Technologies for repairing peripheral nerve injury*: Progress in domestic and foreign investigations

Abstract

Objective Studies on the repair of peripheral nerve injury have achieved great progresses in recent years. Clinical nerve repair prefers microsurgery, while fundamental researches focus on tissue engineering and gene therapy. Recently, microencapsulation technique rises up as a new treatment therapy. This article mainly summarized the repairing techniques referred above, in order to make the basis for further research. Data sources A computer-based online search of Pubmed database was undertaken to identify articles about injury and repair of peripheral nerve published in English between January 1997 and May 2007 using the key words of “peripheral nerve, injury, repair”. At the same time, Chinese relative articles were searched in China National Knowledge Infrastructure (CNKI) using the same key words in Chinese. Study selection The data were primarily checked, and the references after each literature were looked up, and the articles focused on the injury and repair of peripheral nerve were selected. Those published in kola-magazine in recent 5 years were in priority for the articles with similar contents. Repetitive studies or Meta analysis were excluded. Data extraction Totally 144 articles were collected, and 30 literatures were selected as most relative reference literatures, and the other 114 articles were excluded due to old or repeated researches. Among the 30 selected articles, 6 focused on the surgical treatment for peripheral nerve injury, 10 on tissue engineering and Schwann cell, 3 on microencapsulation technology, 5 on gene therapy, 2 on immunosuppresant and 4 on neurotrophic factors. Data synthesis The technologies for repairing peripheral nerve injury are developing with time, also have been successfully combined with tissue engineering and gene therapy techniques which are advanced nowadays. As the researches go further, immunodepression factors have attracted more and more attentions, microencapsulation technology and gene therapy repair also go into the view of researchers. The main aim of technique referred above is to recover the physiological structure and function as much as possible. However, the clinical applications have a long way to go for the series of restrictions from the problems of rejection, etc. The clinical repair of peripheral nerve injury still mainly depends on microscopic neurorrhaphy and nerve grafting at present, whereas the satisfying repair techniques are waiting for more professional researches. Conclusion Restricted by techniques, microsurgery repair is still the first choice for peripheral nerve injury. Microencapsulation technique and gene therapy offer a new direction for peripheral nerve repair; tissue engineering gains great success in animal experiment together have wide prospect on clinical application, many problems wait for solution though, they will be point of following researches.