Abstract
BackgroundTissue-engineered nerve scaffolds hold great potential in bridging large peripheral nerve defects. However, insufficient vascularization of nerve scaffolds limited neural tissues survival and regeneration, which hampered the successful implantation and clinical application of nerve scaffolds. The omentum possesses a high vascularization capacity and enhances regeneration and maturation of tissues and constructs to which it is applied. However, combined application of nerve scaffolds and omentum on axonal regeneration and functional recovery in the treatment of large peripheral nerve defects has rarely been investigated thus far.MethodsIn the present study, an omentum-wrapped collagen-chitosan scaffold was used to bridge a 15-mm-long sciatic nerve defect in rats. Rats that received nerve autografts or scaffolds alone were served as positive control or negative control, respectively. The axonal regeneration and functional recovery were examined by a combination of walking track analysis, electrophysiological assessment, Fluoro-Gold (FG) retrograde tracing, as well as morphometric analyses to both regenerated nerves and target muscles.FindingsThe results demonstrated that axonal regeneration and functional recovery were in the similar range between the omentum-wrapping group and the autograft group, which were significantly better than those in the scaffold alone group. Further investigation showed that the protein levels of vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were significantly higher in the omentum-wrapping group than those in the scaffold alone group in the early weeks after surgery.ConclusionThese findings indicate that the omentum-wrapped scaffold is capable of enhancing axonal regeneration and functional recovery, which might be served as a potent alternative to nerve autografts. The beneficial effect of omentum-wrapping on nerve regeneration might be related with the proteins produced by omentum.
Highlights
Nerve autografting, the therapeutic gold standard of bridging large nerve defects [1], has some disadvantages including limited donor grafts availability and postoperative complications of donor sites such as scarring and neuroma formation [2]
These findings indicate that the omentum-wrapped scaffold is capable of enhancing axonal regeneration and functional recovery, which might be served as a potent alternative to nerve autografts
The beneficial effect of omentumwrapping on nerve regeneration might be related with the proteins produced by omentum
Summary
The therapeutic gold standard of bridging large nerve defects [1], has some disadvantages including limited donor grafts availability and postoperative complications of donor sites such as scarring and neuroma formation [2]. Bridging a large nerve defect without sacrificing a healthy nerve to obtain the nerve autograft has significantly clinical importance. Driven by this consideration, extensive research efforts have been made in the field of neural tissue engineering with an attempt to fabricate nerve scaffolds that can guide nerve regeneration as alternatives to nerve autografts. It has been recognized that insufficient vascularization of nerve scaffolds is among the main factors which limit the performance of nerve scaffolds in promoting nerve regeneration. Insufficient vascularization of nerve scaffolds limited neural tissues survival and regeneration, which hampered the successful implantation and clinical application of nerve scaffolds. Combined application of nerve scaffolds and omentum on axonal regeneration and functional recovery in the treatment of large peripheral nerve defects has rarely been investigated far
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