中国神经再生研究(英文版) ›› 2023, Vol. 18 ›› Issue (6): 1229-1234.doi: 10.4103/1673-5374.358616

• 综述:周围神经损伤修复保护与再生 • 上一篇    下一篇

周围神经再生的转化生物工程策略:机遇、挑战和新概念

  

  • 出版日期:2023-06-15 发布日期:2022-12-22

Translational bioengineering strategies for peripheral nerve regeneration: opportunities, challenges, and novel concepts

Karim A. Sarhane1, Chenhu Qiu2, 3, 4, Thomas G.W. Harris1, Philip J. Hanwright1, Hai-Quan Mao2, 3, 4, 5, Sami H. Tuffaha1, *   

  1. 1Department of Plastic and Reconstructive Surgery, Peripheral Nerve Research Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA;  2Department of Materials Science and Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, MD, USA;  3Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, USA;  4Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA;  5Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
  • Online:2023-06-15 Published:2022-12-22
  • Contact: Sami H. Tuffaha, MD, stuffah1@jhmi.edu.
  • Supported by:
    This work was partly supported by The Plastic Surgery Foundation Research Pilot Grant, No. 627383 (to KAS).

摘要: https://orcid.org/0000-0003-2921-0928 (Sami H. Tuffaha) 

Abstract: Peripheral nerve injuries remain a challenging problem in need of better treatment strategies. Despite best efforts at surgical reconstruction and postoperative rehabilitation, patients are often left with persistent, debilitating motor and sensory deficits. There are currently no therapeutic strategies proven to enhance the regenerative process in humans. A clinical need exists for the development of technologies to promote nerve regeneration and improve functional outcomes. Recent advances in the fields of tissue engineering and nanotechnology have enabled biomaterial scaffolds to modulate the host response to tissue repair through tailored mechanical, chemical, and conductive cues. New bioengineered approaches have enabled targeted, sustained delivery of protein therapeutics with the capacity to unlock the clinical potential of a myriad of neurotrophic growth factors that have demonstrated promise in enhancing regenerative outcomes. As such, further exploration of combinatory strategies leveraging these technological advances may offer a pathway towards clinically translatable solutions to advance the care of patients with peripheral nerve injuries. This review first presents the various emerging bioengineering strategies that can be applied for the management of nerve gap injuries. We cover the rationale and limitations for their use as an alternative to autografts, focusing on the approaches to increase the number of regenerating axons crossing the repair site, and facilitating their growth towards the distal stump. We also discuss the emerging growth factor-based therapeutic strategies designed to improve functional outcomes in a multimodal fashion, by accelerating axonal growth, improving the distal regenerative environment, and preventing end-organs atrophy.  

Key words: bioengineering, biomaterials, growth hormone, insulin-like growth factor 1, nanotechnology, neurobiology, peripheral nerve regeneration, Schwann cells, translational research