Mehdipour Melod, Thakkar Vanshit, Chang Stephano
College of Medicine, California Northstate University, Elk Grove, CA, USA.
Davis (Alumnus), University of California, Sacramento, CA, USA.
Geroscience. 2025 Sep 12. doi: 10.1007/s11357-025-01882-5.
Peripheral nerve injuries (PNI) present a significant challenge, particularly in aging populations where Schwann cell dysfunction, reduced c-Jun expression, increased senescence, and impaired myelin clearance hinder regeneration. Targeted therapies aim to restore Schwann cell plasticity and improve nerve repair. These include gene therapy to upregulate c-Jun, senolytic agents to eliminate senescent Schwann cells, pharmacological activation of JNK, ferroptosis inhibition, and stem cell-based transplantation. Biomaterial advancements, such as nerve guidance conduits, extracellular matrix hydrogels, and 3D-printed scaffolds, provide structural and biochemical support. Despite these advances, clinical translation remains challenging due to patient heterogeneity, the need for personalized approaches, and regulatory considerations. Integrating multimodal strategies holds promise for optimizing peripheral nerve repair in aging individuals. Future research must refine these therapies to develop clinically viable solutions that enhance functional recovery and improve quality of life for patients with PNI.
周围神经损伤（PNI）是一项重大挑战，尤其是在老年人群中，雪旺细胞功能障碍、c-Jun表达降低、衰老增加以及髓鞘清除受损会阻碍神经再生。靶向治疗旨在恢复雪旺细胞可塑性并改善神经修复。这些治疗方法包括上调c-Jun的基因治疗、消除衰老雪旺细胞的衰老细胞溶解剂、JNK的药理学激活、铁死亡抑制以及基于干细胞的移植。生物材料的进步，如神经引导导管、细胞外基质水凝胶和3D打印支架，提供了结构和生化支持。尽管取得了这些进展，但由于患者的异质性、个性化方法的需求以及监管方面的考虑，临床转化仍然具有挑战性。整合多模式策略有望优化老年个体的周围神经修复。未来的研究必须完善这些治疗方法，以开发出临床上可行的解决方案，提高功能恢复并改善PNI患者的生活质量。
