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Repair strategies for injured peripheral nerve: Review
Life Sciences ( IF 5.2 ) Pub Date : 2020-01-15 , DOI: 10.1016/j.lfs.2020.117308 Chand Raza 1 , Hasib Aamir Riaz 2 , Rabia Anjum 1 , Noor Ul Ain Shakeel 1
Life Sciences ( IF 5.2 ) Pub Date : 2020-01-15 , DOI: 10.1016/j.lfs.2020.117308 Chand Raza 1 , Hasib Aamir Riaz 2 , Rabia Anjum 1 , Noor Ul Ain Shakeel 1
Affiliation
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Compromised functional regains in about half of the patients following surgical nerve repair pose a serious socioeconomic burden to the society. Although surgical strategies such as end-to-end neurorrhaphy, nerve grafting and nerve transfer are widely applied in distal injuries leading to optimal recovery; however in proximal nerve defects functional outcomes remain unsatisfactory. Biomedical engineering approaches unite the efforts of the surgeons, engineers and biologists to develop regeneration facilitating structures such as extracellular matrix based supportive polymers and tubular nerve guidance channels. Such polymeric structures provide neurotrophic support from injured nerve stumps, retard the fibrous tissue infiltration and guide regenerating axons to appropriate targets. The development and application of nerve guidance conduits (NGCs) to treat nerve gap injuries offer clinically relevant and feasible solutions. Enhanced understanding of the nerve regeneration processes and advances in NGCs design, polymers and fabrication strategies have led to developing modern NGCs with superior regeneration-conducive capacities. Current review focuses on the advances in surgical and engineering approaches to treat peripheral nerve injuries. We suggest the incorporation of endothelial cell growth promoting cues and factors into the NGC interior for its possible enhancement effects on the axonal regeneration process that may result in substantial functional outcomes.
中文翻译：
受损周围神经的修复策略：回顾
神经修复手术后约一半患者的功能恢复受损，给社会带来严重的社会经济负担。尽管端对端神经缝合、神经移植和神经转移等手术策略广泛应用于远端损伤，从而实现最佳康复；然而，近端神经缺陷的功能结果仍然不令人满意。生物医学工程方法联合外科医生、工程师和生物学家的努力来开发促进再生的结构，例如基于细胞外基质的支持性聚合物和管状神经引导通道。这种聚合结构为受损的神经残端提供神经营养支持，延缓纤维组织浸润并引导再生轴突到达适当的目标。神经引导导管（NGC）的开发和应用治疗神经间隙损伤提供了临床相关且可行的解决方案。对神经再生过程的加深理解以及 NGC 设计、聚合物和制造策略的进步导致开发出具有卓越再生能力的现代 NGC。目前的综述重点关注治疗周围神经损伤的外科和工程方法的进展。我们建议将内皮细胞生长促进信号和因子纳入 NGC 内部，因为它可能对轴突再生过程产生增强作用，从而可能产生实质性的功能结果。
更新日期：2020-01-15
中文翻译：
受损周围神经的修复策略：回顾
神经修复手术后约一半患者的功能恢复受损，给社会带来严重的社会经济负担。尽管端对端神经缝合、神经移植和神经转移等手术策略广泛应用于远端损伤，从而实现最佳康复；然而，近端神经缺陷的功能结果仍然不令人满意。生物医学工程方法联合外科医生、工程师和生物学家的努力来开发促进再生的结构，例如基于细胞外基质的支持性聚合物和管状神经引导通道。这种聚合结构为受损的神经残端提供神经营养支持，延缓纤维组织浸润并引导再生轴突到达适当的目标。神经引导导管（NGC）的开发和应用治疗神经间隙损伤提供了临床相关且可行的解决方案。对神经再生过程的加深理解以及 NGC 设计、聚合物和制造策略的进步导致开发出具有卓越再生能力的现代 NGC。目前的综述重点关注治疗周围神经损伤的外科和工程方法的进展。我们建议将内皮细胞生长促进信号和因子纳入 NGC 内部，因为它可能对轴突再生过程产生增强作用，从而可能产生实质性的功能结果。
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