimental group I and II as compared with the control group. In addition, the nerve conduction velocity (NCV) was significantly higher in the experimental group I and II as compared with the control group (P=0.021 and P=0.020, respectively). On the other hand, there was no significant difference in the NCV between the two experimental groups (P>0.05). Thus, our results will contribute to treating patients with peripheral nerve defects using PCL nanotubes with ADSCs.
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Affiliation(s)
- Dong-Yeon Kim
- Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, Seoul, Korea
| | - Yong-Seong Choi
- Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, Seoul, Korea
| | - Sung-Eun Kim
- Department of Orthopedic Surgery and Rare Diseases Institute, Korea University, Seoul, Korea
| | - Jung-Ho Lee
- Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, Seoul, Korea
| | - Sue-Min Kim
- Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, Seoul, Korea
| | - Young-Jin Kim
- Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, Seoul, Korea
| | - Jong-Won Rhie
- Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, Seoul, Korea
| | - Young-Joon Jun
- Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, Seoul, Korea
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Su WT, Shih YA, Ko CS. Effect of chitosan conduit under a dynamic culture on the proliferation and neural differentiation of human exfoliated deciduous teeth stem cells. J Tissue Eng Regen Med 2013; 10:507-17. [DOI: 10.1002/term.1783] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 05/04/2013] [Accepted: 05/06/2013] [Indexed: 12/19/2022]
Affiliation(s)
- Wen-Ta Su
- Department of Chemical Engineering and Biotechnology; National Taipei University of Technology; Taipei Taiwan
| | - Yi-An Shih
- Department of Chemical Engineering and Biotechnology; National Taipei University of Technology; Taipei Taiwan
| | - Chih-Sheng Ko
- PhytoHealth Corporation; Maywufa Biopharma Group; Taipei Taiwan
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Strauch RJ, Strauch B. Nerve conduits: an update on tubular nerve repair and reconstruction. J Hand Surg Am 2013; 38:1252-5; quiz 1255. [PMID: 23602436 DOI: 10.1016/j.jhsa.2013.02.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 02/05/2013] [Accepted: 02/18/2013] [Indexed: 02/02/2023]
Affiliation(s)
- Robert J Strauch
- Department of Orthopaedic Surgery, Columbia University, New York, NY 10032, USA.
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Nan J, Hu X, Li H, Zhang X, Piao R. Use of nerve conduits for peripheral nerve injury repair: A Web of Science-based literature analysis. Neural Regen Res 2012; 7:2826-33. [PMID: 25317133 PMCID: PMC4190865 DOI: 10.3969/j.issn.1673-5374.2012.35.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 11/02/2012] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE: To identify global research trends in the use of nerve conduits for peripheral nerve injury repair. DATA RETRIEVAL: Numerous basic and clinical studies on nerve conduits for peripheral nerve injury repair were performed between 2002–2011. We performed a bibliometric analysis of the institutions, authors, and hot topics in the field, from the Web of Science, using the key words peripheral nerve and conduit or tube. SELECTION CRITERIA: Inclusion criteria: peer-reviewed published articles on nerve conduits for peripheral nerve injury repair, indexed in the Web of Science; original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items. Exclusion criteria: articles requiring manual searching or telephone access; documents not published in the public domain; and several corrected papers. MAIN OUTCOME MEASURES: (a) Annual publication output; (b) publication type; (c) publication by research field; (d) publication by journal; (e) publication by funding agency; (f) publication by author; (g) publication by country and institution; (h) publications by institution in China; (i) most-cited papers. RESULTS: A total of 793 publications on the use of nerve conduits for peripheral nerve injury repair were retrieved from the Web of Science between 2002–2011. The number of publications gradually increased over the 10-year study period. Articles constituted the main type of publication. The most prolific journals were Biomaterials, Microsurgery, and Journal of Biomedical Materials Research Part A. The National Natural Science Foundation of China supported 27 papers, more than any other funding agency. Of the 793 publications, almost half came from American and Chinese authors and institutions. CONCLUSION: Nerve conduits have been studied extensively for peripheral nerve regeneration; however, many problems remain in this field, which are difficult for researchers to reach a consensus.
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Affiliation(s)
- Jinniang Nan
- Department of General Surgery, Second People's Hospital of Panjin, Panjin 124000, Liaoning Province, China
| | - Xuguang Hu
- Department of General Surgery, Second People's Hospital of Panjin, Panjin 124000, Liaoning Province, China
| | - Hongxiu Li
- Department of General Surgery, Second People's Hospital of Panjin, Panjin 124000, Liaoning Province, China
| | - Xiaonong Zhang
- Department of General Surgery, Second People's Hospital of Panjin, Panjin 124000, Liaoning Province, China
| | - Renjing Piao
- Department of General Surgery, Second People's Hospital of Panjin, Panjin 124000, Liaoning Province, China
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Papalia I, Raimondo S, Ronchi G, Magaudda L, Giacobini-Robecchi MG, Geuna S. Repairing nerve gaps by vein conduits filled with lipoaspirate-derived entire adipose tissue hinders nerve regeneration. Ann Anat 2012; 195:225-30. [PMID: 23287534 DOI: 10.1016/j.aanat.2012.10.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 10/04/2012] [Accepted: 10/07/2012] [Indexed: 01/20/2023]
Abstract
In spite of great recent advancements, the definition of the optimal strategy for bridging a nerve defect, especially across long gaps, still remains an open issue since the amount of autologous nerve graft material is limited while the outcome after alternative tubulization techniques is often unsatisfactory. The aim of this study was to investigate a new tubulization technique based on the employment of vein conduits filled with whole subcutaneous adipose tissue obtained by lipoaspiration. In adult rats, a 1cm-long defect of the left median nerve was repaired by adipose tissue-vein-combined conduits and compared with fresh skeletal muscle tissue-vein-combined conduits and autologous nerve grafts made by the excised nerve segment rotated by 180°. Throughout the postoperative period, functional recovery was assessed using the grasping test. Regenerated nerve samples were withdrawn at postoperative month-6 and processed for light and electron microscopy and stereology of regenerated nerve fibers. Results showed that functional recovery was significantly slower in the adipose tissue-enriched group in comparison to both control groups. Light and electron microscopy showed that a large amount of adipose tissue was still present inside the vein conduits at postoperative month-6. Stereology showed that all quantitative morphological predictors analyzed performed significantly worse in the adipose tissue-enriched group in comparison to the two control groups. On the basis of this experimental study in the rat, the use of whole adipose tissue for tissue engineering of peripheral nerves should be discouraged. Pre-treatment of adipose tissue aimed at isolating stromal vascular fraction and/or adipose derived stem/precursor cells should be considered a fundamental requisite for nerve repair.
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Affiliation(s)
- Igor Papalia
- Department of Biomorphology and Biotechnologies, University of Messina, Italy
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Pereira Lopes FR, Martin PKM, Frattini F, Biancalana A, Almeida FM, Tomaz MA, Melo PA, Borojevic R, Han SW, Martinez AMB. Double gene therapy with granulocyte colony-stimulating factor and vascular endothelial growth factor acts synergistically to improve nerve regeneration and functional outcome after sciatic nerve injury in mice. Neuroscience 2012; 230:184-97. [PMID: 23103791 DOI: 10.1016/j.neuroscience.2012.10.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 10/09/2012] [Accepted: 10/10/2012] [Indexed: 12/17/2022]
Abstract
Peripheral-nerve injuries are a common clinical problem and often result in long-term functional deficits. Reconstruction of peripheral-nerve defects is currently undertaken with nerve autografts. However, there is a limited availability of nerves that can be sacrificed and the functional recovery is never 100% satisfactory. We have previously shown that gene therapy with vascular endothelial growth factor (VEGF) significantly improved nerve regeneration, neuronal survival, and muscle activity. Our hypothesis is that granulocyte colony-stimulating factor (G-CSF) synergizes with VEGF to improve the functional outcome after sciatic nerve transection. The left sciatic nerves and the adjacent muscle groups of adult mice were exposed, and 50 or 100 μg (in 50 μl PBS) of VEGF and/or G-CSF genes was injected locally, just below the sciatic nerve, and transferred by electroporation. The sciatic nerves were transected and placed in an empty polycaprolactone (PCL) nerve guide, leaving a 3-mm gap to challenge nerve regeneration. After 6 weeks, the mice were perfused and the sciatic nerve, the dorsal root ganglion (DRG), the spinal cord and the gastrocnemius muscle were processed for light and transmission electron microscopy. Treated animals showed significant improvement in functional and histological analyses compared with the control group. However, the best results were obtained with the G-CSF+VEGF-treated animals: quantitative analysis of regenerated nerves showed a significant increase in the number of myelinated fibers and blood vessels, and the number of neurons in the DRG and motoneurons in the spinal cord was significantly higher. Motor function also showed that functional recovery occurred earlier in animals receiving G-CSF+VEGF-treatment. The gastrocnemius muscle showed an increase in weight and in the levels of creatine phosphokinase, suggesting an improvement of reinnervation and muscle activity. These results suggest that these two factors acted synergistically and optimized the nerve repair potential, improving regeneration after a transection lesion.
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Affiliation(s)
- F R Pereira Lopes
- Programa de Neurociência Básica e Clínica, Instituto de Ciências Biomédicas, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, RJ, Brazil
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21
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Lin KM, Sant HJ, Gale BK, Agarwal JP. New approaches to bridge nerve gaps: development of a novel drug-delivering nerve conduit. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2012; 2012:747-750. [PMID: 23366000 DOI: 10.1109/embc.2012.6346039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Contemporary bridging techniques for repairing nerve gaps caused by trauma require autologous nerve grafts, which are difficult to harvest and handle and result in significant donor site deficit. Several nerve conduits with axon growth-enhancing potential have been proposed, developed and tested over the past fifteen years. In this work, prototypes of a nerve conduit designed to bridge large nerve gaps (≥10mm) end-to-end were incorporated with concentric drug reservoirs for constant and controlled drug delivery to enhance axon growth. These devices were designed, fabricated and tested in vitro in amber glass vials with bovine serum albumin in order to determine the drug release kinetics for future application. Our devices have shown the capability to deliver the drug of interest over a 6-day period.
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Affiliation(s)
- Keng-Min Lin
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT 84112, USA.
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Huang W, Begum R, Barber T, Ibba V, Tee N, Hussain M, Arastoo M, Yang Q, Robson L, Lesage S, Gheysens T, Skaer NJ, Knight D, Priestley J. Regenerative potential of silk conduits in repair of peripheral nerve injury in adult rats. Biomaterials 2012; 33:59-71. [DOI: 10.1016/j.biomaterials.2011.09.030] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Accepted: 09/13/2011] [Indexed: 01/03/2023]
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23
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Gardiner NJ. Integrins and the extracellular matrix: Key mediators of development and regeneration of the sensory nervous system. Dev Neurobiol 2011; 71:1054-72. [DOI: 10.1002/dneu.20950] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Korte N, Schenk HC, Grothe C, Tipold A, Haastert-Talini K. Evaluation of periodic electrodiagnostic measurements to monitor motor recovery after different peripheral nerve lesions in the rat. Muscle Nerve 2011; 44:63-73. [DOI: 10.1002/mus.22023] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Kaplan S, Pişkin A, Ayyildiz M, Aktaş A, Köksal B, Ulkay MB, Türkmen AP, Bakan F, Geuna S. The effect of melatonin and platelet gel on sciatic nerve repair: an electrophysiological and stereological study. Microsurgery 2011; 31:306-13. [PMID: 21520268 DOI: 10.1002/micr.20876] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 12/06/2010] [Indexed: 01/26/2023]
Abstract
Nerve regeneration after surgical reconstruction is far from optimal, and thus effective strategies for improving the outcome of nerve repair are being sought. In this experiment, we verified if postoperative intraperitoneal melatonin (MLT) administration after intraoperative platelet gel application improves peripheral nerve regeneration. In adult male rats, 1-cm long sciatic nerve defects were repaired using four different strategies: autologous nerve graft repair followed by MLT (NM, n = 5), collagen conduit repair followed by MLT (CM, n = 5), platelet gel-enriched collagen conduit repair followed by MLT (CGM, n = 6), and platelet gel-enriched collagen conduit (CG, n = 5) repair followed by no substance administration. Sham operated animals were used as controls (Cont, n = 5). Ninety days after surgery, the nerve regeneration outcome was comparatively assessed by means of electrophysiological and stereological analysis. Electrophysiology revealed no significant differences between the experimental and the sham control groups. Stereological analysis showed no significant differences among the experimental groups regarding axon size and myelin thickness, but the axon number was significantly lower in the CM compared to Cont and NM group. Moreover, there was no significant difference between number of axons in CG and Cont groups, between CGM and CM, and between CM and NM. Although it was observed that platelet gel have a positive effect on nerve regeneration, but a combination of local platelet gel with MLT does not have the same effect on nerve repair.
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Affiliation(s)
- Süleyman Kaplan
- Department of Histology and Embryology, Ondokuz Mayis University School of Medicine, Samsun, Turkey.
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Abstract
Peripheral nerve regeneration is a complicated and long-term medical challenge that requires suitable guides for bridging nerve injury gaps and restoring nerve functions. Many natural and synthetic polymers have been used to fabricate nerve conduits as well as luminal fillers for achieving desired nerve regenerative functions. It is important to understand the intrinsic properties of these polymers and techniques that have been used for fabricating nerve conduits. Previously extensive reviews have been focused on the biological functions and in vivo performance of polymeric nerve conduits. In this paper, we emphasize on the structures, thermal and mechanical properties of these naturally derived synthetic polymers, and their fabrication methods. These aspects are critical for the performance of fabricated nerve conduits. By learning from the existing candidates, we can advance the strategies for designing novel polymeric systems with better properties for nerve regeneration.
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