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Shiroud Heidari B, Dodda JM, El-Khordagui LK, Focarete ML, Maroti P, Toth L, Pacilio S, El-Habashy SE, Boateng J, Catanzano O, Sahai N, Mou L, Zheng M. Emerging materials and technologies for advancing bioresorbable surgical meshes. Acta Biomater 2024:S1742-7061(24)00327-1. [PMID: 38879102 DOI: 10.1016/j.actbio.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/22/2024] [Accepted: 06/10/2024] [Indexed: 06/29/2024]
Abstract
Surgical meshes play a significant role in the treatment of various medical conditions, such as hernias, pelvic floor issues, guided bone regeneration, and wound healing. To date, commercial surgical meshes are typically made of non-absorbable synthetic polymers, notably polypropylene and polytetrafluoroethylene, which are associated with postoperative complications, such as infections. Biological meshes, based on native tissues, have been employed to overcome such complications, though mechanical strength has been a main disadvantage. The right balance in mechanical and biological performances has been achieved by the advent of bioresorbable meshes. Despite improvements, recurrence of clinical complications associated with surgical meshes raises significant concerns regarding the technical adequacy of current materials and designs, pointing to a crucial need for further development. To this end, current research focuses on the design of meshes capable of biomimicking native tissue and facilitating the healing process without post-operative complications. Researchers are actively investigating advanced bioresorbable materials, both synthetic polymers and natural biopolymers, while also exploring the performance of therapeutic agents, surface modification methods and advanced manufacturing technologies such as 4D printing. This review seeks to evaluate emerging biomaterials and technologies for enhancing the performance and clinical applicability of the next-generation surgical meshes. STATEMENT OF SIGNIFICANCE: In the ever-transforming landscape of regenerative medicine, the embracing of engineered bioabsorbable surgical meshes stands as a key milestone in addressing persistent challenges and complications associated with existing treatments. The urgency to move beyond conventional non-absorbable meshes, fraught with post-surgery complications, emphasises the necessity of using advanced biomaterials for engineered tissue regeneration. This review critically examines the growing field of absorbable surgical meshes, considering their potential to transform clinical practice. By strategically combining mechanical strength with bioresorbable characteristics, these innovative meshes hold the promise of mitigating complications and improving patient outcomes across diverse medical applications. As we navigate the complexities of modern medicine, this exploration of engineered absorbable meshes emerges as a promising approach, offering an overall perspective on biomaterials, technologies, and strategies adopted to redefine the future of surgical meshes.
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Affiliation(s)
- Behzad Shiroud Heidari
- Centre for Orthopaedic Research, Medical School, The University of Western Australia, Nedlands, WA, Australia
| | - Jagan Mohan Dodda
- New Technologies - Research Centre (NTC), University of West Bohemia, Univerzitní 8, 301 00 Pilsen, Czech Republic.
| | | | - Maria Letizia Focarete
- Department of Chemistry "Giacomo Ciamician" and INSTM UdR of Bologna, University of Bologna, Italy. Health Sciences & Technologies (HST) CIRI, University of Bologna, Via Tolara di Sopra 41/E, 40064 Ozzano Emilia, Italy
| | - Peter Maroti
- University of Pecs, Medical School, 3D Printing and Visualization Centre, Hungary, University of Pecs, Medical Skills Education and Innovation Centre, Hungary
| | - Luca Toth
- University of Pecs, Medical School, Institute for Translational Medicine, Hungary, University of Pecs, Medical School, Department of Neurosurgery, Hungary
| | - Serafina Pacilio
- Department of Chemistry "Giacomo Ciamician" and INSTM UdR of Bologna, University of Bologna, Italy. Health Sciences & Technologies (HST) CIRI, University of Bologna, Via Tolara di Sopra 41/E, 40064 Ozzano Emilia, Italy; Department of Biomedical and Neuromotor Sciences DIBINEM, Alma Mater Studiorum-University of Bologna, Italy
| | - Salma E El-Habashy
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Egypt
| | - Joshua Boateng
- Faculty of Engineering and Science, University of Greenwich, Medway Campus, UK
| | - Ovidio Catanzano
- Institute for Polymers, Composites and Biomaterials (IPCB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, NA, Italy
| | - Nitin Sahai
- University of Pecs, Medical School, 3D Printing and Visualization Centre, Hungary, University of Pecs, Medical Skills Education and Innovation Centre, Hungary; Department of Biomedical Engineering, North Eastern Hill University, Meghalaya, India
| | - Lingjun Mou
- WA Liver and Kidney Transplant Department, Sir Charles Gairdner Hospital, Western Australia, Australia
| | - Minghao Zheng
- Centre for Orthopaedic Research, Medical School, The University of Western Australia, Nedlands, WA, Australia; Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
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Zhu Y, Yi D, Wang J, Zhang Y, Li M, Ma J, Ji Y, Peng J, Wang Y, Luo Y. Harnessing three-dimensional porous chitosan microsphere embedded with adipose-derived stem cells to promote nerve regeneration. Stem Cell Res Ther 2024; 15:158. [PMID: 38824568 PMCID: PMC11144330 DOI: 10.1186/s13287-024-03753-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/05/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Nerve guide conduits are a promising strategy for reconstructing peripheral nerve defects. Improving the survival rate of seed cells in nerve conduits is still a challenge and microcarriers are an excellent three-dimensional (3D) culture scaffold. Here, we investigate the effect of the 3D culture of microcarriers on the biological characteristics of adipose mesenchymal stem cells (ADSCs) and to evaluate the efficacy of chitosan nerve conduits filled with microcarriers loaded with ADSCs in repairing nerve defects. METHODS In vitro, we prepared porous chitosan microspheres by a modified emulsion cross-linking method for loading ADSCs and evaluated the growth status and function of ADSCs. In vivo, ADSCs-loaded microcarriers were injected into chitosan nerve conduits to repair a 12 mm sciatic nerve defect in rats. RESULTS Compared to the conventional two-dimensional (2D) culture, the prepared microcarriers were more conducive to the proliferation, migration, and secretion of trophic factors of ADSCs. In addition, gait analysis, neuro-electrophysiology, and histological evaluation of nerves and muscles showed that the ADSC microcarrier-loaded nerve conduits were more effective in improving nerve regeneration. CONCLUSIONS The ADSCs-loaded chitosan porous microcarrier prepared in this study has a high cell engraftment rate and good potential for peripheral nerve repair.
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Affiliation(s)
- Yaqiong Zhu
- Department of Ultrasound, the First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China
- Beijing Key Lab of Regenerative Medicine in Orthopaedics, Chinese PLA General Hospital, Beijing, China
- Key Lab of Musculoskeletal Trauma & War Injuries, Chinese PLA General Hospital, Beijing, China
- Beijing Key Laboratory of Chronic Heart Failure Precision Medicine, Chinese PLA General Hospital, Beijing, China
| | - Dan Yi
- Department of Ultrasound, the First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Jing Wang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui Province, China
| | - Yongyi Zhang
- Medical School of Chinese PLA, Beijing, 100853, China
- Department of Rehabilitation Medicine, the Second Medical Centre, Chinese PLA General Hospital, Beijing, China
- No.962 Hospital of the PLA Joint Logistic Support Force, Harbin, China
| | - Molin Li
- Department of Ultrasound, the First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Jun Ma
- Department of Ultrasound, the First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yongjiao Ji
- Department of Ultrasound, the First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jiang Peng
- Beijing Key Lab of Regenerative Medicine in Orthopaedics, Chinese PLA General Hospital, Beijing, China.
- Key Lab of Musculoskeletal Trauma & War Injuries, Chinese PLA General Hospital, Beijing, China.
- Department of Orthopaedics, The Fourth Centre of Chinese PLA General Hospital, Beijing, China.
| | - Yuexiang Wang
- Department of Ultrasound, the First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Yukun Luo
- Department of Ultrasound, the First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China.
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Zhang F, Wu X, Li Q, Ma B, Zhang M, Zhang W, Kou Y. Dual growth factor methacrylic alginate microgels combined with chitosan-based conduits facilitate peripheral nerve repair. Int J Biol Macromol 2024; 268:131594. [PMID: 38621568 DOI: 10.1016/j.ijbiomac.2024.131594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/05/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Abstract
Treating severe peripheral nerve injuries is difficult. Nerve repair with conduit small gap tubulization is a treatment option but still needs to be improved. This study aimed to assess the use of microgels containing growth factors, along with chitosan-based conduits, for repairing nerves. Using the water-oil emulsion technique, microgels of methacrylic alginate (AlgMA) that contained vascular endothelial growth factor (VEGF) and brain-derived neurotrophic factor (BDNF) were prepared. The effects on rat Schwann cells (RSC96) and human umbilical vein endothelial cells (HUVECs) were evaluated. Chitosan-based conduits were fabricated and used in conjunction with microgels containing two growth factors to treat complete neurotmesis in rats. The results showed that the utilization of dual growth factor microgels improved the migration and decreased the apoptosis of RSC96 cells while promoting the growth and formation of tubes in HUVECs. The utilization of dual growth factor microgels and chitosan-based conduits resulted in notable advancements in the regeneration and myelination of nerve fibers, recovery of neurons, alleviation of muscle atrophy and recovery of neuromotor function and nerve conduction. In conclusion, the use of dual growth factor AlgMA microgels in combination with chitosan-based conduits has the potential to significantly improve the effectiveness of nerve repair.
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Affiliation(s)
- Fengshi Zhang
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing 100044, China; Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China; National Center for Trauma Medicine, Beijing 100044, China; Beijing Laboratory of Trauma and Nerve Regeneration, Beijing 100044, China
| | - Xiaotong Wu
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - Qicheng Li
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing 100044, China; Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China; National Center for Trauma Medicine, Beijing 100044, China; Beijing Laboratory of Trauma and Nerve Regeneration, Beijing 100044, China
| | - Bo Ma
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing 100044, China; Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China; National Center for Trauma Medicine, Beijing 100044, China; Beijing Laboratory of Trauma and Nerve Regeneration, Beijing 100044, China
| | - Meng Zhang
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing 100044, China; Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China; National Center for Trauma Medicine, Beijing 100044, China; Beijing Laboratory of Trauma and Nerve Regeneration, Beijing 100044, China
| | - Wenjing Zhang
- Department of teaching and research, Shenzhen University General Hospital, Shenzhen 518055, China.
| | - Yuhui Kou
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing 100044, China; Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China; National Center for Trauma Medicine, Beijing 100044, China; Beijing Laboratory of Trauma and Nerve Regeneration, Beijing 100044, China.
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Cao S, Yihao W, Qi T, Xiong A, Liu P, Chen Y, Zeng H, Yu F, Weng J. Combination of stem cells and nerve guide conduit for the treatment of peripheral nerve injury: A meta-analysis. Muscle Nerve 2024; 69:227-238. [PMID: 38063327 DOI: 10.1002/mus.28018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 01/18/2024]
Abstract
INTRODUCTION/AIMS Many small-sized, single-center preclinical studies have investigated the benefits of introducing stem cells into the interior of nerve conduit. The aims of this meta-analysis are to review and contrast the effects of various types of stem cells in in vivo models used to reconstruct peripheral nerve injuries (PNIs) and to assess the reliability and stability of the available evidence. METHODS A systematic search was conducted using Cochrane Library, Embase, PubMed, and Web of Science to identify studies conducted from January 1, 2000, to September 21, 2022, and investigate stem cell therapy in peripheral nerve reconstruction animal models. Studies that met the relevant criteria were deemed eligible for this meta-analysis. RESULTS Fifty-five preclinical studies with a total of 1234 animals were incorporated. Stem cells demonstrated a positive impact on peripheral nerve regeneration at different follow-up times in the forest plots of five outcome indicators: compound muscle action potential (CMAP) amplitude, latency, muscle mass ratio, nerve conduction velocity, and sciatic functional index (SFI). In most comparisons, stem cell groups showed substantial differences compared with the control groups. The superior performance of adipose-derived stem cells (ADSCs) in terms of SFI, CMAP amplitude, and latency (p < .001) was identified. DISCUSSION The findings consistently demonstrated a favorable outcome in the reconstruction process when utilizing different groups of stem cells, as opposed to control groups where stem cells were not employed.
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Affiliation(s)
- Siyang Cao
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
| | - Wei Yihao
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
| | - Tiantian Qi
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
| | - Ao Xiong
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
| | - Peng Liu
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
| | - Yingqi Chen
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
| | - Hui Zeng
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
| | - Fei Yu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
| | - Jian Weng
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
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Sun J, Cao W, Pan S, He L, Ji D, Zheng N, Sun X, Wang R, Niu Y. Porous Organic Materials in Tissue Engineering: Recent Advances and Applications for Severed Facial Nerve Injury Repair. Molecules 2024; 29:566. [PMID: 38338311 PMCID: PMC10856494 DOI: 10.3390/molecules29030566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 02/12/2024] Open
Abstract
The prevalence of facial nerve injury is substantial, and the restoration of its structure and function remains a significant challenge. Autologous nerve transplantation is a common treatment for severed facial nerve injury; however, it has great limitations. Therefore, there is an urgent need for clinical repair methods that can rival it. Tissue engineering nerve conduits are usually composed of scaffolds, cells and neurofactors. Tissue engineering is regarded as a promising method for facial nerve regeneration. Among different factors, the porous nerve conduit made of organic materials, which has high porosity and biocompatibility, plays an indispensable role. This review introduces facial nerve injury and the existing treatment methods and discusses the necessity of the application of porous nerve conduit. We focus on the application of porous organic polymer materials from production technology and material classification and summarize the necessity and research progress of these in repairing severed facial nerve injury, which is relatively rare in the existing articles. This review provides a theoretical basis for further research into and clinical interventions on facial nerve injury and has certain guiding significance for the development of new materials.
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Affiliation(s)
- Jingxuan Sun
- The First Affiliated Hospital of Harbin Medical University, School of Stomatology, Harbin Medical University, Harbin 150001, China; (J.S.); (S.P.); (L.H.); (X.S.)
| | - Wenxin Cao
- National Key Laboratory of Science and Technology on Advanced Composites in Special Environments, Harbin Institute of Technology, Harbin 150080, China; (W.C.); (D.J.)
- Zhengzhou Research Institute, Harbin Institute of Technology, Zhengzhou 450000, China
| | - Shuang Pan
- The First Affiliated Hospital of Harbin Medical University, School of Stomatology, Harbin Medical University, Harbin 150001, China; (J.S.); (S.P.); (L.H.); (X.S.)
| | - Lina He
- The First Affiliated Hospital of Harbin Medical University, School of Stomatology, Harbin Medical University, Harbin 150001, China; (J.S.); (S.P.); (L.H.); (X.S.)
| | - Dongchao Ji
- National Key Laboratory of Science and Technology on Advanced Composites in Special Environments, Harbin Institute of Technology, Harbin 150080, China; (W.C.); (D.J.)
| | - Nannan Zheng
- Key Laboratory of Micro-Systems and Micro-Structures Manufacturing (Ministry of Education), School of Medicine and Health, Harbin Institute of Technology, Harbin 150001, China;
| | - Xiangyu Sun
- The First Affiliated Hospital of Harbin Medical University, School of Stomatology, Harbin Medical University, Harbin 150001, China; (J.S.); (S.P.); (L.H.); (X.S.)
| | - Ranxu Wang
- The First Affiliated Hospital of Harbin Medical University, School of Stomatology, Harbin Medical University, Harbin 150001, China; (J.S.); (S.P.); (L.H.); (X.S.)
| | - Yumei Niu
- The First Affiliated Hospital of Harbin Medical University, School of Stomatology, Harbin Medical University, Harbin 150001, China; (J.S.); (S.P.); (L.H.); (X.S.)
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Giglia G, Rosatti F, Giannone AG, Gambino G, Zizzo MG, Florena AM, Sardo P, Toia F. Vascularized versus Free Nerve Grafts: An Experimental Study on Rats. J Pers Med 2023; 13:1682. [PMID: 38138909 PMCID: PMC10744603 DOI: 10.3390/jpm13121682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/13/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Vascularized nerve grafts (VNGs) have been proposed as a superior alternative to free nerve grafts (FNGs) for complex nerve defects. A greater regenerative potential has been suggested by clinical and experimental studies, but conclusive evidence is still lacking. METHODS In this experimental study, 10 adult male Wistar rats received a non-vascularized orthotopic sciatic nerve graft on their right side, and a vascularized orthotopic sciatic nerve graft nerve on their left side. Functional outcome following nerve regeneration was evaluated through electrodiagnostic studies, target muscles weight and histomorphology, and data of VNGs and FNGs were compared. RESULTS The results of this study showed a significant difference in the motor unit number of Gastrocnemius Medialis (GM) estimated by MUNE in the VNG side compared to the FNG side. No other significant differences in axonal regeneration and muscle reinnervation were evident at either electrodiagnostic, histomorphology studies or muscle weight. CONCLUSIONS This experimental model showed slight differences in nerve regeneration between VNGs and FNGs, but cannot support a high clinical advantage for VNGs. The results of this study show that VNGs are not strongly superior to FNGs in the rat model, even in avascular beds. Clinical advantages of VNGs are likely to be limited to extensive and thick nerve defects and can only be assessed on experimental model with bigger animals. Also, we showed that the MUNE technique provided a reliable and reproducible evaluation of functional outcomes in the rat sciatic nerve and defined a reproducible protocol for functional evaluation of muscle reinnervation.
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Affiliation(s)
- Giuseppe Giglia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, 90127 Palermo, Italy; (G.G.); (G.G.); (P.S.)
- Euro-Mediterranean Institute of Science and Technology (IEMEST), 90139 Palermo, Italy
| | - Fernando Rosatti
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy;
| | - Antonino Giulio Giannone
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.G.G.); (A.M.F.)
| | - Giuditta Gambino
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, 90127 Palermo, Italy; (G.G.); (G.G.); (P.S.)
| | - Maria Grazia Zizzo
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Viale delle Scienze, 90127 Palermo, Italy;
- ATeN (Advanced Technologies Network) Center, University of Palermo, Viale delle Scienze, 90127 Palermo, Italy
| | - Ada Maria Florena
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.G.G.); (A.M.F.)
| | - Pierangelo Sardo
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, 90127 Palermo, Italy; (G.G.); (G.G.); (P.S.)
| | - Francesca Toia
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy;
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Casal D, Casimiro MH, Ferreira LM, Leal JP, Rodrigues G, Lopes R, Moura DL, Gonçalves L, Lago JB, Pais D, Santos PMP. Review of Piezoelectrical Materials Potentially Useful for Peripheral Nerve Repair. Biomedicines 2023; 11:3195. [PMID: 38137416 PMCID: PMC10740581 DOI: 10.3390/biomedicines11123195] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
It has increasingly been recognized that electrical currents play a pivotal role in cell migration and tissue repair, in a process named "galvanotaxis". In this review, we summarize the current evidence supporting the potential benefits of electric stimulation (ES) in the physiology of peripheral nerve repair (PNR). Moreover, we discuss the potential of piezoelectric materials in this context. The use of these materials has deserved great attention, as the movement of the body or of the external environment can be used to power internally the electrical properties of devices used for providing ES or acting as sensory receptors in artificial skin (e-skin). The fact that organic materials sustain spontaneous degradation inside the body means their piezoelectric effect is limited in duration. In the case of PNR, this is not necessarily problematic, as ES is only required during the regeneration period. Arguably, piezoelectric materials have the potential to revolutionize PNR with new biomedical devices that range from scaffolds and nerve-guiding conduits to sensory or efferent components of e-skin. However, much remains to be learned regarding piezoelectric materials, their use in manufacturing of biomedical devices, and their sterilization process, to fine-tune their safe, effective, and predictable in vivo application.
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Affiliation(s)
- Diogo Casal
- Departamento de Anatomia, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal; (L.G.); (D.P.)
- Plastic and Reconstructive Surgery Department and Burn Unit, Centro Hospitalar Universitário de Lisboa Central, Rua José António Serrano, 1169-045 Lisbon, Portugal
| | - Maria Helena Casimiro
- Centro de Ciências e Tecnologias Nucleares (C2TN), Instituto Superior Técnico (IST), Universidade de Lisboa, 2695-066 Bobadela, Portugal; (M.H.C.); (P.M.P.S.)
| | - Luís M. Ferreira
- Departamento de Engenharia e Ciências Nucleares (DECN), Instituto Superior Técnico (IST), Universidade de Lisboa, 2695-066 Bobadela, Portugal;
| | - João Paulo Leal
- Centro de Química Estrutural (CQE), Institute of Molecular Sciences (IMS), Instituto Superior Técnico (IST), Universidade de Lisboa, 2695-066 Bobadela, Portugal;
| | - Gabriela Rodrigues
- Centro de Ecologia, Evolução e Alterações Ambientais (cE3c) & CHANGE—Global Change and Sustainability Institute, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa (FCUL), 1749-016 Lisboa, Portugal;
| | - Raquel Lopes
- Gynaecology and Obstetrics Department, Maternidade Alfredo da Costa, Centro Hospitalar Universitário de Lisboa Central, R. Viriato 1, 2890-495 Lisboa, Portugal;
| | - Diogo Lino Moura
- Anatomy Institute and Orthopedics Department, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal;
- Spine Unit, Orthopedics Department, Coimbra University Hospital, 3000-602 Coimbra, Portugal
| | - Luís Gonçalves
- Departamento de Anatomia, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal; (L.G.); (D.P.)
| | - João B. Lago
- Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa (FCUL), 1749-016 Lisboa, Portugal;
| | - Diogo Pais
- Departamento de Anatomia, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal; (L.G.); (D.P.)
| | - Pedro M. P. Santos
- Centro de Ciências e Tecnologias Nucleares (C2TN), Instituto Superior Técnico (IST), Universidade de Lisboa, 2695-066 Bobadela, Portugal; (M.H.C.); (P.M.P.S.)
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8
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Wan T, Wang YL, Zhang FS, Zhang XM, Zhang YC, Jiang HR, Zhang M, Zhang PX. The Porous Structure of Peripheral Nerve Guidance Conduits: Features, Fabrication, and Implications for Peripheral Nerve Regeneration. Int J Mol Sci 2023; 24:14132. [PMID: 37762437 PMCID: PMC10531895 DOI: 10.3390/ijms241814132] [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: 07/08/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Porous structure is an important three-dimensional morphological feature of the peripheral nerve guidance conduit (NGC), which permits the infiltration of cells, nutrients, and molecular signals and the discharge of metabolic waste. Porous structures with precisely customized pore sizes, porosities, and connectivities are being used to construct fully permeable, semi-permeable, and asymmetric peripheral NGCs for the replacement of traditional nerve autografts in the treatment of long-segment peripheral nerve injury. In this review, the features of porous structures and the classification of NGCs based on these characteristics are discussed. Common methods for constructing 3D porous NGCs in current research are described, as well as the pore characteristics and the parameters used to tune the pores. The effects of the porous structure on the physical properties of NGCs, including biodegradation, mechanical performance, and permeability, were analyzed. Pore structure affects the biological behavior of Schwann cells, macrophages, fibroblasts, and vascular endothelial cells during peripheral nerve regeneration. The construction of ideal porous structures is a significant advancement in the regeneration of peripheral nerve tissue engineering materials. The purpose of this review is to generalize, summarize, and analyze methods for the preparation of porous NGCs and their biological functions in promoting peripheral nerve regeneration to guide the development of medical nerve repair materials.
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Affiliation(s)
- Teng Wan
- Department of OrthopedSics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (T.W.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Centre for Trauma Medicine, Beijing 100044, China
| | - Yi-Lin Wang
- Department of OrthopedSics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (T.W.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Centre for Trauma Medicine, Beijing 100044, China
| | - Feng-Shi Zhang
- Department of OrthopedSics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (T.W.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Centre for Trauma Medicine, Beijing 100044, China
| | - Xiao-Meng Zhang
- Department of OrthopedSics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (T.W.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Centre for Trauma Medicine, Beijing 100044, China
| | - Yi-Chong Zhang
- Department of OrthopedSics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (T.W.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Centre for Trauma Medicine, Beijing 100044, China
| | - Hao-Ran Jiang
- Department of OrthopedSics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (T.W.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Centre for Trauma Medicine, Beijing 100044, China
| | - Meng Zhang
- Department of OrthopedSics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (T.W.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Centre for Trauma Medicine, Beijing 100044, China
| | - Pei-Xun Zhang
- Department of OrthopedSics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (T.W.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Centre for Trauma Medicine, Beijing 100044, China
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Mankavi F, Ibrahim R, Wang H. Advances in Biomimetic Nerve Guidance Conduits for Peripheral Nerve Regeneration. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:2528. [PMID: 37764557 PMCID: PMC10536071 DOI: 10.3390/nano13182528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
Injuries to the peripheral nervous system are a common clinical issue, causing dysfunctions of the motor and sensory systems. Surgical interventions such as nerve autografting are necessary to repair damaged nerves. Even with autografting, i.e., the gold standard, malfunctioning and mismatches between the injured and donor nerves often lead to unwanted failure. Thus, there is an urgent need for a new intervention in clinical practice to achieve full functional recovery. Nerve guidance conduits (NGCs), providing physicochemical cues to guide neural regeneration, have great potential for the clinical regeneration of peripheral nerves. Typically, NGCs are tubular structures with various configurations to create a microenvironment that induces the oriented and accelerated growth of axons and promotes neuron cell migration and tissue maturation within the injured tissue. Once the native neural environment is better understood, ideal NGCs should maximally recapitulate those key physiological attributes for better neural regeneration. Indeed, NGC design has evolved from solely physical guidance to biochemical stimulation. NGC fabrication requires fundamental considerations of distinct nerve structures, the associated extracellular compositions (extracellular matrices, growth factors, and cytokines), cellular components, and advanced fabrication technologies that can mimic the structure and morphology of native extracellular matrices. Thus, this review mainly summarizes the recent advances in the state-of-the-art NGCs in terms of biomaterial innovations, structural design, and advanced fabrication technologies and provides an in-depth discussion of cellular responses (adhesion, spreading, and alignment) to such biomimetic cues for neural regeneration and repair.
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Affiliation(s)
| | | | - Hongjun Wang
- Department of Biomedical Engineering, Semcer Center for Healthcare Innovation, Stevens Institute of Technology, Hoboken, NJ 07030, USA; (F.M.); (R.I.)
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Zhang M, An H, Zhang F, Jiang H, Wan T, Wen Y, Han N, Zhang P. Prospects of Using Chitosan-Based Biopolymers in the Treatment of Peripheral Nerve Injuries. Int J Mol Sci 2023; 24:12956. [PMID: 37629137 PMCID: PMC10454829 DOI: 10.3390/ijms241612956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/10/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023] Open
Abstract
Peripheral nerve injuries are common neurological disorders, and the available treatment options, such as conservative management and surgical repair, often yield limited results. However, there is growing interest in the potential of using chitosan-based biopolymers as a novel therapeutic approach to treating these injuries. Chitosan-based biopolymers possess unique characteristics, including biocompatibility, biodegradability, and the ability to stimulate cell proliferation, making them highly suitable for repairing nerve defects and promoting nerve regeneration and functional recovery. Furthermore, these biopolymers can be utilized in drug delivery systems to control the release of therapeutic agents and facilitate the growth of nerve cells. This comprehensive review focuses on the latest advancements in utilizing chitosan-based biopolymers for peripheral nerve regeneration. By harnessing the potential of chitosan-based biopolymers, we can pave the way for innovative treatment strategies that significantly improve the outcomes of peripheral nerve injury repair, offering renewed hope and better prospects for patients in need.
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Affiliation(s)
- Meng Zhang
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (M.Z.)
- Key Laboratory of Trauma and Neural Regeneration, Ministry of Education, Beijing 100044, China
| | - Heng An
- Beijing Key Laboratory for Bioengineering and Sensing Technology, Daxing Research Institute, School of Chemistry & Biological Engineering, University of Science & Technology Beijing, Beijing 100083, China; (H.A.)
| | - Fengshi Zhang
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (M.Z.)
- Key Laboratory of Trauma and Neural Regeneration, Ministry of Education, Beijing 100044, China
| | - Haoran Jiang
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (M.Z.)
- Key Laboratory of Trauma and Neural Regeneration, Ministry of Education, Beijing 100044, China
| | - Teng Wan
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (M.Z.)
- Key Laboratory of Trauma and Neural Regeneration, Ministry of Education, Beijing 100044, China
| | - Yongqiang Wen
- Beijing Key Laboratory for Bioengineering and Sensing Technology, Daxing Research Institute, School of Chemistry & Biological Engineering, University of Science & Technology Beijing, Beijing 100083, China; (H.A.)
| | - Na Han
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (M.Z.)
- Key Laboratory of Trauma and Neural Regeneration, Ministry of Education, Beijing 100044, China
| | - Peixun Zhang
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (M.Z.)
- Key Laboratory of Trauma and Neural Regeneration, Ministry of Education, Beijing 100044, China
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