The role of precisely matching fascicles in the quick recovery of nerve function in long peripheral nerve defects.

Liwei Yan,Jintao Fang,Jian Qi,Liqiang Gu,Zhi Yao,Qingtang Zhu,Tao Lin,Xiang Zhou,Xiaolin Liu

doi:10.1097/wnr.0000000000000873

Abstract

Peripheral nerve injury therapy in the clinic remains less than satisfactory. The gold standard of treatment for long peripheral nerve defects is autologous nerve grafts; however, numerous clinical complications are associated with this treatment. As tissue engineering has developed, tissue-engineered nerve grafts (TENGs) have shown potential applications as alternatives to autologous nerve grafts. To verify the important role of the biomimetic pathway of fascicle design in TENGs, we designed an animal model to study the role of the precise matching of fascicles in the effectiveness of nerve function recovery. 24 Sprague-Dawley rats were divided randomly into three groups (eight/group) that corresponded to 100% fascicle matching (100%FM), 50%FM and 0%FM. We selected Sprague–Dawley rat long-gap (15 mm) sciatic nerve defects. In the 6 weeks after surgery, we found that the 100%FM group showed the most effective functional recovery among the three groups. The 100%FM group showed better functional recovery on the basis of the sciatic functional index than the 50%FM and 0%FM groups. According to histological evaluation, the 100%FM group showed more regenerating nerve fibres. Moreover, in terms of the prevention of muscle atrophy, the 100%FM group showed excellent physiological outcomes. The 100%FM as tissue-engineered scaffolds can enhance nerve regeneration and effective functional recovery after the repair of large nerve defects. The results of this study provide a theoretical basis for future TENG designs including biomimetic fascicle pathways for repairing long nerve defects.

Highlights

Nerve injuries, especially peripheral nerve injuries (PNIs), are common clinical problems worldwide [1], causing morbidity in over 2.8% of trauma patients [2]
The results of this study provide a theoretical basis for next-generation tissue-engineered nerve grafts (TENGs) for repairing long nerve defects
The 100% fascicle matching (100%FM) group showed a greater increase in sciatic functional index (SFI) than the other two groups

Summary

Introduction

Especially peripheral nerve injuries (PNIs), are common clinical problems worldwide [1], causing morbidity in over 2.8% of trauma patients [2]. Autografts and ANAs used to repair long nerve defects have some disadvantages, such as donor nerve distal organ dysfunction, physical and microstructure size mismatching, requirement of surgery at the donor site, limited donor sources and potential immune responses [6,7] This has motivated alternative nerve repair strategies, such as three-dimensional (3D) printed nerve guidance channels, which provide anatomical pathways for the regeneration of damaged nerves [8]. Our team previously focused on using a biofabricated nerve graft strategy to repair long peripheral nerve defects It is unknown whether precisely matched fascicles in the pathway design are necessary for the use of our 3D printing nerve grafts. The results of this study provide a theoretical basis for next-generation TENGs for repairing long nerve defects

Materials and methods

Results

Discussion