Therapeutic strategies for peripheral nerve injury: decellularized nerve conduits and Schwann cell transplantation

Abstract

In recent years, the use of Schwann cell transplantation to repair peripheral nerve injury has attracted much attention. Animal-based studies show that the transplantation of Schwann cells in combination with nerve scaffolds promotes the repair of injured peripheral nerves. Autologous Schwann cell transplantation in humans has been reported recently. This article reviews current methods for removing the extracellular matrix and analyzes its composition and function. The development and secretory products of Schwann cells are also reviewed. The methods for the repair of peripheral nerve injuries that use myelin and Schwann cell transplantation are assessed. This survey of the literature data shows that using a decellularized nerve conduit combined with Schwann cells represents an effective strategy for the treatment of peripheral nerve injury. This analysis provides a comprehensive basis on which to make clinical decisions for the repair of peripheral nerve injury.

A Subpopulation of Schwann Cell-Like Cells With Nerve Regeneration Signatures Is Identified Through Single-Cell RNA Sequencing

“…Following a PNI, the damaged nerve can be regenerated through nerve end-to-end anastomosis, autologous nerve transplantation, or nerve conduits ( Kubiak et al, 2020 ). However, the nerve regeneration outcomes of these treatments, and especially the recovery of nerve function, are not always favorable, with painful neuroma, anastomotic scars, and flawed development of motor sensory nerve axons being commonly reported ( Sullivan et al, 2016 ; Han et al, 2019 ).…”

Terminal Schwann Cell Aging: Implications for Age-Associated Neuromuscular Dysfunction

“…Schwann cell transplantation enhances myelination and spinal nerve regeneration in the spinal cord [ 300 - 304 ]. Schwann cell grafts could also be a potential therapy for peripheral nerve injury [ 305 ]: SC transplantation successfully enhances sciatic nerve regeneration not only in rodents [ 302 , 306 - 310 ], but also in monkeys [ 311 ] and in humans [ 312 ]. However, SC therapy presents the obstacle of limited cell sources.…”

Schwann Cell Cultures: Biology, Technology and Therapeutics

“…Many preclinical studies have shown that SCs obtained via in vitro culture methods form a bridge across a lesion site, recruit endogenous SCs, promote axon growth and sparing, and provide a new myelin sheath to regenerated and demyelinated axons in the PNS [16,120,121] and CNS [10,14,118]. SCs do not naturally reside in the CNS but cells with SC characteristics can be found within traumatic and demyelinating lesions in the brain and the spinal cord [122].…”

“…For instance, SCs can be isolated from assorted mouse models [13] and transgenic animals expressing gene reporters. In this way, researchers have been able to compare cell behavior in vitro and in vivo, and trace the fate of transplanted SCs to grasp the associated mechanisms of repair, migration and myelination in central and peripheral nerve lesions [10,[14][15][16]. A particular advantage of SCs is that it is possible to manufacture them at a large scale from human autologous tissues following guidelines compatible with safe manufacturing practices, which has made it possible to re-implant cultured SCs for therapeutic benefit in human patients [17].…”