Abstract

Entubulating devices to repair peripheral nerve injuries are limited in their effectiveness particularly for critical gap injuries. Current clinically used nerve guidance conduits are often simple tubes, far stiffer than that of the native tissue. This study assesses the use of poly(glycerol sebacate methacrylate) (PGSm), a photocurable formulation of the soft biodegradable material, PGS, for peripheral nerve repair. The material was synthesized, the degradation rate and mechanical properties of material were assessed and nerve guidance conduits were structured via stereolithography. In vitro cell studies confirmed PGSm as a supporting substrate for both neuronal and glial cell growth. Ex vivo studies highlight the ability of the cells from a dissociated dorsal root ganglion to grow out and align along the internal topographical grooves of printed nerve guide conduits. In vivo results in a mouse common fibular nerve injury model show regeneration of axons through the PGSm conduit into the distal stump after 21 days. After conduit repair levels of spinal cord glial activation (an indicator for neuropathic pain development) were equivalent to those seen following graft repair. In conclusion, results indicate that PGSm can be structured via additive manufacturing into functional NGCs. This study opens the route of personalized conduit manufacture for nerve injury repair. Statement of SignificanceThis study describes the use of photocurable of Poly(Glycerol Sebacate) (PGS) for light-based additive manufacturing of Nerve Guidance Conduits (NGCs). PGS is a promising flexible biomaterial for soft tissue engineering, and in particular for nerve repair. Its mechanical properties and degradation rate are within the desirable range for use in neuronal applications. The nerve regeneration supported by the PGS NGCs is similar to an autologous nerve transplant, the current gold standard. A second assessment of regeneration is the activation of glial cells within the spinal cord of the tested animals which reveals no significant increase in neuropathic pain by using the NGCs. This study highlights the successful use of a biodegradable additive manufactured NGC for peripheral nerve repair.

Highlights

  • The peripheral nervous system (PNS) is distinct from the central nervous system (CNS) in function and in anatomical protection

  • The material properties of the PGS methacrylate (PGSm) were found to be favorable for peripheral nerve repair, with the conduits showing flexibility and an appropriate Young’s modulus

  • Structuring of the material via sterolithography enables PGSm to be used in scaffolds with intricate micro- and macroscopic structures for a range of biomaterial applications

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Summary

Introduction

The peripheral nervous system (PNS) is distinct from the central nervous system (CNS) in function and in anatomical protection. The CNS is unique with the vertebral column and skull affording protection, whereas the PNS innervates the extremities of the body, and as such, peripheral nerve injuries are more common. Nerve damage can occur via a variety of different mechanisms, such as traumatic wounds, thermal and chemical damage, myelin or axonal degeneration and acute compression [3]. It is reported that 2.8% of trauma injuries are related to peripheral nerve injury [4], and affect over 300,000 people across Europe annually [5]. Regeneration via axonal regrowth from the region proximal to the injury can happen naturally, if the nerve is severely damaged, successful regeneration is only likely to occur with surgical intervention.

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