Mankavi Faranak, Ibrahim Rana, Wang Hongjun
Department of Biomedical Engineering, Semcer Center for Healthcare Innovation, Stevens Institute of Technology, Hoboken, NJ 07030, USA.
Nanomaterials (Basel). 2023 Sep 10;13(18):2528. doi: 10.3390/nano13182528.
Injuries to the peripheral nervous system are a common clinical issue, causing dysfunctions of the motor and sensory systems. Surgical interventions such as nerve autografting are necessary to repair damaged nerves. Even with autografting, i.e., the gold standard, malfunctioning and mismatches between the injured and donor nerves often lead to unwanted failure. Thus, there is an urgent need for a new intervention in clinical practice to achieve full functional recovery. Nerve guidance conduits (NGCs), providing physicochemical cues to guide neural regeneration, have great potential for the clinical regeneration of peripheral nerves. Typically, NGCs are tubular structures with various configurations to create a microenvironment that induces the oriented and accelerated growth of axons and promotes neuron cell migration and tissue maturation within the injured tissue. Once the native neural environment is better understood, ideal NGCs should maximally recapitulate those key physiological attributes for better neural regeneration. Indeed, NGC design has evolved from solely physical guidance to biochemical stimulation. NGC fabrication requires fundamental considerations of distinct nerve structures, the associated extracellular compositions (extracellular matrices, growth factors, and cytokines), cellular components, and advanced fabrication technologies that can mimic the structure and morphology of native extracellular matrices. Thus, this review mainly summarizes the recent advances in the state-of-the-art NGCs in terms of biomaterial innovations, structural design, and advanced fabrication technologies and provides an in-depth discussion of cellular responses (adhesion, spreading, and alignment) to such biomimetic cues for neural regeneration and repair.
外周神经系统损伤是常见的临床问题，可导致运动和感觉系统功能障碍。神经自体移植等手术干预对于修复受损神经是必要的。即使采用自体移植这种黄金标准方法，受损神经与供体神经之间的功能异常和不匹配也常常导致不理想的失败结果。因此，临床实践迫切需要新的干预措施以实现完全功能恢复。神经引导导管（NGC）能提供物理化学线索来引导神经再生，在外周神经临床再生方面具有巨大潜力。通常，NGC是具有各种结构的管状结构，可营造一种微环境，诱导轴突定向加速生长，并促进受损组织内神经元细胞迁移和组织成熟。一旦对天然神经环境有了更好的理解，理想的NGC应最大程度地重现那些关键生理特性，以实现更好的神经再生。事实上，NGC的设计已从单纯的物理引导发展到生化刺激。NGC的制造需要从不同神经结构、相关细胞外成分（细胞外基质、生长因子和细胞因子）、细胞成分以及能够模拟天然细胞外基质结构和形态的先进制造技术等方面进行基础考量。因此，本综述主要总结了在生物材料创新、结构设计和先进制造技术方面最先进的NGC的最新进展，并深入讨论了细胞对这种用于神经再生和修复的仿生线索的反应（黏附、铺展和排列）。
