The progress of biomaterials in peripheral nerve repair and regeneration

Abstract

Repair and regeneration of the injured peripheral nerve (PN) is a challenging issue in clinics. Although the regeneration outcome of large PN defects is currently unsatisfactory, recently, the study of PN repair has considerably progressed. In particular, biomaterials for repairing PNs, such as nerve guidance conduits and nerve repair membranes, have been well developed. Herein, we summarize the anatomy of the PN, the pathophysiological features of the nerve injury, and the repair process post injury. Then, we highlight the progress in the development of natural and synthetic biomaterials and summarize the applications, advantages, and disadvantages of these materials. These materials can be used as nerve repair membranes and nerve conduits in the field of PN repair. Finally, we discuss the challenges encountered and development strategies for PN repair in the future.

Potential of Fibrin Glue and Mesenchymal Stem Cells (MSCs) to Regenerate Nerve Injuries: A Systematic Review

“…The nervous system is a highly specialized tissue, responsible for the functional sensory and motor activity of the organism. As other tissues, the nervous system is susceptible to trauma by mechanical, electrical and thermal action, as well as by ischemic compression or drug injection [ 1 , 2 ]. The severity of the sequelae and the tissue recovery ability depends on the nature and extent of the injury.…”

“…All these strategies have advantages and disadvantages, with limited potential to regenerate the damaged nerve [ 5 ]. Among the available techniques, autogenous nerve grafts are considered the gold standard, especially in cases of large nerve gaps [ 1 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. Autogenous nerve grafts constitute a biological scaffold that contains native cells, neurotrophic growth factors, blood vessels, extracellular matrix proteins, adhesion molecules and neuronal cells, such as Schwann cells [ 5 , 6 , 7 , 8 ].…”

“…The conduits can be constructed of synthetic materials, biodegradable or of natural components, such as veins, arteries and tendons. Nonetheless, an ideal conduit must have some fundamental properties, such as biocompatibility, biodegradability, low immunogenicity, mechanical strength and adequate permeability to allow the exchange of nutrients and biological molecules [ 1 ]. Additionally, the success of this technique depends on the formation of a fibrin matrix in the conduit lumen, which will support vascular infiltration and cell migration [ 5 ].…”

“…Additionally, the success of this technique depends on the formation of a fibrin matrix in the conduit lumen, which will support vascular infiltration and cell migration [ 5 ]. Furthermore, the use of conduits should only be indicated for the treatment of small nerve gaps (<3 cm) [ 1 , 3 , 4 , 5 , 7 ].…”

“…In addition to these strategies, cell therapy emerges as an interesting alternative for treating nervous tissue injuries. Cellular components play an important role in overall tissue healing.In the same way, nerve regeneration is a complex process that requires the interaction of various types of cells, extracellular matrix components, blood vessels, cytokines and growth factors [ 1 ]. Besides that, it is also critical that an endogenous fibrin matrix forms at the injury site in order to support axonal growth, vascular infiltration and immune system cell migration [ 4 , 8 ].…”