Material advancement in tissue-engineered nerve conduit

Abstract Peripheral nerve injuries resulting from various traumatic events can cause mobility problems and sensory impairment, jeopardizing patients’ life quality and bringing serious economic burdens. Due to the shortcomings of autologous nerve grafts, such as limited tissue sources, unmatched size, and loss of innervation at the donor site, tissue-engineered nerve grafts using both natural and synthetic materials have been employed in the treatment of peripheral nerve defect and to promote nerve regeneration. Apart from traditional advantages such as good biocompatibility and controllable degradation, the development of fabrication technology and the advancement in material science have endowed tissue-engineered nerve conduits with upgraded properties such as biomimetic surface topography, extracellular matrix components, neurotrophic factors, and cell seeding, or a conduit with micropores on the surface for substance exchange and/or with fillers inside for microenvironment simulation. This article reviews recent progress in the biomaterials employed in fabricating tissue-engineered nerve conduits, in vitro characterization, and their applications in nerve repair in animal studies as well as in clinical trials.

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Peripheral Nerve Repair with Cultured Schwann Cells: Getting Closer to the Clinics

The Scientific World JOURNAL ◽

10.1100/2012/413091 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 21

Author(s):

Maria Carolina O. Rodrigues ◽

Antonio Antunes Rodrigues ◽

Loren E. Glover ◽

Julio Voltarelli ◽

Cesario V. Borlongan

Keyword(s):

Bone Marrow ◽

Peripheral Nerve ◽

Schwann Cells ◽

Nerve Repair ◽

Experimental Studies ◽

Experimental Treatment ◽

Mesenchymal Cells ◽

Nerve Conduits ◽

Cultured Schwann Cells

Peripheral nerve injuries are a frequent and disabling condition, which affects 13 to 23 per 100.000 persons each year. Severe cases, with structural disruption of the nerve, are associated with poor functional recovery. The experimental treatment using nerve grafts to replace damaged or shortened axons is limited by technical difficulties, invasiveness, and mediocre results. Other therapeutic choices include the adjunctive application of cultured Schwann cells and nerve conduits to guide axonal growth. The bone marrow is a rich source of mesenchymal cells, which can be differentiatedin vitrointo Schwann cells and subsequently engrafted into the damaged nerve. Alternatively, undifferentiated bone marrow mesenchymal cells can be associated with nerve conduits and afterward transplanted. Experimental studies provide evidence of functional, histological, and electromyographical improvement following transplantation of bone-marrow-derived cells in animal models of peripheral nerve injury. This paper focuses on this new therapeutic approach highlighting its direct translational and clinical utility in promoting regeneration of not only acute but perhaps also chronic cases of peripheral nerve damage.

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Recent Advances and Developments in Neural Repair and Regeneration for Hand Surgery

The Open Orthopaedics Journal ◽

10.2174/1874325001206010103 ◽

2012 ◽

Vol 6 (1) ◽

pp. 103-107 ◽

Cited By ~ 19

Author(s):

Mukai Chimutengwende-Gordon ◽

Wasim Khan

Keyword(s):

Gold Standard ◽

Peripheral Nerves ◽

Nerve Repair ◽

Hand Surgery ◽

Matrix Proteins ◽

Neural Repair ◽

Nerve Grafts ◽

Nerve Conduits

End-to-end suture of nerves and autologous nerve grafts are the ‘gold standard’ for repair and reconstruction of peripheral nerves. However, techniques such as sutureless nerve repair with tissue glues, end-to-side nerve repair and allografts exist as alternatives. Biological and synthetic nerve conduits have had some success in early clinical studies on reconstruction of nerve defects in the hand. The effectiveness of nerve regeneration could potentially be increased by using these nerve conduits as scaffolds for delivery of Schwann cells, stem cells, neurotrophic and neurotropic factors or extracellular matrix proteins. There has been extensivein vitroandin vivoresearch conducted on these techniques. The clinical applicability and efficacy of these techniques needs to be investigated fully.

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The Use of Degradable Nerve Conduits for Human Nerve Repair: A Review of the Literature

Applied Bionics and Biomechanics ◽

10.1155/2005/209702 ◽

2005 ◽

Vol 2 (1) ◽

pp. 39-43 ◽

Cited By ~ 1

Author(s):

M. F. Meek ◽

K. Jansen ◽

P. H. Robinson

Keyword(s):

Peripheral Nerve ◽

Peripheral Nerves ◽

Nerve Repair ◽

Experimental Studies ◽

Review Of The Literature ◽

Nerve Grafts ◽

Nerve Guides ◽

Clinical Challenge ◽

Nerve Conduits ◽

Human Nerve

The management of peripheral nerve injury continues to be a major clinical challenge. The most widely used technique for bridging defects in peripheral nerves is the use of autologous nerve grafts. This technique, however, has some disadvantages. Many alternative experimental techniques have thus been developed, such as degradable nerve conduits. Degradable nerve guides have been extensively studied in animal experimental studies. However, the repair of human nerves by degradable nerve conduits has been limited to only a few clinical studies. In this paper, an overview of the available international published literature on degradable nerve conduits for bridging human peripheral nerve defects is presented for literature available until 2004. Also, the philosophy on the use of nerve guides and nerve grafts is given.

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Peripheral Nerve Injury: Principles for Repair and Regeneration

The Open Orthopaedics Journal ◽

10.2174/1874325001408010199 ◽

2014 ◽

Vol 8 (1) ◽

pp. 199-203 ◽

Cited By ~ 46

Author(s):

Griffin M.F ◽

Malahias M ◽

Hindocha S ◽

Wasim S Khan

Keyword(s):

Peripheral Nerve ◽

Nerve Injury ◽

Nerve Repair ◽

Donor Site ◽

Donor Site Morbidity ◽

Biological Research ◽

Peripheral Nerve Injuries ◽

Nerve Injuries ◽

Nerve Conduits ◽

Limb Trauma

Peripheral Nerve Injuries are one of the most common causes of hand dysfunction caused by upper limb trauma but still current management has remained suboptimal. This review aims to explain the traditional view of pathophysiology of nerve repair and also describe why surgical management is still inadequate in using the new biological research that has documented the changes that occur after the nerve injury, which, could cause suboptimal clinical outcomes. Subsequently presentation and diagnosis will be described for peripheral nerve injuries. When traditional surgical repair using end-to-end anastomosis is not adequate nerve conduits are required with the gold standard being the autologous nerve. Due to associated donor site morbidity and poor functional outcome documented with autologous nerve repair several new advancements for alternatives to bridge the gap are being investigated. We will summarise the new and future advancements of non-biological and biological replacements as well as gene therapy, which are being considered as the alternatives for peripheral nerve repair.

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Nerve Repair with Nerve Conduits: Problems, Solutions, and Future Directions

Journal of Hand and Microsurgery ◽

10.1055/s-0038-1626687 ◽

2018 ◽

Vol 10 (02) ◽

pp. 61-65 ◽

Cited By ~ 9

Author(s):

Ryan Rebowe ◽

Ashley Rogers ◽

Xuebin Yang ◽

S. Kundu ◽

Thomas Smith ◽

...

Keyword(s):

Peripheral Nerve ◽

Nerve Repair ◽

Functional Limitations ◽

Donor Site ◽

Clinical Problem ◽

Donor Site Morbidity ◽

Future Directions ◽

Nerve Conduits ◽

Attractive Option ◽

The Common

AbstractNerve conduits are becoming increasingly popular for the repair of peripheral nerve injuries. Their ease of application and lack of donor site morbidity make them an attractive option for nerve repair in many situations. Today, there are many different conduits to choose in different sizes and materials, giving the reconstructive surgeon many options for any given clinical problem. However, to properly utilize these unique reconstructive tools, the peripheral nerve surgeon must be familiar not only with their standard indications but also with their functional limitations. In this review, the authors identify the common applications of nerve conduits, expected results, and shortcomings of current techniques. Furthermore, future directions for nerve conduit use are identified.

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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 ◽

10.1155/2016/3856262 ◽

2016 ◽

Vol 2016 ◽

pp. 1-18 ◽

Cited By ~ 69

Author(s):

Robert Gaudin ◽

Christian Knipfer ◽

Anders Henningsen ◽

Ralf Smeets ◽

Max Heiland ◽

...

Keyword(s):

Peripheral Nerve ◽

Nerve Injury ◽

Peripheral Nerve Injury ◽

Nerve Repair ◽

Treatment Options ◽

Donor Site ◽

Nerve Reconstruction ◽

Craniomaxillofacial Surgery

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 testedin vitroandin 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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Modulation of Matrix Metalloproteinases by Plant-Derived Products

Current Cancer Drug Targets ◽

10.2174/1568009620666201120144838 ◽

2020 ◽

Vol 20 ◽

Author(s):

Nur Najmi Mohamad Anuar ◽

Nurul Iman Natasya Zulkafali ◽

Azizah Ugusman

Keyword(s):

Clinical Trials ◽

Natural Products ◽

Matrix Metalloproteinases ◽

Animal Studies ◽

Current Knowledge ◽

In Vitro Models ◽

In Vivo Studies ◽

Extracellular Matrix Components

: Matrix metalloproteinases (MMPs) are a group of zinc-dependent metallo-endopeptidase that are responsible towards the degradation, repair and remodelling of extracellular matrix components. MMPs play an important role in maintaining a normal physiological function and preventing diseases such as cancer and cardiovascular diseases. Natural products derived from plants have been used as traditional medicine for centuries. Its active compounds, such as catechin, resveratrol and quercetin, are suggested to play an important role as MMPs inhibitors, thereby opening new insights into their applications in many fields, such as pharmaceutical, cosmetic and food industries. This review summarises the current knowledge on plant-derived natural products with MMP-modulating activities. Most of the reviewed plant-derived products exhibit an inhibitory activity on MMPs. Amongst MMPs, MMP-2 and MMP-9 are the most studied. The expression of MMPs is inhibited through respective signalling pathways, such as MAPK, NF-κB and PI3 kinase pathways, which contribute to the reduction in cancer cell behaviours, such as proliferation and migration. Most studies have employed in vitro models, but a limited number of animal studies and clinical trials have been conducted. Even though plant-derived products show promising results in modulating MMPs, more in vivo studies and clinical trials are needed to support their therapeutic applications in the future.

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