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Yılmaz MM, Akdere ÖE, Gümüşderelioğlu M, Kaynak Bayrak G, Koç S, Erdem A, Tuncer M, Atalay Ö, Take Kaplanoğlu G, Akarca Dizakar SÖ, Calis M. Biological nerve conduit model with de-epithelialized human amniotic membrane and adipose-derived mesenchymal stem cell sheet for repair of peripheral nerve defects. Cell Tissue Res 2023; 391:505-522. [PMID: 36562866 DOI: 10.1007/s00441-022-03732-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
In this study, a biological conduit, consisting of an adipocyte-derived mesenchymal stem cell (AdMSCs) sheet and amniotic membrane (AM), was designed for the reconstruction of peripheral nerve defects. To evaluate the effect of the produced conduit on neural regeneration, a 10-mm sciatic nerve defect was created in rats, and experiments were carried out on six groups, i.e., sham control group (SC), negative control group (NC), nerve autograft group (NG), the biological conduit (AdMSCs + AM) group, the commercial PGA tube conduit (PGA) group, and the conduit only consisting of AM (AM) group. The effects of different nerve repair methods on the peripheral nerve and gastrocnemius muscle were evaluated by functional, histological, and immunohistochemical tests. When the number of myelinated axons was compared between the groups of AdMSCs + AM and PGA, it was higher in the AdMSCs + AM group (p < 0.05). The percentage of gastrocnemius collagen bundle area of AdMSCs + AM group was found to be statistically lower than the PGA group (p < 0.05). The muscle fiber diameter of AdMSCs + AM group was lower than that of the NG group, but significantly higher than that of the PGA group and the AM group (p < 0.001). Muscle weight index was significantly higher in the AdMSCs + AM group compared to the PGA group (p < 0.05). It was observed that nerve regeneration was faster in the AdMSCs + AM group, and there was an earlier improvement in pin-prick score and sciatic functional index compared to the PGA group and the AM group. In conclusion, the biological conduit prepared from the AdMSCs sheet and AM is regarded as a new biological conduit that can be used as an alternative treatment method to nerve autograft in clinical applications.
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Affiliation(s)
- Mahmut Muhsin Yılmaz
- Department of Plastic Reconstructive and Aesthetic Surgery, Hacettepe University Faculty of Medicine, Hacettepe Universitesi Eriskin Hastanesi, Kat B, Plastik Cerrahi Anabilim Dali, 06100, Sihhiye - Ankara, Turkey
| | | | | | | | - Sena Koç
- Chemical Engineering Department, Hacettepe University, Ankara, Turkey
| | - Ayşen Erdem
- Department of Physiology, Hacettepe University, Ankara, Turkey
| | - Meltem Tuncer
- Department of Physiology, Hacettepe University, Ankara, Turkey
| | - Özbeyen Atalay
- Department of Physiology, Hacettepe University, Ankara, Turkey
| | | | | | - Mert Calis
- Department of Plastic Reconstructive and Aesthetic Surgery, Hacettepe University Faculty of Medicine, Hacettepe Universitesi Eriskin Hastanesi, Kat B, Plastik Cerrahi Anabilim Dali, 06100, Sihhiye - Ankara, Turkey.
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Fontaine C, Yeager EA, Sledziona M, Jones AK, Cheetham J. Revitalizing the common peroneal function index for assessing functional recovery following nerve injury. Brain Behav 2021; 11:e01968. [PMID: 33314721 PMCID: PMC7882187 DOI: 10.1002/brb3.1968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 10/04/2020] [Accepted: 11/02/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND AIMS Peripheral nerve injury is common with poor functional recovery and consequent high personal and societal costs. Sciatic nerve transection and assessment of recovery using sciatic functional index (SFI) are widely used. SFI is biologically limited as axonal misdirection of axons supplying flexors and extensors in the hindlimb, after nerve injury can lead to synkinetic innervation and function which does not correspond to the degree of axonal regeneration. METHODS We reevaluated the use of traditional metrics such as print length (PL), toe spread (TS), and intermediate toe spread (ITS) as well as hock angle at mid-swing as approaches for determining recovery. We used two alternative approaches in discrete cohorts of rats following common peroneal crush injury, transection with repair and critical gap, using transection with ligation as a negative control. We compared walking track analysis (print) with digital capture and kinematics. RESULTS PL, TS, and ITS varied as expected after injury. The traditional functional index for common peroneal injury using inked prints failed to describe recovery and we derived new indices to describe recovery (all R2 > 0.88, p < .0001) although pre-injury PFI was never attained by any of the models. Kinematic analysis identified hock angle at mid-swing as a useful predictor of recovery (p < .0001). INTERPRETATION Using complementary approaches.
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Affiliation(s)
- Calder Fontaine
- Department of Clinical Sciences, Cornell College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Eric A Yeager
- Department of Clinical Sciences, Cornell College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Michael Sledziona
- Department of Clinical Sciences, Cornell College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Amanda K Jones
- Department of Clinical Sciences, Cornell College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Jonathan Cheetham
- Department of Clinical Sciences, Cornell College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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Saltzman EB, Villa JC, Doty SB, Feinberg JH, Lee SK, Wolfe SW. A Comparison Between Two Collagen Nerve Conduits and Nerve Autograft: A Rat Model of Motor Nerve Regeneration. J Hand Surg Am 2019; 44:700.e1-700.e9. [PMID: 30502013 DOI: 10.1016/j.jhsa.2018.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 08/27/2018] [Accepted: 10/15/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare recovery in a rat model of sciatic nerve injury using a novel polyglycolic acid (PGA) conduit, which contains collagen fibers within the tube, as compared with both a hollow collagen conduit and nerve autograft. We hypothesize that a conduit with a scaffold will provide improved nerve regeneration over hollow conduits and demonstrate no significant differences when compared with autograft. METHODS A total of 72 Sprague-Dawley rats were randomized into 3 experimental groups, in which a unilateral 10-mm sciatic defect was repaired using either nerve autograft, a hollow collagen conduit, or a PGA collagen-filled conduit. Outcomes were measured at 12 and 16 weeks after surgery, and included bilateral tibialis anterior muscle weight, voltage and force maximal contractility, assessment of ankle contracture, and nerve histology. RESULTS In all groups, outcomes improved between 12 and 16 weeks. On average, the autograft group outperformed both conduit groups, and the hollow conduit demonstrated improved outcomes when compared with the PGA collagen-filled conduit. Differences in contractile force, however, were significant only at 12 weeks (autograft > hollow collagen conduit > PGA collagen-filled conduit). At 16 weeks, contractile force demonstrated no significant difference but corroborated the same absolute results (autograft > hollow collagen conduit > PGA collagen-filled conduit). CONCLUSIONS Nerve repair using autograft provided superior motor nerve recovery over the 2 conduits for a 10-mm nerve gap in a murine acute transection injury model. The hollow collagen conduit demonstrated superior results when compared with the PGA collagen-filled conduit. CLINICAL RELEVANCE The use of a hollow collagen conduit provides superior motor nerve recovery as compared with a PGA collagen-filled conduit.
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Affiliation(s)
- Eliana B Saltzman
- Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery, New York, NY
| | - Jordan C Villa
- Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery, New York, NY
| | - Stephen B Doty
- Hospital for Special Surgery, Mineralized Tissue Laboratory, New York, NY
| | - Joseph H Feinberg
- Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery, New York, NY
| | - Steve K Lee
- Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - Scott W Wolfe
- Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery, New York, NY; Weill Medical College of Cornell University, New York, NY.
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Fujimaki H, Uchida K, Inoue G, Matsushita O, Nemoto N, Miyagi M, Inage K, Takano S, Orita S, Ohtori S, Tanaka K, Sekiguchi H, Takaso M. Polyglycolic acid-collagen tube combined with collagen-binding basic fibroblast growth factor accelerates gait recovery in a rat sciatic nerve critical-size defect model. J Biomed Mater Res B Appl Biomater 2019; 108:326-332. [PMID: 31016841 DOI: 10.1002/jbm.b.34391] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/24/2019] [Accepted: 04/04/2019] [Indexed: 02/03/2023]
Abstract
Several nerve conduits have been investigated for their potential as alternative sources of autografts for bridging neural gaps. However, autologous nerve transplants remain the most effective for nerve repair. We examined clinically approved nerve conduits containing collagen and polyglycolic acid (PGA-c) combined with collagen-binding basic fibroblast growth factor (bFGF) containing a polycystic kidney disease (PKD) domain and collagen binding domain (CBD) (bFGF-PKD-CBD) in a rat 15-mm sciatic nerve critical-size defect model. The treatment groups were: PGA-c immersed in phosphate-buffered saline (PBS) (PGA-c/PBS group), bFGF (PGA-c/bFGF group), or bFGF-PKD-CBD (PGA-c/bFGF-PKD-CBD group), and no treatment (Defect group). Gait and histological analyses were performed. Four weeks after treatment, the recovery rate of the paw print area was significantly greater in the PGA-c/bFGFPKD-CBD group than the PGA-c/PBS and PGA-c/bFGF groups. Mean intensity of paw prints was significantly greater in the PGA-c/bFGF-PKD-CBD group than the PGA-c/PBS and Defect groups. Swing time was significantly greater in the PGA-c/PBS, PGA-c/bFGF, and PGA-c/bFGF-PKD-CBD groups than the Defect group. At 8 weeks, all three parameters were significantly greater in the PGA-c/PBS, PGA-c/bFGF, and PGA-c/bFGF-PKD-CBD groups than the Defect group. Regenerated myelinated fibers were observed in 7/8 (87.5%) rats in the PGA-c/bFGF-PKD-CBD group after 8 weeks, and in 1/8 (12.5%) and 3/8 (37.5%) rats in the PGA-c/PBS and PGA-c/bFGF groups, respectively. PGA-c/bFGF-PKD-CBD composites may be promising biomaterials for promoting functional recovery of long-distance peripheral nerve defects in clinical practice.
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Affiliation(s)
- Hisako Fujimaki
- Department of Orthopedic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Kentaro Uchida
- Department of Orthopedic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Gen Inoue
- Department of Orthopedic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Osamu Matsushita
- Research Center for Biological Imaging, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Noriko Nemoto
- Department of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masayuki Miyagi
- Department of Orthopedic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Kazuhide Inage
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shotaro Takano
- Department of Orthopedic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Sumihisa Orita
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Keisuke Tanaka
- Nippi Research Institute of Biomatrix and Protein Engineering Project, 520-11, Toride, Japan
| | - Hiroyuki Sekiguchi
- Shonan University of Medical Sciences Research Institute, Chigasaki City, Kanagawa, Japan
| | - Masashi Takaso
- Department of Orthopedic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
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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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Comparison of conduit and autograft efficiency in repairing femoral nerve injury in New Zealand rabbits. Med J Islam Repub Iran 2018; 32:99. [PMID: 31024865 PMCID: PMC6477882 DOI: 10.14196/mjiri.32.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Indexed: 11/18/2022] Open
Abstract
Background: Peripheral nerve injuries may affect all age groups and exert devastating impacts on the professional and personal life of the patients. The investigation of nerve regeneration and use of biomaterials and synthetic materials have resulted in advancements in the treatment of peripheral nerve injuries and lesions. Nerve conduits can be used to adjoin the digital sensory nerve spaces of less than 3 cm, especially when the direct tension-free repair of peripheral nerve lesions is not possible. The present study was conducted to evaluate the use of nerve conduits by functional and nonfunctional parameters (i.e. histological study). Methods: This experimental study was conducted on 30 male rabbits. After cutting or crushing the right femoral nerve of the rabbits, they were divided into 3 groups: group 1, with right femoral nerve cut; group 2, with right femoral nerve crushed; and group 3, with right femoral nerve cut using a conduit. The 3 groups were evaluated after 1, 8, and 16 weeks for functional parameters (i.e. walking track analysis). In addition, they were subjected to nonfunctional examination (i.e. histological study) after 16 weeks, then, the results were compared. Results: The 3 groups showed no statistically significant differences in motor recovery in the eighth and 16th weeks (p>0.05). Based on the histological study, group 3 with an end-to-end nerve cutting using a conduit, showed a significantly higher axon count compared to groups 2 and 3 (p<0.05). Conclusion: End-to-end anastomosis using conduit led to axon growth; moreover, comparable functional recovery was observed with end-to-end neurorrhaphy in a rabbit model. Given that the diameter of the nerves and muscles, which might be neurotized in humans, and is much bigger and not comparable to that of the rabbits, it is highly recommended to conduct studies on animals with the larger size, such as primates, to facilitate the generalization of the results to humans.
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Evaluation of two collagen conduits and autograft in rabbit sciatic nerve regeneration with quantitative magnetic resonance DTI, electrophysiology, and histology. Eur Radiol Exp 2018; 2:19. [PMID: 30148252 PMCID: PMC6091702 DOI: 10.1186/s41747-018-0049-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/24/2018] [Indexed: 12/18/2022] Open
Abstract
Background We compared different surgical techniques for nerve regeneration in a rabbit sciatic nerve gap model using magnetic resonance diffusion tensor imaging (DTI), electrophysiology, limb function, and histology. Methods A total of 24 male New Zealand white rabbits were randomized into three groups: autograft (n = 8), hollow conduit (n = 8), and collagen-filled conduit (n = 8). A 10-mm segment of the rabbit proximal sciatic nerve was cut, and autograft or collagen conduit was used to bridge the gap. DTI on a 3-T system was performed preoperatively and 13 weeks after surgery using the contralateral, nonoperated nerve as a control. Results Overall, autograft performed better compared with both conduit groups. Differences in axonal diameter were significant (autograft > hollow conduit > collagen-filled conduit) at 13 weeks (autograft vs. hollow conduit, p = 0.001, and hollow conduit vs. collagen-filled conduit, p < 0.001). Significant group differences were found for axial diffusivity but not for any of the other DTI metrics (autograft > hollow conduit > collagen-filled conduit) (autograft vs. hollow conduit, p = 0.001 and hollow conduit vs. collagen-filled conduit, p = 0.021). As compared with hollow conduit (autograft > collagen-filled conduit > hollow conduit), collagen-filled conduit animals demonstrated a nonsignificant increased maximum tetanic force. Conclusions Autograft-treated rabbits demonstrated improved sciatic nerve regeneration compared with collagen-filled and hollow conduits as assessed by histologic, functional, and DTI parameters at 13 weeks.
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8
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Niimi Y, Matsumine H, Takeuchi Y, Hironobu O, Tsunoda S, Miyata M, Yamato M, Sakurai H. A collagen-coated PGA conduit for interpositional-jump graft with end-to-side neurorrhaphy for treating facial nerve paralysis in rat. Microsurgery 2018; 39:70-80. [DOI: 10.1002/micr.30291] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 11/05/2017] [Accepted: 12/15/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Yosuke Niimi
- Department of Plastic and Reconstructive Surgery; Tokyo Women's Medical University; 8-1 Kawada-cho, Shinjuku-ku Tokyo 162-8666 Japan
- Institute of Advanced Biomedical Engineering and Science; Tokyo Women's Medical University; 8-1 Kawada-cho, Shinjuku-ku Tokyo 162-8666 Japan
| | - Hajime Matsumine
- Department of Plastic and Reconstructive Surgery; Tokyo Women's Medical University; 8-1 Kawada-cho, Shinjuku-ku Tokyo 162-8666 Japan
- Institute of Advanced Biomedical Engineering and Science; Tokyo Women's Medical University; 8-1 Kawada-cho, Shinjuku-ku Tokyo 162-8666 Japan
| | - Yuichi Takeuchi
- Department of Physiology I (Neurophysiology); Tokyo Women's Medical University; 8-1 Kawada-cho, Shinjuku-ku Tokyo, 162-8666 Japan
| | - Osaki Hironobu
- Department of Physiology I (Neurophysiology); Tokyo Women's Medical University; 8-1 Kawada-cho, Shinjuku-ku Tokyo, 162-8666 Japan
| | - Satoshi Tsunoda
- The Institute of Medical Science; The University of Tokyo; 4-6-1 Shirokanedai, Minato-ku Tokyo, 108-8639 Japan
| | - Mariko Miyata
- Department of Physiology I (Neurophysiology); Tokyo Women's Medical University; 8-1 Kawada-cho, Shinjuku-ku Tokyo, 162-8666 Japan
| | - Masayuki Yamato
- Institute of Advanced Biomedical Engineering and Science; Tokyo Women's Medical University; 8-1 Kawada-cho, Shinjuku-ku Tokyo 162-8666 Japan
| | - Hiroyuki Sakurai
- Department of Plastic and Reconstructive Surgery; Tokyo Women's Medical University; 8-1 Kawada-cho, Shinjuku-ku Tokyo 162-8666 Japan
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Yokoi T, Uemura T, Takamatsu K, Shintani K, Onode E, Okada M, Hidaka N, Nakamura H. Bioabsorbable nerve conduits coated with induced pluripotent stem cell-derived neurospheres enhance axonal regeneration in sciatic nerve defects in aged mice. J Biomed Mater Res B Appl Biomater 2017; 106:1752-1758. [PMID: 28888079 DOI: 10.1002/jbm.b.33983] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 05/16/2017] [Accepted: 08/16/2017] [Indexed: 11/10/2022]
Abstract
Aging influences peripheral nerve regeneration. Nevertheless, most basic research of bioabsorbable nerve conduits including commercial products have been performed in very young animals. Results from these studies may not provide information about axonal regeneration in aged tissue, because young nerve tissue holds sufficient endogenous potential for axonal regeneration. The clinical target age for nerve conduit application is most likely going to increase with a rapidly growing elderly population. In the present study, we examined axonal regeneration after sciatic nerve defects in aged and young mice. 5-mm sciatic nerve defects in young (6 weeks old) and aged (92 weeks old) mice were reconstructed using nerve conduits (composed of a poly lactide and caprolactone) or autografts. In addition, in aged mice, sciatic nerve defects were reconstructed using nerve conduits coated with mouse induced pluripotent stem cell (iPSc)-derived neurospheres. Using electrophysiological and histological techniques, we demonstrated axonal regeneration was significantly less effective in aged than in young mice both for nerve conduits and for nerve autografts. However, despite the low regenerative capacity of the peripheral nerve in aged mice, axonal regeneration significantly increased when nerve conduits coated with iPSc-derived neurospheres, rather than nerve conduits alone, were used. The present study shows that aging negatively affects peripheral nerve regeneration based on nerve conduits in mice. However, axonal regeneration using nerve conduits was improved when supportive iPSc-derived neurospheres were added in the aged mice. We propose that tissue-engineered bioabsorbable nerve conduits in combination with iPSc-derived neurospheres hold therapeutic potential both in young and elderly patients. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1752-1758, 2018.
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Affiliation(s)
- Takuya Yokoi
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takuya Uemura
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kiyohito Takamatsu
- Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Kosuke Shintani
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Ema Onode
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mitsuhiro Okada
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Noriaki Hidaka
- Department of Orthopaedic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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Sowa Y, Kishida T, Tomita K, Yamamoto K, Numajiri T, Mazda O. Direct Conversion of Human Fibroblasts into Schwann Cells that Facilitate Regeneration of Injured Peripheral Nerve In Vivo. Stem Cells Transl Med 2017; 6:1207-1216. [PMID: 28186702 PMCID: PMC5442846 DOI: 10.1002/sctm.16-0122] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 11/28/2016] [Indexed: 12/18/2022] Open
Abstract
Schwann cells (SCs) play pivotal roles in the maintenance and regeneration of the peripheral nervous system. Although transplantation of SCs enhances repair of experimentally damaged peripheral and central nerve tissues, it is difficult to prepare a sufficient number of functional SCs for transplantation therapy without causing adverse events for the donor. Here, we generated functional SCs by somatic cell reprogramming procedures and demonstrated their capability to promote peripheral nerve regeneration. Normal human fibroblasts were phenotypically converted into SCs by transducing SOX10 and Krox20 genes followed by culturing for 10 days resulting in approximately 43% directly converted Schwann cells (dSCs). The dSCs expressed SC‐specific proteins, secreted neurotrophic factors, and induced neuronal cells to extend neurites. The dSCs also displayed myelin‐forming capability both in vitro and in vivo. Moreover, transplantation of the dSCs into the transected sciatic nerve in mice resulted in significantly accelerated regeneration of the nerve and in improved motor function at a level comparable to that with transplantation of the SCs obtained from a peripheral nerve. The dSCs induced by our procedure may be applicable for novel regeneration therapy for not only peripheral nerve injury but also for central nerve damage and for neurodegenerative disorders related to SC dysfunction. Stem Cells Translational Medicine2017;6:1207–1216
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Affiliation(s)
- Yoshihiro Sowa
- Department of Immunology, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan.,Department of Plastic and Reconstructive Surgery, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Tsunao Kishida
- Department of Immunology, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Koichi Tomita
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka Suita, Osaka, 565-0871, Japan
| | - Kenta Yamamoto
- Department of Immunology, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan.,Department of Dental Medicine, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Toshiaki Numajiri
- Department of Plastic and Reconstructive Surgery, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Osam Mazda
- Department of Immunology, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan
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Approaches to Peripheral Nerve Repair: Generations of Biomaterial Conduits Yielding to Replacing Autologous Nerve Grafts in Craniomaxillofacial Surgery. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3856262. [PMID: 27556032 PMCID: PMC4983313 DOI: 10.1155/2016/3856262] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/29/2016] [Indexed: 01/09/2023]
Abstract
Peripheral nerve injury is a common clinical entity, which may arise due to traumatic, tumorous, or even iatrogenic injury in craniomaxillofacial surgery. Despite advances in biomaterials and techniques over the past several decades, reconstruction of nerve gaps remains a challenge. Autografts are the gold standard for nerve reconstruction. Using autografts, there is donor site morbidity, subsequent sensory deficit, and potential for neuroma development and infection. Moreover, the need for a second surgical site and limited availability of donor nerves remain a challenge. Thus, increasing efforts have been directed to develop artificial nerve guidance conduits (ANCs) as new methods to replace autografts in the future. Various synthetic conduit materials have been tested in vitro and in vivo, and several first- and second-generation conduits are FDA approved and available for purchase, while third-generation conduits still remain in experimental stages. This paper reviews the current treatment options, summarizes the published literature, and assesses future prospects for the repair of peripheral nerve injury in craniomaxillofacial surgery with a particular focus on facial nerve regeneration.
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Adipose-Derived Stem Cells Promote Peripheral Nerve Regeneration In Vivo without Differentiation into Schwann-Like Lineage. Plast Reconstr Surg 2016; 137:318e-330e. [PMID: 26818322 DOI: 10.1097/01.prs.0000475762.86580.36] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND During recent decades, multipotent stem cells were found to reside in the adipose tissue, and these adipose-derived stem cells were shown to play beneficial roles, like those of Schwann cells, in peripheral nerve regeneration. However, it has not been well established whether adipose-derived stem cells offer beneficial effects to peripheral nerve injuries in vivo as Schwann cells do. Furthermore, the in situ survival and differentiation of adipose-derived stem cells after transplantation at the injured peripheral nerve tissue remain to be fully elucidated. METHODS Adipose-derived stem cells and Schwann cells were transplanted with gelatin hydrogel tubes at the artificially blunted sciatic nerve lesion in mice. Neuroregenerative abilities of them were comparably estimated. Cre-loxP-mediated fate tracking was performed to visualize survival in vivo of transplanted adipose-derived stem cells and to investigate whether they differentiated into Schwann linage cells at the peripheral nerve injury site. RESULTS The transplantation of adipose-derived stem cells promoted regeneration of axons, formation of myelin, and restoration of denervation muscle atrophy to levels comparable to those achieved by Schwann cell transplantation. The adipose-derived stem cells survived for at least 4 weeks after transplantation without differentiating into Schwann cells. CONCLUSIONS Transplanted adipose-derived stem cells did not differentiate into Schwann cells but promoted peripheral nerve regeneration at the injured site. The neuroregenerative ability was comparable to that of Schwann cells. Adipose-derived stem cells at an undifferentiated stage may be used as an alternative cell source for autologous cell therapy for patients with peripheral nerve injury.
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Effect of Artificial Nerve Conduit Vascularization on Peripheral Nerve in a Necrotic Bed. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e665. [PMID: 27257595 PMCID: PMC4874309 DOI: 10.1097/gox.0000000000000652] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 02/01/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Several types of artificial nerve conduit have been used for bridging peripheral nerve gaps as an alternative to autologous nerves. However, their efficacy in repairing nerve injuries accompanied by surrounding tissue damage remains unclear. We fabricated a novel nerve conduit vascularized by superficial inferior epigastric (SIE) vessels and evaluated whether it could promote axonal regeneration in a necrotic bed. METHODS A 15-mm nerve conduit was implanted beneath the SIE vessels in the groin of a rat to supply it with blood vessels 2 weeks before nerve reconstruction. We removed a 13-mm segment of the sciatic nerve and then pressed a heated iron against the dorsal thigh muscle to produce a burn. The defects were immediately repaired with an autograft (n = 10), nerve conduit graft (n = 8), or vascularized nerve conduit graft (n = 8). Recovery of motor function was examined for 18 weeks after surgery. The regenerated nerves were electrophysiologically and histologically evaluated. RESULTS The vascularity of the nerve conduit implanted beneath the SIE vessels was confirmed histologically 2 weeks after implantation. Between 14 and 18 weeks after surgery, motor function of the vascularized conduit group was significantly better than that of the nonvascularized conduit group. Electrophysiological and histological evaluations revealed that although the improvement did not reach the level of reinnervation achieved by an autograft, the vascularized nerve conduit improved axonal regeneration more than did the conduit alone. CONCLUSION Vascularization of artificial nerve conduits accelerated peripheral nerve regeneration, but further research is required to improve the quality of nerve regeneration.
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Leibig N, Boyle V, Kraus D, Stark GB, Penna V. Il10 and poly-dl
-lactide-ɛ-caprolactone conduits in critical size nerve defect bridging-An experimental study. Microsurgery 2015; 36:410-416. [DOI: 10.1002/micr.22423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 04/07/2015] [Accepted: 04/10/2015] [Indexed: 12/17/2022]
Affiliation(s)
- Nico Leibig
- Department of Hand; Plastic and Reconstructive Surgery, BG Trauma Centre; Ludwigshafen Germany
| | - Veronika Boyle
- Clinic for Neurology, Ortenau Klinikum Lahr-Ettenheim; Lahr Germany
| | - Daniel Kraus
- Clinic of Plastic and Hand Surgery, University Medical Center; Freiburg Germany
| | | | - Vincenzo Penna
- Clinic of Plastic and Hand Surgery, University Medical Center; Freiburg Germany
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C3 toxin and poly-DL-lactide-ε-caprolactone conduits in the critically damaged peripheral nervous system: a combined therapeutic approach. Ann Plast Surg 2015; 74:350-3. [PMID: 25643184 DOI: 10.1097/sap.0000000000000415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Peripheral nerve regeneration over longer distances through conduits is limited. In the presented study, critical size nerve gap bridging with a poly-DL-lactide-ε-caprolactone (PLC) conduit was combined with application of C3 toxin to facilitate axonal sprouting. MATERIALS AND METHODS The PLC filled with fibrin (n = 10) and fibrin gel loaded with 1-μg C3-C2I and 2-μg C2II (n = 10) were compared to autologous nerve grafts (n = 10) in a 15-mm sciatic nerve gap lesion model of the rat. Functional and electrophysiological analyses were performed before histological evaluation. RESULTS Evaluation of motor function and nerve conduction velocity at 16 weeks revealed no differences between the groups. All histological parameters and muscle weight were significantly elevated in nerve graft group. No differences were observed in both PLC groups. CONCLUSIONS The PLCs are permissive for nerve regeneration over a 15-mm defect in rats. Intraluminal application of C3 toxin did not lead to significant enhancement of nerve sprouting.
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Schaakxs D, Kalbermatten DF, Pralong E, Raffoul W, Wiberg M, Kingham PJ. Poly-3-hydroxybutyrate strips seeded with regenerative cells are effective promoters of peripheral nerve repair. J Tissue Eng Regen Med 2015; 11:812-821. [DOI: 10.1002/term.1980] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 08/17/2014] [Accepted: 11/26/2014] [Indexed: 12/21/2022]
Affiliation(s)
- Dominique Schaakxs
- Department of Integrative Medical Biology; Umeå University; Sweden
- Division of Plastic, Reconstructive and Aesthetic Surgery, CHUV; University Hospital of Lausanne; Switzerland
| | - Daniel F. Kalbermatten
- Department of Plastic, Reconstructive and Aesthetic Surgery; University Hospital of Basel; Switzerland
| | - Etienne Pralong
- Department of Neurosurgery; University Hospital of Lausanne; Switzerland
| | - Wassim Raffoul
- Division of Plastic, Reconstructive and Aesthetic Surgery, CHUV; University Hospital of Lausanne; Switzerland
| | - Mikael Wiberg
- Department of Integrative Medical Biology; Umeå University; Sweden
- Department of Surgical and Perioperative Sciences; Umeå University; Sweden
| | - Paul J. Kingham
- Department of Integrative Medical Biology; Umeå University; Sweden
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Berrocal YA, Almeida VW, Gupta R, Levi AD. Transplantation of Schwann cells in a collagen tube for the repair of large, segmental peripheral nerve defects in rats. J Neurosurg 2013; 119:720-32. [DOI: 10.3171/2013.4.jns121189] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
Segmental nerve defects pose a daunting clinical challenge, as peripheral nerve injury studies have established that there is a critical nerve gap length for which the distance cannot be successfully bridged with current techniques. Construction of a neural prosthesis filled with Schwann cells (SCs) could provide an alternative treatment to successfully repair these long segmental gaps in the peripheral nervous system. The object of this study was to evaluate the ability of autologous SCs to increase the length at which segmental nerve defects can be bridged using a collagen tube.
Methods
The authors studied the use of absorbable collagen conduits in combination with autologous SCs (200,000 cells/μl) to promote axonal growth across a critical size defect (13 mm) in the sciatic nerve of male Fischer rats. Control groups were treated with serum only–filled conduits of reversed sciatic nerve autografts. Animals were assessed for survival of the transplanted SCs as well as the quantity of myelinated axons in the proximal, middle, and distal portions of the channel.
Results
Schwann cell survival was confirmed at 4 and 16 weeks postsurgery by the presence of prelabeled green fluorescent protein–positive SCs within the regenerated cable. The addition of SCs to the nerve guide significantly enhanced the regeneration of myelinated axons from the nerve stump into the proximal (p < 0.001) and middle points (p < 0.01) of the tube at 4 weeks. The regeneration of myelinated axons at 16 weeks was significantly enhanced throughout the entire length of the nerve guide (p < 0.001) as compared with their number in a serum–only filled tube and was similar in number compared with the reversed autograft. Autotomy scores were significantly lower in the animals whose sciatic nerve was repaired with a collagen conduit either without (p < 0.01) or with SCs (p < 0.001) when compared with a reversed autograft.
Conclusions
The technique of adding SCs to a guidance channel significantly enhanced the gap distance that can be repaired after peripheral nerve injury with long segmental defects and holds promise in humans. Most importantly, this study represents some of the first essential steps in bringing autologous SC-based therapies to the domain of peripheral nerve injuries with long segmental defects.
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Affiliation(s)
- Yerko A. Berrocal
- 1The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida; and
| | - Vania W. Almeida
- 1The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida; and
| | - Ranjan Gupta
- 2Department of Orthopedic Surgery, University of California–Irvine, California
| | - Allan D. Levi
- 1The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida; and
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Cellularized microcarriers as adhesive building blocks for fabrication of tubular tissue constructs. Ann Biomed Eng 2013; 42:1470-81. [PMID: 23943070 DOI: 10.1007/s10439-013-0883-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 07/29/2013] [Indexed: 10/26/2022]
Abstract
To meet demands of vascular reconstruction, there is a need for prosthetic alternatives to natural blood vessels. Here we explored a new conduit fabrication approach. Macroporous, gelatin microcarriers laden with human umbilical vein endothelial cells and aortic smooth muscle cells were dispensed into tubular agarose molds and found to adhere to form living tubular tissues. The ability of cellularized microcarriers to adhere to one another involved cellular and extracellular matrix bridging that included the formation of epithelium-like cell layers lining the lumenal and ablumenal surfaces of the constructs and the deposition of collagen and elastin fibers. The tubular tissues behaved as elastic solids, with a uniaxial mechanical response that is qualitatively similar to that of native vascular tissues and consistent with their elastin and collagen composition. Linearized measures of the mechanical response of the fabricated tubular tissues at both low and high strains were observed to increase with duration of static culture, with no significant loss of stiffness following decellularization. The findings highlight the utility of cellularized macroporous gelatin microcarriers as self-adhering building blocks for the fabrication of living tubular structures.
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Giusti G, Kremer T, Willems WF, Friedrich PF, Bishop AT, Shin AY. Description and validation of isometric tetanic muscle force test in rabbits. Microsurgery 2011; 32:35-42. [DOI: 10.1002/micr.20941] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 06/20/2011] [Indexed: 01/18/2023]
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Surgical Procedure for Transplanting Artificial Nerve Conduits for Peripheral Nerve Regeneration. Plast Reconstr Surg 2011; 128:95e-97e. [DOI: 10.1097/prs.0b013e31821ef380] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Stump rotation in a nerve autograft by 2 factors: cross-connection and difference in diameter. J Craniofac Surg 2011; 22:1087-92. [PMID: 21586951 DOI: 10.1097/scs.0b013e31821076f6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The aim of this study was to determine the influence of stump rotation (fascicular cross-connection) on nerve autograft functional recovery. Thirty rat sciatic nerves were transected and repaired by autograft. The rats were divided into 3 groups according to the number of stump rotations of the autograft: (1) plain graft (PG-g, with no change in fascicular orientation, no difference in diameter), (2) graft rotation (GR-g, with no change in fascicular orientation, and diameter difference between fascicles), (3) stump rotation (SR-g, with cross-connection and diameter difference between fascicles). Relative gastrocnemius muscle weight and nerve fiber count were examined as anatomic recovery indices, and autotomy score (ATS) and toe-out angle as functional recovery indices. The results showed that SR-g had a significantly low functional recovery compared with PG-g and GR-g. However, there was no difference found in the anatomic recovery. These findings suggest that the stump rotation in nerve autograft had no effect on neural regeneration and muscle reinnervation; however, it had a negative effect on functional recovery. Because GR-g was similar to PG-g rather than SR-g in functional recovery, the diameter difference between fascicles appears to have had little effect on the functional recovery. The results of this study suggest that a novel approach to ATS interpretation is needed. It is recommended that (1) ATS 2 be considered the onset of autotomy instead of ATS 1; and (2) the frequency of "ATS 2 and above" should be considered for the comparison of the autotomy rather than the mean ATS.
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Lippens E, Vertenten G, Gironès J, Declercq H, Saunders J, Luyten J, Duchateau L, Schacht E, Vlaminck L, Gasthuys F, Cornelissen M. Evaluation of Bone Regeneration with an Injectable, In Situ Polymerizable Pluronic® F127 Hydrogel Derivative Combined with Autologous Mesenchymal Stem Cells in a Goat Tibia Defect Model. Tissue Eng Part A 2010; 16:617-27. [DOI: 10.1089/ten.tea.2009.0418] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Evi Lippens
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Geert Vertenten
- Department of Surgery and Anaesthesiology of Domestic Animals, Ghent University, Merelbeke, Belgium
| | - Jordi Gironès
- Polymer Chemistry and Biomaterials Research Group, Department Organic Chemistry, Ghent University, Ghent, Belgium
| | - Heidi Declercq
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Jimmy Saunders
- Department of Medical Imaging of Domestic Animals, Ghent University, Merelbeke, Belgium
| | | | - Luc Duchateau
- Department of Physiology and Biometrics, Ghent University, Merelbeke, Belgium
| | - Etienne Schacht
- Polymer Chemistry and Biomaterials Research Group, Department Organic Chemistry, Ghent University, Ghent, Belgium
| | - Lieven Vlaminck
- Department of Surgery and Anaesthesiology of Domestic Animals, Ghent University, Merelbeke, Belgium
| | - Frank Gasthuys
- Department of Surgery and Anaesthesiology of Domestic Animals, Ghent University, Merelbeke, Belgium
| | - Maria Cornelissen
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
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Sinis N, Kraus A, Tselis N, Haerle M, Werdin F, Schaller HE. Functional recovery after implantation of artificial nerve grafts in the rat- a systematic review. J Brachial Plex Peripher Nerve Inj 2009; 4:19. [PMID: 19852862 PMCID: PMC2770034 DOI: 10.1186/1749-7221-4-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2009] [Accepted: 10/25/2009] [Indexed: 01/26/2023] Open
Abstract
Purpose The aim of this study was to compare functional data of different nerve-gap bridging materials evaluated in rat experiments by means of a systematic review. Materials and methods A systematic review was conducted, searching MEDLINE, HTS and CENTRAL to identify all trials evaluating functional recovery of artificial nerve conduits in the rat model. Results There was a trend towards a favourable outcome of conduits coated with Schwann-cells compared to the plain synthetics. Histomorphometry, electrophysiology and muscle-weight correlated poorly with functional outcome. Conclusion Schwann-cell coated conduits showed promising results concerning functional recovery. Further standardization in outcome reporting is encouraged.
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Affiliation(s)
- Nektarios Sinis
- Clinic for Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Center, Eberhard-Karls University, Schnarrenbergstrasse 95, D-72076 Tuebingen, Germany
| | - Armin Kraus
- Clinic for Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Center, Eberhard-Karls University, Schnarrenbergstrasse 95, D-72076 Tuebingen, Germany
| | - Nikolaos Tselis
- Dept of Radiotherapy, Hospital of Offenbach, Starkenburgring 66, D-63069 Offenbach, Germany
| | - Max Haerle
- Dept of Hand and Plastic Surgery, Orthopaedic Hospital Markgroeningen, Kurt-Lindemann-Weg 10 D-71706 Markgroeningen, Germany
| | - Frank Werdin
- Clinic for Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Center, Eberhard-Karls University, Schnarrenbergstrasse 95, D-72076 Tuebingen, Germany
| | - Hans-Eberhard Schaller
- Clinic for Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Center, Eberhard-Karls University, Schnarrenbergstrasse 95, D-72076 Tuebingen, Germany
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Shin RH, Friedrich PF, Crum BA, Bishop AT, Shin AY. Treatment of a segmental nerve defect in the rat with use of bioabsorbable synthetic nerve conduits: a comparison of commercially available conduits. J Bone Joint Surg Am 2009; 91:2194-204. [PMID: 19723997 DOI: 10.2106/jbjs.h.01301] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The use of biodegradable synthetic nerve conduits for the reconstruction of segmental nerve defects has been extensively reported in both animal and human studies, with a majority of studies evaluating sensory nerve recovery. However, few studies have compared these nerve conduits for functional motor recovery. The purpose of this study was to compare three commercially available, synthetic, bioabsorbable nerve conduits and autograft with respect to compound muscle action potentials, maximum isometric tetanic force, wet muscle weight, and nerve histomorphometry. METHODS Eighty Lewis rats were divided into four groups according to the type of repair of a 10-mm excision of the sciatic nerve: group I had a reversed autograft; group II, a poly-DL-lactide-epsilon-caprolactone conduit; group III, a type-I collagen conduit; and group IV, a polyglycolic acid conduit. All results were compared with the contralateral side. At twelve weeks, the rats underwent bilateral measurements of the compound muscle action potentials of the tibialis anterior and flexor digiti quinti brevis muscles, isometric tetanic force and muscle weight of the tibialis anterior, and peroneal nerve histomorphometry. RESULTS At twelve weeks, no difference in the percentage of recovery between the autograft and the poly-DL-lactide-epsilon-caprolactone conduit was observed with respect to compound muscle action potentials, isometric muscle force, muscle weight, and axon count measurements. The poly-DL-lactide-epsilon-caprolactone and collagen conduits remained structurally stable at twelve weeks, while the polyglycolic acid conduits had completely collapsed. The polyglycolic acid conduit had the poorest results, with a recovery rate of 15% for compound muscle action potentials and 29% for muscle force. CONCLUSIONS The functional outcome in this rat model was similar for the autograft and the poly-DL-lactide-epsilon-caprolactone conduits when they were used to reconstruct a 10-mm sciatic nerve defect. Functional recovery following the use of the polyglycolic acid conduit was the poorest.
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Affiliation(s)
- Richard H Shin
- Microvascular Research Laboratory, Mayo Clinic, Rochester, MN 55905, USA
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Effect of Aging on Recovery of Cutaneous Nociception After End-to-Side Nerve Repair in the Rat. Ann Plast Surg 2009; 62:439-45. [DOI: 10.1097/sap.0b013e318180c8cb] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Chiono V, Tonda-Turo C, Ciardelli G. Chapter 9: Artificial scaffolds for peripheral nerve reconstruction. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2009; 87:173-98. [PMID: 19682638 DOI: 10.1016/s0074-7742(09)87009-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Posttraumatic peripheral nerve repair is one of the major challenges in restorative medicine and microsurgery. Despite the recent progresses in the field of tissue engineering, functional recovery after severe nerve lesions is generally partial and unsatisfactory. Autograft is still the best method to treat peripheral nerve lesions, although it has several drawbacks and does not allow complete functional recovery. Full recovery of nerve functionality could ideally be achieved by proper guiding axon regeneration toward the original target tissues, through the use of purposely engineered artificial nerve guidance channels (NGCs). In the last decade, artificial NGCs have been produced using a variety of both natural and synthetic, biodegradable and nonbiodegradable polymers. Several techniques have been developed to obtain porous and nonporous NGCs and to realize and incorporate bioactive fillers for NGCs. Some of the developed products have been approved for clinical applications. Many other NGC typologies have been object of interest and are currently under investigation. The current trend of nerve tissue engineering is the realization of biomimetic NGCs, providing chemotactic, topological, and haptotactic signalling to cells, respectively by surface functionalization with cell binding domains, the use of internal-oriented matrices/fibres and the sustained release of neurotrophic factors. The present contribution provides a balanced integration of the most recent achievements of tissue engineering in the field of peripheral nerve repair. By an accurate evaluation of the status of research, the review delineates the most promising directions to which research should address for consistent progress in the field of peripheral nerve repair.
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Affiliation(s)
- Valeria Chiono
- Department of Mechanics, Politecnico di Torino, Torino, Italy
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Functional recovery after peripheral nerve injury and implantation of a collagen guide. Biomaterials 2008; 30:363-73. [PMID: 18929405 DOI: 10.1016/j.biomaterials.2008.09.043] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2008] [Accepted: 09/10/2008] [Indexed: 11/21/2022]
Abstract
Although surgery techniques improved over the years, the clinical results of peripheral nerve repair remain unsatisfactory. In the present study, we compare the results of a collagen nerve guide conduit to the standard clinical procedure of nerve autografting to promote repair of transected peripheral nerves. We assessed behavioral and functional sensori-motor recovery in a rat model of peroneal nerve transection. A 1cm segment of the peroneal nerve innervating the Tibialis anterior muscle was removed and immediately replaced by a new biodegradable nerve guide fabricated from highly purified type I+III collagens derived from porcine skin. Four groups of animals were included: control animals (C, n=12), transected animals grafted with either an autologous nerve graft (Gold Standard; GS, n=12) or a collagen tube filled with an acellular skeletal muscle matrix (Tube-Muscle; TM, n=12) or an empty collagen tube (Collagen-Tube; CT, n=12). We observed that 1) the locomotor recovery pattern, analyzed with kinetic parameters and peroneal functional index, was superior in the GS and CT groups; 2) a muscle contraction was obtained in all groups after stimulation of the proximal nerve but the mechanical muscle properties (twitch and tetanus threshold) parameters indicated a fast to slow fiber transition in all operated groups; 3) the muscular atrophy was greater in animals from TM group; 4) the metabosensitive afferent responses to electrically induced fatigue and to two chemical agents (KCl and lactic acid) was altered in GS, CT and TM groups; 5) the empty collagen tube supported motor axonal regeneration. Altogether, these data indicate that motor axonal regeneration and locomotor recovery can be obtained with the insertion of the collagen tube RevolNerv. Future studies may include engineered conduits that mimic as closely as possible the internal organization of uninjured nerve.
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Pierucci A, de Duek EAR, de Oliveira ALR. Peripheral Nerve Regeneration through Biodegradable Conduits Prepared Using Solvent Evaporation. Tissue Eng Part A 2008; 14:595-606. [DOI: 10.1089/tea.2007.0271] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- Amauri Pierucci
- Department of Anatomy, Institute of Biology, State University of Campinas, Campinas, SP, Brazil
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Waitayawinyu T, Parisi DM, Miller B, Luria S, Morton HJ, Chin SH, Trumble TE. A comparison of polyglycolic acid versus type 1 collagen bioabsorbable nerve conduits in a rat model: an alternative to autografting. J Hand Surg Am 2007; 32:1521-9. [PMID: 18070638 DOI: 10.1016/j.jhsa.2007.07.015] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2007] [Revised: 07/20/2007] [Accepted: 07/20/2007] [Indexed: 02/02/2023]
Abstract
PURPOSE Severe nerve injury with segmental loss requires nerve graft or conduit repair. We compared 2 synthetic, bioabsorbable nerve conduits with the gold standard of autogenous nerve grafting using histopathologic and neurophysiologic analyses. METHODS A 10-mm segment of the sciatic nerve of 45 Sprague-Dawley rats was resected, leaving a gap defect. Three experimental groups were used: 15 coaptations using type I collagen nerve conduits, 15 coaptations using polyglycolic acid (PGA) nerve conduits, and 15 coaptations using the excised segments as autogenous nerve grafts. The contralateral legs were used as unoperated controls. After 15 weeks, nerve regeneration was evaluated by measuring isometric muscle contraction force, axonal counting, wet muscle weights, and histology. RESULTS Statistically significant differences in the isometric muscle contraction force, axonal counts, and wet muscle weights were found between type I collagen conduit and nerve graft compared to the PGA conduit. Axonal sprouting was less organized and less dense with the PGA conduits when compared to nerve reconstruction with the type I collagen conduits and nerve grafts. CONCLUSIONS Type I collagen conduits and autografts produced comparable results, which were significantly better than PGA conduits. The use of type I collagen conduit is a reliable alternative to nerve grafting for gaps up to 10 mm in length.
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Affiliation(s)
- Thanapong Waitayawinyu
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA 98195, USA
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