Neural Regeneration Research ›› 2016, Vol. 11 ›› Issue (4): 525-528.doi: 10.4103/1673-5374.180724

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A novel technique using hydrophilic polymers to promote axonal fusion

Ravinder Bamba1, 2, *, D. Colton Riley1, 3, Nathaniel D. Kelm4, Mark D. Does4, Richard D. Dortch5, Wesley P. Thayer1   

  1. 1 Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
    2 Department of Surgery, Georgetown University, Washington, DC, USA
    3 Georgetown University School of Medicine, Washington, DC, USA
    4 Vanderbilt University Institute of Imaging Science, Nashville, TN, USA
    5 Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
  • Received:2016-02-26 Online:2016-04-30 Published:2016-04-30
  • Contact: Ravinder Bamba, M.D., Ravinder.bamba@vanderbilt.edu.
  • Supported by:

    This work was supported by the Department of Defense: Grant Number OR120216--Development of Class II Medical Device for Clinical Translation of a Novel PEG Fusion Method for Immediate Physiological Recovery after Peripheral Nerve Injury.

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Abstract:

The management of traumatic peripheral nerve injury remains a considerable concern for clinicians. With
minimal innovations in surgical technique and a limited number of specialists trained to treat peripheral
nerve injury, outcomes of surgical intervention have been unpredictable. The inability to manipulate the
pathophysiology of nerve injury (i.e., Wallerian degeneration) has left scientists and clinicians depending
on the slow and lengthy process of axonal regeneration (~1 mm/day). When axons are severed, the endings
undergo calcium-mediated plasmalemmal sealing, which limits the ability of the axon to be primarily repaired.
Polythethylene glycol (PEG) in combination with a bioengineered process overcomes the inability
to fuse axons. The mechanism for PEG axonal fusion is not clearly understood, but multiple studies have
shown that a providing a calcium-free environment is essential to the process known as PEG fusion. The
proposed mechanism is PEG-induced lipid bilayer fusion by removing the hydration barrier surrounding
the axolemma and reducing the activation energy required for membrane fusion to occur. This review
highlights PEG fusion, its past and current studies, and future directions in PEG fusion.

Key words: peripheral nerve injury, polyethylene glycol, axonal fusion, nerve transection, traumatic neuropathy