Challenges for nerve repair using chitosan-siloxane hybrid porous scaffolds.

Yuki Shirosaki,Ana C Mauricio,Maria A Lopes,Akiyoshi Osaka,Stefano Geuna,José D Santos,Satoshi Hayakawa

doi:10.1155/2014/153808

Abstract

The treatment of peripheral nerve injuries remains one of the greatest challenges of neurosurgery, as functional recover is rarely satisfactory in these patients. Recently, biodegradable nerve guides have shown great potential for enhancing nerve regeneration. A major advantage of these nerve guides is that no foreign material remains after the device has fulfilled its task, which spares a second surgical intervention. Recently, we studied peripheral nerve regeneration using chitosan-γ-glycidoxypropyltrimethoxysilane (chitosan-GPTMS) porous hybrid membranes. In our studies, these porous membranes significantly improved nerve fiber regeneration and functional recovery in rat models of axonotmetic and neurotmetic sciatic nerve injuries. In particular, the number of regenerated myelinated nerve fibers and myelin thickness were significantly higher in rat treated with chitosan porous hybrid membranes, whether or not they were used in combination with mesenchymal stem cells isolated from the Wharton's jelly of the umbilical cord. In this review, we describe our findings on the use of chitosan-GPTMS hybrids for nerve regeneration.

Highlights

Nerve regeneration is a complex biological process
The number of regenerated myelinated nerve fibers and myelin thickness were significantly higher in rat treated with chitosan porous hybrid membranes, whether or not they were used in combination with mesenchymal stem cells isolated from the Wharton’s jelly of the umbilical cord
These findings demonstrate the therapeutic potential of human MSCs (hMSCs) and porous hybrid chitosan membranes in promoting myelin production in surgically reconstructed nerves after axonotmetic and neurotmetic injuries

Summary

Introduction

While approaches for peripheral nerve repair have improved over the last few decades, functional recovery is usually incomplete. Nerve cells can regenerate into the cylinder-shaped tubes, where the microenvironment promotes regeneration towards the distal nerve stump. These tube guides can be made of different biomaterials, and they allow the incorporation of various molecules and cellular systems [12]. The tube guides should be biocompatible, nontoxic, biodegradable, permeable, and noninflammatory, like other tissue engineering scaffolds. They should prevent fibrous scar tissue invasion but allow local revascularization to improve nutrient and oxygen supply. The tube guides should have an adequate mechanical strength to maintain a stable support structure for nerve regeneration over the healing period [27]

Nerve Conduits Prepared from Chitosan-Based Materials

Challenges for Nerve Repair Using Chitosan-Siloxane Hybrids

Findings

Conclusions