Jones Salazar, Eisenberg Howard M, Jia Xiaofeng
Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Int J Mol Sci. 2016 Sep 7;17(9):1494. doi: 10.3390/ijms17091494.
Peripheral nerve injuries remain a significant source of long lasting morbidity, disability, and economic costs. Much research continues to be performed in areas related to improving the surgical outcomes of peripheral nerve repair. In this review, the physiology of peripheral nerve regeneration and the multitude of efforts to improve surgical outcomes are discussed. Improvements in tissue engineering that have allowed for the use of synthetic conduits seeded with neurotrophic factors are highlighted. Selected pre-clinical and available clinical data using cell based methods such as Schwann cell, undifferentiated, and differentiated stem cell transplantation to guide and enhance peripheral nerve regeneration are presented. The limitations that still exist in the utility of neurotrophic factors and cell-based therapies are outlined. Strategies that are most promising for translation into the clinical arena are suggested.
周围神经损伤仍然是导致长期发病、残疾和经济成本的重要原因。在改善周围神经修复手术效果相关领域,仍在进行大量研究。在本综述中,将讨论周围神经再生的生理学以及为改善手术效果所做的诸多努力。重点介绍了组织工程学的进展,这些进展使得使用接种神经营养因子的合成导管成为可能。还介绍了使用基于细胞的方法(如施万细胞、未分化和分化的干细胞移植)来引导和增强周围神经再生的部分临床前和现有临床数据。概述了神经营养因子和基于细胞的疗法在应用中仍然存在的局限性。提出了最有希望转化为临床应用的策略。