CIC IT 808, service d'orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25033 Besançon, France; Université de Franche-Comté sciences médicales et pharmaceutiques, 19, rue Ambroise-Paré, 25030 Besançon cedex, France.
CIC IT 808, service d'orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25033 Besançon, France; Université de Franche-Comté sciences médicales et pharmaceutiques, 19, rue Ambroise-Paré, 25030 Besançon cedex, France.
Hand Surg Rehabil. 2020 Oct;39(5):343-351. doi: 10.1016/j.hansur.2020.05.007. Epub 2020 May 30.
Functionalized neurotube are a third-generation of conduits with chemical or architectural bioactivity developed for axonal proliferation. The goal of this review is to provide a synopsis of the functionalized nerve conduits described in the literature according to their chemical and architectural properties and answer two questions: what are their mechanisms of action? Has their efficacy been proven compared to the autologous nerve graft? Our literature review relates all kind of conduits corresponding to functionalized neurotubes in peripheral nerve regeneration found in Medline and PubMed Central. Studies developing nerve gaps, chemotactic or structural features promoting each conduit, results, efficiency were selected. Fifty-five studies were selected and classified in: (a) intraluminal neurotrophic factors; (b) cell-based therapy (combined-in-vein muscles, amniotic membrane, Schwann cells, stem cells); (c) extracellular matrix proteins; (d) tissue engineering; (e) bioimplants. Functionalized neurotubes showed significantly better functional results than after end-to-end nerve suture. No studies can be able to show that neurotube results were better than autologous nerve graft results. We included all studies regardless of effectives to evaluate quality of reinnervation with modern tubulization. Functionalized neurotubes promote basic conduits for peripheral nerve regeneration. Thanks to bioengineering and microsurgery improvement, further neurotubes could promote best level of regeneration and functional recovery to successfully bridge a critical nerve gap.
功能性神经导管是第三代具有化学或结构生物活性的导管，用于促进轴突增殖。本综述的目的是根据其化学和结构特性，对文献中描述的功能性神经导管进行概述，并回答两个问题：它们的作用机制是什么？与自体神经移植相比，其疗效是否得到证实？我们的文献综述涉及到 Medline 和 PubMed Central 中所有与周围神经再生相关的功能性神经导管。选择了研究开发神经间隙、趋化或结构特征促进每个导管、结果、效率的研究。选择了 55 项研究并进行分类：(a)管腔内神经营养因子；(b)基于细胞的治疗（联合静脉肌肉、羊膜、施万细胞、干细胞）；(c)细胞外基质蛋白；(d)组织工程；(e)生物植入物。功能性神经导管在功能恢复方面明显优于端端神经缝合。没有研究能够表明神经导管的效果优于自体神经移植的效果。我们包括了所有的研究，无论效果如何，都用现代的导管化来评估神经再支配的质量。功能性神经导管促进了周围神经再生的基本导管。借助生物工程和显微外科的改进，进一步的神经导管可以促进最佳的再生水平和功能恢复，成功桥接临界神经间隙。
