Lackington William A, Ryan Alan J, O'Brien Fergal J
Tissue Engineering Research Group (TERG), Department of Anatomy, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Advanced Materials and Bioengineering Research Centre (AMBER), Trinity College Dublin and Royal College of Surgeons in Ireland, Dublin 2, Ireland.
ACS Biomater Sci Eng. 2017 Jul 10;3(7):1221-1235. doi: 10.1021/acsbiomaterials.6b00500. Epub 2017 Jan 10.
Peripheral nerve injuries have high incidence rates, limited treatment options and poor clinical outcomes, rendering a significant socioeconomic burden. For effective peripheral nerve repair, the gap or site of injury must be structurally bridged to promote correct reinnervation and functional regeneration. However, effective repair becomes progressively more difficult with larger gaps. Autologous nerve grafting remains the best clinical option for the repair of large gaps (20-80 mm) despite being associated with numerous limitations including permanent donor site morbidity, a lack of available tissue and the formation of neuromas. To meet the clinical demand of large gap repair and overcome these limitations, tissue engineering has led to the development of nerve guidance conduit-based therapeutics. This review focuses on the advances of nerve guidance conduit-based therapeutics in terms of their structural properties including biomimetic composition, permeability, architecture, and surface modifications. Associated biochemical properties, pertaining to the incorporation of cells and neurotrophic factors, are also reviewed. After reviewing the progress in the field, we conclude by presenting an outlook on their clinical translatability and the next generation of therapeutics.
周围神经损伤发病率高、治疗选择有限且临床预后不佳，造成了巨大的社会经济负担。为实现有效的周围神经修复，损伤的间隙或部位必须在结构上进行桥接，以促进正确的神经再支配和功能再生。然而，间隙越大，有效修复就变得越困难。自体神经移植仍然是修复大间隙（20 - 80毫米）的最佳临床选择，尽管它存在许多局限性，包括供体部位永久性损伤、可用组织不足以及神经瘤的形成。为满足大间隙修复的临床需求并克服这些局限性，组织工程学推动了基于神经引导导管的治疗方法的发展。本综述重点关注基于神经引导导管的治疗方法在其结构特性方面的进展，包括仿生组成、渗透性、结构和表面修饰。还综述了与细胞和神经营养因子掺入相关的生化特性。在回顾该领域的进展后，我们通过展望其临床可转化性和下一代治疗方法来得出结论。
