Fundamentals and Current Strategies for Peripheral Nerve Repair and Regeneration

Abstract

A body of evidence indicates that peripheral nerves have an extraordinary yet limited capacity to regenerate after an injury. Peripheral nerve injuries have confounded professionals in this field, from neuroscientists to neurologists, plastic surgeons, and the scientific community. Despite all the efforts, full functional recovery is still seldom. The inadequate results attained with the "gold standard" autograft procedure still encourage a dynamic and energetic research around the world for establishing good performing tissue engineered alternative grafts. Resourcing to nerve guidance conduits, a variety of methods have been experimentally used to bridge peripheral nerve gaps of limited size, up to 30-40 mm in length, in humans. Herein, we aim to summarize the fundamentals related to peripheral nerve anatomy and overview the challenges and scientific evidences related to peripheral nerve injury and repair mechanisms. The most relevant reports dealing with the use of both synthetic and naturalbased biomaterials used in tissue engineering strategies when treatment of nerve injuries is envisioned are also discussed in depth, along with the state-of-the-art approaches in this field.

Calotropis procera (leaves) supplementation exerts curative effects on promoting functional recovery in a mouse model of peripheral nerve injury

“…Compression of the sciatic nerve results in loss of conduction to the skeletal muscles, which eventually results in loss of motor function of that limb (Hussain et al., 2020 ). Motor function restoration happens upon revival of nerve impulses (Carvalho et al, 2020 ). In the current scenario, a significant restoration in the motor functions was observed in terms of SFI measurement and the grip strength force (% of initial force) in all treatment groups as compared to the control (Figure 2a,b ).…”

Polymer Scaffolds for Biomedical Applications in Peripheral Nerve Reconstruction

“…The interaction between cells and carriers is primarily limited by the surface characteristics and structure of the vessel. Although nanofibers can mimic the morphology of extracellular matrix, some modifications are still needed [ 70 , 71 ]. These are necessary to obtain essential characteristics that can respond to specific biological signals and improve cell attachment, cell proliferation, cell differentiation, and tissue regeneration [ 72 , 73 , 74 ].…”

Morphometric analysis of the human endoneurial extracellular matrix components during aging

“…There are several surgical techniques in practice with varying outcomes, such as neurosutures, nerve transfers, autografts and allografts, and nerve guidance conduits [9]. Autologous nerve grafting is the gold standard technique for larger gaps [10] in the peripheral nervous system (PNS), with the sural nerve as a preferred donor nerve [8]. The sural nerve is a sensory nerve that supplies the skin over the lateral and posterior ankle and lateral foot to the base of the fifth toe [11].…”