scholarly journals Peripheral Nerve Reconstruction after Injury: A Review of Clinical and Experimental Therapies

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
D. Grinsell ◽  
C. P. Keating
Keyword(s):  
Peripheral Nerve ◽  
Nerve Repair ◽  
Peripheral Nerve Regeneration ◽  
Surgical Techniques ◽  
The Body ◽  
Sensory Function ◽  
Nerve Reconstruction ◽  
Nerve Transfers ◽  
Experimental Therapies ◽  
Surgical Options

Unlike other tissues in the body, peripheral nerve regeneration is slow and usually incomplete. Less than half of patients who undergo nerve repair after injury regain good to excellent motor or sensory function and current surgical techniques are similar to those described by Sunderland more than 60 years ago. Our increasing knowledge about nerve physiology and regeneration far outweighs our surgical abilities to reconstruct damaged nerves and successfully regenerate motor and sensory function. It is technically possible to reconstruct nerves at the fascicular level but not at the level of individual axons. Recent surgical options including nerve transfers demonstrate promise in improving outcomes for proximal nerve injuries and experimental molecular and bioengineering strategies are being developed to overcome biological roadblocks limiting patient recovery.

scholarly journals Schwann cell plasticity regulates neuroblastic tumor cell differentiation via epidermal growth factor-like protein 8

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Tamara Weiss ◽  
Sabine Taschner-Mandl ◽  
Lukas Janker ◽  
Andrea Bileck ◽  
Fikret Rifatbegovic ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Primary Repair ◽  
Nerve Repair ◽  
Peripheral Nerve Regeneration ◽  
Neuroblastoma Cells ◽  
Tumor Development ◽  
Matricellular Protein ◽  
Neuroblastic Tumor ◽  
Plastic Potential ◽  
Neuroblastic Tumors

AbstractAdult Schwann cells (SCs) possess an inherent plastic potential. This plasticity allows SCs to acquire repair-specific functions essential for peripheral nerve regeneration. Here, we investigate whether stromal SCs in benign-behaving peripheral neuroblastic tumors adopt a similar cellular state. We profile ganglioneuromas and neuroblastomas, rich and poor in SC stroma, respectively, and peripheral nerves after injury, rich in repair SCs. Indeed, stromal SCs in ganglioneuromas and repair SCs share the expression of nerve repair-associated genes. Neuroblastoma cells, derived from aggressive tumors, respond to primary repair-related SCs and their secretome with increased neuronal differentiation and reduced proliferation. Within the pool of secreted stromal and repair SC factors, we identify EGFL8, a matricellular protein with so far undescribed function, to act as neuritogen and to rewire cellular signaling by activating kinases involved in neurogenesis. In summary, we report that human SCs undergo a similar adaptive response in two patho-physiologically distinct situations, peripheral nerve injury and tumor development.

scholarly journals IL-17F depletion accelerates chitosan conduit guided peripheral nerve regeneration

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Feixiang Chen ◽  
Weihuang Liu ◽  
Qiang Zhang ◽  
Ping Wu ◽  
Ao Xiao ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Sciatic Nerve ◽  
Peripheral Nerve ◽  
Nerve Regeneration ◽  
Knockout Mice ◽  
Inflammatory Markers ◽  
Nerve Repair ◽  
Peripheral Nerve Regeneration ◽  
Wild Type ◽  
Anti Inflammatory

AbstractPeripheral nerve injury is a serious health problem and repairing long nerve deficits remains a clinical challenge nowadays. Nerve guidance conduit (NGC) serves as the most promising alternative therapy strategy to autografts but its repairing efficiency needs improvement. In this study, we investigated whether modulating the immune microenvironment by Interleukin-17F (IL-17F) could promote NGC mediated peripheral nerve repair. Chitosan conduits were used to bridge sciatic nerve defect in IL-17F knockout mice and wild-type mice with autografts as controls. Our data revealed that IL-17F knockout mice had improved functional recovery and axonal regeneration of sciatic nerve bridged by chitosan conduits comparing to the wild-type mice. Notably, IL-17F knockout mice had enhanced anti-inflammatory macrophages in the NGC repairing microenvironment. In vitro data revealed that IL-17F knockout peritoneal and bone marrow derived macrophages had increased anti-inflammatory markers after treatment with the extracts from chitosan conduits, while higher pro-inflammatory markers were detected in the Raw264.7 macrophage cell line, wild-type peritoneal and bone marrow derived macrophages after the same treatment. The biased anti-inflammatory phenotype of macrophages by IL-17F knockout probably contributed to the improved chitosan conduit guided sciatic nerve regeneration. Additionally, IL-17F could enhance pro-inflammatory factors production in Raw264.7 cells and wild-type peritoneal macrophages. Altogether, IL-17F may partially mediate chitosan conduit induced pro-inflammatory polarization of macrophages during nerve repair. These results not only revealed a role of IL-17F in macrophage function, but also provided a unique and promising target, IL-17F, to modulate the microenvironment and enhance the peripheral nerve regeneration.

Functional Screening and Biosafety Identify of the Potential Application of Let-7a in Injured Peripheral Nerve Regeneration

2021 ◽  
Author(s):  
Qianqian Chen ◽  
Qianyan Liu ◽  
Pan Wang ◽  
Tianmei Qian ◽  
Xinghui Wang ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Potential Application ◽  
Gene Expression Analysis ◽  
Nerve Repair ◽  
Peripheral Nerve Regeneration ◽  
Functional Approach ◽  
Cell Permeability ◽  
Functional Screening ◽  
The Core

Abstract Proper supporting factor can possess the ability to enhance neuron regeneration, for instance, neurotrophic effects especially nerve growth factor (NGF). However, the in vivo applications of NGF are largely limited by its intrinsic disadvantages. Considering that let-7 targets and regulates NGF, and let-7 is also the core and harbor regulators in peripheral nerve repair and regeneration, we evaluated the potential application in clinical. We firstly screened the let-7a as the most ideal let-7 family molecular by gene expression analysis and functional approach. We further evaluated the in vivo safety, the cell permeability of 3 main cells in regeneration micro-environment, and the morphological and functional indicators. Our study provides an essential basis for in vivo application of let-7 and pictured a vision for the clinical translation of miRNA as a prospective alternative for regenerative medicine.

The fate of motoneurons in the spinal cord after peripheral nerve repair: a quantitative study using the neural tracer horseradish peroxidase

1995 ◽  
Vol 82 (4) ◽  
pp. 623-629
Author(s):  
Joyce A. Gilmour ◽  
Lynn M. Myles ◽  
Michael A. Glasby
Keyword(s):  
Horseradish Peroxidase ◽  
Peripheral Nerve ◽  
Nerve Repair ◽  
Surgical Techniques ◽  
Nerve Graft ◽  
Severe Injuries ◽  
Content Type ◽  
Muscle Graft ◽  
Functional Connections ◽  
Motoneuron Pool

✓ This study assessed the changes that occurred in the spinal motoneuron pool after the repair of a specific peripheral nerve by means of several clinically appropriate surgical techniques: nerve graft, muscle graft, and epineurial suture. The motoneuron pool relating to a single muscle was assessed at 50, 100, 200, and 300 days after repair via retrograde axonal transport of the neural tracer horseradish peroxidase. The results indicate that although a small portion of the motoneuron population dies following peripheral nerve surgery, this is not a significant number. The majority of the anterior horn cells appear to have the ability to both survive nerve transection and form new functional connections with the regenerated nerve after repair. The degree of cell loss is influenced by the nature of the injury and the method of repair implemented. Injuries involving neurotmesis result in the loss of a greater proportion of the cell population than less severe injuries involving axonotmesis. A greater proportion of the motoneuron population is preserved when the severed nerve has been repaired using a direct epineurial suture than when repair is achieved by means of a graft. The two methods of grafting produced comparable results, although the muscle graft tended to result in the preservation of a greater number of cells than the nerve graft, making it an acceptable alternative method for the surgical repair of short gaps in peripheral nerves.

scholarly journals Gellan Gum-based luminal fillers for peripheral nerve regeneration: an in vivo study in the rat sciatic nerve repair model

2018 ◽  
Vol 6 (5) ◽  
pp. 1059-1075 ◽  
Author(s):  
C. R. Carvalho ◽  
S. Wrobel ◽  
C. Meyer ◽  
C. Brandenberger ◽  
I. F. Cengiz ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Peripheral Nerve ◽  
Nerve Regeneration ◽  
Experimental Work ◽  
Nerve Repair ◽  
Peripheral Nerve Regeneration ◽  
Gellan Gum ◽  
In Vivo Study ◽  
Rat Sciatic Nerve

This experimental work considers the innovative use of the biomaterial Gellan Gum (GG) as a luminal filler for nerve guidance channels.

scholarly journals Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-17 ◽  
Author(s):  
Felix J. Paprottka ◽  
Petra Wolf ◽  
Yves Harder ◽  
Yasmin Kern ◽  
Philipp M. Paprottka ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Nerve Repair ◽  
Donor Site ◽  
Surgical Techniques ◽  
Graft Material ◽  
Digital Nerve ◽  
Nerve Reconstruction ◽  
Level Of Evidence ◽  
Sensory Recovery ◽  
End To End

Good clinical outcome after digital nerve repair is highly relevant for proper hand function and has a significant socioeconomic impact. However, level of evidence for competing surgical techniques is low. The aim is to summarize and compare the outcomes of digital nerve repair with different methods (end-to-end and end-to-side coaptations, nerve grafts, artificial conduit-, vein-, muscle, and muscle-in-vein reconstructions, and replantations) to provide an aid for choosing an individual technique of nerve reconstruction and to create reference values of standard repair for nonrandomized clinical studies. 87 publications including 2,997 nerve repairs were suitable for a precise evaluation. For digital nerve repairs there was practically no particular technique superior to another. Only end-to-side coaptation had an inferior two-point discrimination in comparison to end-to-end coaptation or nerve grafting. Furthermore, this meta-analysis showed that youth was associated with an improved sensory recovery outcome in patients who underwent digital replantation. For end-to-end coaptations, recent publications had significantly better sensory recovery outcomes than older ones. Given minor differences in outcome, the main criteria in choosing an adequate surgical technique should be gap length and donor site morbidity caused by graft material harvesting. Our clinical experience was used to provide a decision tree for digital nerve repair.

scholarly journals Introduction: the value of peripheral nerve surgery

2018 ◽  
Vol 44 (videosuppl1) ◽  
pp. Intro
Author(s):  
Robert J. Spinner ◽  
Holly S. Gilmer ◽  
Gregory R. Trost
Keyword(s):  
Peripheral Nerve ◽  
Patient Outcomes ◽  
Surgical Techniques ◽  
Nerve Transfer ◽  
Nerve Reconstruction ◽  
Tumor Biopsy ◽  
Nerve Decompression ◽  
Peripheral Nerve Surgery ◽  
Nerve Surgery ◽  
Logical Extension

If a single picture is worth a thousand words, then a video, by logical extension, would be priceless. This edition showcases peripheral nerve surgery in all its grandeur and preserves it for posterity. Classic and novel surgical techniques are shown related to tumor biopsy or resection; nerve decompression for entrapment; and nerve reconstruction with direct repair or nerve transfer. Akin to a nautical chart filled with detailed maps for sailors, this Neurosurgical Focus Video Atlas provides navigational tools for neurosurgeons. The shared underlying message is that a sound knowledge of anatomy can lead to innovation (i.e., creative approaches or solutions) and excellence (i.e., improved patient outcomes).

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