Trends in Biotechnology
The development of bioartificial nerve grafts for peripheral-nerve regeneration
Section snippets
Nonresorbable artificial nerve grafts
Because of its inert and elastic properties, silicone tubing was one of the first and most frequently used synthetic materials for nerve grafts. Clinical intubulation of regenerating nerves, however, often leads to long-term complications including fibrosis and chronic nerve compression, requiring surgical removal of the conduit[7]. Despite diminishing clinical use, the silicone chamber (and other nonresorbable materials such as polyethylene) has been a tremendously useful model for studying
Resorbable artificial nerve grafts
Although artificial nerve grafts constructed from nonresorbable materials have shown good motor and sensory recovery over the short term, long-term complications often mean that a second surgical procedure is necessary to remove the conduit. Shortly after the axons penetrate the distal stump, the nerve guide may actually become detrimental because of its toxicity or its tendency to constrict the nerve[1]. A graft made of bioresorbable materials is a promising alternative for promoting
Bioartificial nerve grafts
Although controlled release is one means of supplying factors to enhance nerve regeneration in a synthetic conduit, providing the necessary quantities and types of compounds at the rates most conducive to regeneration will surely be a challenge. Many of the neurotrophic factors that have been or will be considered for controlled release are made by Schwann cells, which serve several important roles in nerve regeneration: Schwann cells secrete neurotrophic factors and express cell-adhesion
Conclusions and future outlook
Although the silicone chamber provided an extremely valuable model for studying nerve regeneration, new technology, which has overcome many of the disadvantages of biodurable nerve grafts, promises to offer improved repair to injuries of the PNS. The most significant recent advances are the use of biodegradable channels, controlled release of trophic factors and conduits seeded with Schwann cells. All of these discoveries are making their way into the clinic and showing great potential for
Acknowledgements
The authors gratefully acknowledge the financial support of the State of Iowa Agricultural Experiment Station and the National Science Foundation.
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