Armaiz Flores Abdel, Wang Huan
Ann Plast Surg. 2018 Apr;80(4):448-456. doi: 10.1097/SAP.0000000000001259.
Outcomes following peripheral nerve injury remain poor despite the regenerative capacity displayed by the peripheral nervous system. Current therapies are limited and do not provide satisfactory functional recovery in a multitude of cases. Biomaterials have decreased the need for nerve autograft across small nerve gaps in small-caliber nerves, but the lack of a cellular substrate presents a limiting factor to the effectiveness of this therapy. Schwann cells are the supportive cells in the peripheral nervous system and play an integral role in the physiological response and regeneration following nerve injury. Limitations to autologous Schwann cells include donor site morbidity during harvesting, limited expansion capability, and finite source. Stem cells are multipotent or pluripotent cells with self-renewing capabilities that show promise to improve functional recovery following nerve injury. Differentiation of stem cells into supportive Schwann cells could provide additional trophic support without the disadvantages of autologous Schwann cells, providing an avenue to improve existing therapies. A variety of stem cells have been evaluated in animal models for this clinical application; the current options, along with their clinical feasibility, are summarized in this article.
尽管周围神经系统具有再生能力，但周围神经损伤后的预后仍然很差。目前的治疗方法有限，在许多情况下并不能提供令人满意的功能恢复。生物材料减少了小口径神经中小神经间隙对神经自体移植的需求，但缺乏细胞基质是这种治疗效果的一个限制因素。雪旺细胞是周围神经系统中的支持细胞，在神经损伤后的生理反应和再生中起着不可或缺的作用。自体雪旺细胞的局限性包括采集过程中供体部位的发病率、有限的扩增能力和有限的来源。干细胞是具有自我更新能力的多能或全能细胞，有望改善神经损伤后的功能恢复。将干细胞分化为支持性雪旺细胞可以提供额外的营养支持，而没有自体雪旺细胞的缺点，为改进现有治疗方法提供了一条途径。已经在动物模型中评估了多种干细胞用于这种临床应用；本文总结了目前的选择及其临床可行性。
