Acellular nerve allografts in peripheral nerve regeneration: A comparative study

Moore, Amy M.; MacEwan, Matthew R.; Santosa, Katherine B.; Chenard, Kristofer E.; Ray, Wilson Z.; Hunter, Daniel A.; Mackinnon, Susan E.; Johnson, Philip J.

doi:10.1002/mus.22033

Cited by 197 publications

(186 citation statements)

References 56 publications

(84 reference statements)

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“…The data indicated that nerve conduction velocity in the autograft group was markedly higher, as compared with those in the acellular nerve graft groups, however no significant differences were present between the allograft and xenograft groups, results that were concordant with those of previous histological findings. A previous study reported that there is close correlation between histomorphometric and electrophysiological analysis results (16), and increased nerve regeneration is indicative of increased functional recovery (33). Rats receiving xenografts displayed poorer functional recovery, as compared with those receiving autografts shortly following grafting, however over a longer period of time, functional recovery was similar between the two groups (9).…”

Section: A B C a B Cmentioning

confidence: 94%

A comparative study of acellular nerve xenografts and allografts in repairing rat facial nerve defects

Huang

Xiao

Liu

et al. 2015

Molecular Medicine Reports

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Abstract. Acellular nerves are composed of a basal lamina tube, which retains sufficient bioactivity to promote axon regeneration, thereby repairing peripheral nerve gaps. However, the clinical application of acellular allografts has been restricted due to its limited availability. To investigate whether xenografts, a substitute to allograft acellular nerves in abundant supply, could efficiently promote nerve regeneration, rabbit and rat acellular nerve grafts were used to reconstruct 1 cm defects in Wistar rat facial nerves. Autologous peroneal nerve grafts served as a positive control group. A total of 12 weeks following the surgical procedure, the axon number, myelinated axon number, myelin sheath thickness, and nerve conduction velocity of the rabbit and rat-derived acellular nerve grafts were similar, whereas the fiber diameter of the rabbit-derived acellular xenografts decreased, as compared with those of rat-derived acellular allografts. Autografts exerted superior effects on nerve regeneration; however, no significant difference was observed between the axon number in the autograft group, as compared with the two acellular groups. These results suggested that autografts perform better than acellular nerve grafts, and chemically extracted acellular allografts and xenografts have similar effects on the regeneration of short facial nerve defects.

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Section: A B C a B Cmentioning

confidence: 94%

A comparative study of acellular nerve xenografts and allografts in repairing rat facial nerve defects

Huang

Xiao

Liu

et al. 2015

Molecular Medicine Reports

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“…Unfortunately, substantial immunogenicity in human nerve tissue necessitated the concomitant administration of immunosuppressive agents [38]. Though there is data to support this approach as potentially effective, the toxicity of these agents hindered routine use of donated human allograft and its use was relegated to extreme clinical situations or investigational research [35].…”

Section: Allograftmentioning

confidence: 99%

Overcoming Short Gaps in Peripheral Nerve Repair: Conduits and Human Acellular Nerve Allograft

Isaacs

Browne

2014

Hand (New York, N,Y.)

102

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Nerve conduits and acellular nerve allograft offer efficient and convenient tools for overcoming unexpected gaps during nerve repair. Both techniques offer guidance for migrating Schwann cells and axonal regeneration though utilizing very different scaffolds. The substantially greater amount of animal and clinical data published on nerve conduits is marked by wide discrepancies in results that may be partly explained by a still poorly defined critical repair gap and diameter size. The available information on acellular allografts appears more consistently positive though this tool is also hampered by a longer but also limited critical length. This article reviews the current relative literature and examines pertinent parameters for application of both acellular allograft and nerve conduits in overcoming short nerve gaps.

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“…High molecular weight basic fibroblast growth factor support the regeneration of the injured axons across 15 mm long adult sciatic nerve across gaps bridged with silicone tubes filled with Matrigel or a mixture of Schwann Cells (SC) and Matrigel [287].…”

Section: Schwann Cells and Bone Marrow-derived Mesenchymal Stem Cellsmentioning

confidence: 99%

“…This influence is increased if Schwann cells overexpressing high molecular weight FGF-2 is combined with the Matrigel [287]. An alternate approach is to use conduits to bridge nerve gaps that contain intraluminal guidance structures, vs. unstructured conduits.…”

Section: -Dimensional Scaffoldsmentioning

confidence: 99%

Promoting Axon Regeneration and Neurological Recovery Following Traumatic Peripheral Nerve Injuries

Kuffler¹

2015

Int J Neurorehabilitation Eng

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Repairing Peripheral Nerves following Traumas Nerve crushWithin several days of crushing a peripheral nerve, the injured axons begin to regenerate through their distal pathway until they reach their original targets with which they restore neurological function. The larger the number of axons that regenerate through the distal nerve, the greater the extent of neurological recovery [1][2][3]. The number of axons that regenerate, and thus neurological recovery, is influenced by the physiological state of the distal denervated nerve pathway [4][5][6][7].Following a peripheral nerve crush, the injured axons begin to regenerate within 2 days of injury [8]. They may regenerate to their targets through their original pathway in association with and promoted by its Schwann cells, the neurotrophic factors they release, and the Schwann cell extracellular matrix [1,4,[9][10][11][12][13][14]. Thus, the distal nerve provides a simple means for promoting and directing the regenerating axons to their original targets [15][16][17][18]. However, when a nerve has a gap, the gap must be bridged with a material that is permissive to and promotes axon regeneration across the entire gap to reach the distal nerve stump, through which the axons must then be able to regenerate.The Schwann cells in the denervated distal nerve release neurotrophic factors that promote axon regeneration, but also release extracellular matrix components that promote and inhibit axon regeneration [19][20][21][22][23][24][25][26]. Thus, regeneration through the distal nerve is a balance of the influences of factors that both promote and inhibit regeneration. If the Schwann cells are present, such as after a simple nerve crush, virtually 100% of the axons regenerate and they innervate all the denervated synaptic sites. If the Schwann cells within the distal nerve pathway are killed, leaving only the extracellular matrix intact, the number of axons that regenerates to their targets decreases by 94%. This is because the factors required to trigger the regenerating axons to branch at extracellular matrix branch points are missing, axons do not branch, and therefore each axon reinnervates only a single denervated muscle fiber. Thus, Schwann cells along the distal nerve pathway and a AbstractFollowing a peripheral nerve crush, or when a peripheral the nerve is transected and the nerve stumps anastomosed, neurological recovery is generally excellent. This is because the axons merely have to regenerate through the distal portion of the nerve through the existing extracellular matrix of the denervated Schwann cells that direct and promote them to their distant denervated motor and sensory targets. However, when a length of a peripheral nerve is destroyed, and anastomosis is not possible, the standard surgical repair technique is to graft a length/s of autologous sensory nerve into the gap. Neurological recovery is generally good if the nerve gap is <2 cm in length, the repair is performed <4 months post trauma, and the patients are <25 years of age. Because the nerve ...

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Acellular nerve allografts in peripheral nerve regeneration: A comparative study

Abstract: Background-Processed nerve allografts offer a promising alternative to nerve autografts in the surgical management of peripheral nerve injuries where short deficits exist.

Cited by 197 publications

References 56 publications

A comparative study of acellular nerve xenografts and allografts in repairing rat facial nerve defects

A comparative study of acellular nerve xenografts and allografts in repairing rat facial nerve defects

Overcoming Short Gaps in Peripheral Nerve Repair: Conduits and Human Acellular Nerve Allograft

Promoting Axon Regeneration and Neurological Recovery Following Traumatic Peripheral Nerve Injuries

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