Zhang Rui-Cheng, Du Wen-Qi, Zhang Jing-Yuan, Yu Shao-Xia, Lu Fang-Zhi, Ding Hong-Mei, Cheng Yan-Bo, Ren Chao, Geng De-Qin
Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China.
Department of Human Anatomy, Xuzhou Medical University, Xuzhou, Jiangsu Province, China.
Neural Regen Res. 2021 Nov;16(11):2170-2176. doi: 10.4103/1673-5374.310941.
Peripheral nerve injuries occur as the result of sudden trauma and lead to reduced quality of life. The peripheral nervous system has an inherent capability to regenerate axons. However, peripheral nerve regeneration following injury is generally slow and incomplete that results in poor functional outcomes such as muscle atrophy. Although conventional surgical procedures for peripheral nerve injuries present many benefits, there are still several limitations including scarring, difficult accessibility to donor nerve, neuroma formation and a need to sacrifice the autologous nerve. For many years, other therapeutic approaches for peripheral nerve injuries have been explored, the most notable being the replacement of Schwann cells, the glial cells responsible for clearing out debris from the site of injury. Introducing cultured Schwann cells to the injured sites showed great benefits in promoting axonal regeneration and functional recovery. However, there are limited sources of Schwann cells for extraction and difficulties in culturing Schwann cells in vitro. Therefore, novel therapeutic avenues that offer maximum benefits for the treatment of peripheral nerve injuries should be investigated. This review focused on strategies using mesenchymal stem cells to promote peripheral nerve regeneration including exosomes of mesenchymal stem cells, nerve engineering using the nerve guidance conduits containing mesenchymal stem cells, and genetically engineered mesenchymal stem cells. We present the current progress of mesenchymal stem cell treatment of peripheral nerve injuries.
周围神经损伤是由突然的创伤引起的，会导致生活质量下降。周围神经系统具有轴突再生的内在能力。然而，损伤后的周围神经再生通常缓慢且不完全，导致诸如肌肉萎缩等不良功能结果。尽管用于周围神经损伤的传统外科手术有许多益处，但仍存在一些局限性，包括瘢痕形成、获取供体神经困难、神经瘤形成以及需要牺牲自体神经。多年来，人们一直在探索用于周围神经损伤的其他治疗方法，其中最值得注意的是替换施万细胞，即负责清除损伤部位碎片的神经胶质细胞。将培养的施万细胞引入损伤部位在促进轴突再生和功能恢复方面显示出巨大益处。然而，施万细胞的提取来源有限，并且在体外培养施万细胞存在困难。因此，应该研究能为周围神经损伤治疗带来最大益处的新型治疗途径。本综述重点关注使用间充质干细胞促进周围神经再生的策略，包括间充质干细胞外泌体、使用含有间充质干细胞的神经引导导管进行神经工程以及基因工程化的间充质干细胞。我们展示了间充质干细胞治疗周围神经损伤的当前进展。
