Progress and perspectives of neural tissue engineering

doi:10.1007/s11684-015-0415-x

Front. Med.

2015, Vol. 9

Issue (4) : 401-411 https://doi.org/10.1007/s11684-015-0415-x

REVIEW

Progress and perspectives of neural tissue engineering

Xiaosong Gu(

)

Jiangsu Key Laboratory of Neuroregeneration, Co-innovation Center of Neuroregeneration, Nantong University, Nantong 226001, China

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Abstract

Traumatic injuries to the nervous system lead to a common clinical problem with a quite high incidence and affect the patient’s quality of life. Based on a major challenge not yet addressed by current therapeutic interventions for these diseases, a novel promising field of neural tissue engineering has emerged, grown, and attracted increasing interest. This review provides a brief summary of the recent progress in the field, especially in combination with the research experience of the author’s group. Several important aspects related to tissue engineered nerves, including the theory on their construction, translation into the clinic, improvements in fabrication technologies, and the formation of a regenerative environment, are delineated and discussed. Furthermore, potential research directions for the future development of neural tissue engineering are suggested.

Keywords nerve injury tissue engineering nerve grafts

Just Accepted Date: 11 September 2015 Online First Date: 13 October 2015 Issue Date: 26 November 2015

Cite this article:

Xiaosong Gu. Progress and perspectives of neural tissue engineering[J]. Front. Med., 2015, 9(4): 401-411.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-015-0415-x
https://academic.hep.com.cn/fmd/EN/Y2015/V9/I4/401

Fig.1 An innovative theory about the construction of tissue engineered nerves. (A) Schematic showing that a neural scaffold consists of a porous, biomaterial-based nerve guidance conduit (NGC) and intraluminal filaments. (B) Schematic showing the regeneration process of injured neurons with help of a neural scaffold, which allows vascularization from the nerve stump and trans-wall blood vessel infiltration to provide nutrition for Schwann cell migration and axonal extension and to facilitate reinnervation of target muscles. (C) Schematic showing that a neural scaffold protects and guides axonal regrowth and Schwann cell migration. (D) Schematic showing preferential reinnervation of basal lamina tubes in the distal nerve stump by corresponding motor, sensory, and sympathetic axons. (E) Schematic showing that chitooligosaccharides (COS) promote nerve regeneration and stimulate Schwann cell proliferation via the miRNA-27a/FOXO1 axis.

Fig.2 Repair of 50 mm-long median nerve defects in rhesus monkeys with marrow mesenchymal stem cell-containing, chitosan-based tissue engineered nerve grafts (TENFs). (A) The observation of finger function at 12 months post-surgery for TENG group (a and b) and non-grafted group (c and d). (B) The appearance and function of the thenar muscles observed at 12 months post-surgery for scaffold (a), TENG (b), autograft (c), and non-grafted (d) groups, in which arrows indicate the left, injured hand. (C) Gross view of the regenerated nerve-like tissue segment at 12 months post-surgery for scaffold (a), TENG (b), autograft (c), and non-grafted (d) groups. The arrow and arrowhead mark the proximal and distal coaptation, respectively. (D) CMAP examinations were performed at 12 months post-surgery. Representative recordings at the injured side in scaffold (a), TENG (b), and autograft (c) groups, respectively, or at the contralateral, uninjured side (d). Traces were recorded after stimulating the distal (upper) and proximal (lower) positions of the nerve trunk. Histograms respectively showing CMAP amplitudes (e) or motor nerve conduction velocities (f) detected at the injured side for scaffold, TENG, and autograft groups, as well as at the normal (contralateral uninjured) side. *P<0.05 versus normal side (on the corresponding distal or proximal position), and #P<0.05 versus autograft group. This Figure has been adapted from Ref. 35 with permission of Elsevier.

Fig.3 Bridging a 30 mm-long human median nerve gap in the distal forearm using a chitosan-based (chitosan/PGA) nerve graft. Intra-operative view (A) showing that the nerve graft (labeled with *) was implanted across a nerve gap between two nerve stumps (labeled with an arrow and arrowhead). Photographs (B−E) showing that functional recovery of target thenar muscles at 36 months after grafting enabled the injured hand to perform various actions, such as digital opposition of the thumb to the index and little fingers (B and C), coin picking (D), and handling of chopsticks (E). Representative electromyographic data depicting the compound muscle action potentials recorded on the right abductor pollicis of the patient at 36 months after grafting (F). This figure is adapted from Ref. 38 with permission from John Wiley & Sons, Inc.

Fig.4 Schematics showing benefits of a cell-derived extracellular matrix (ECM)-modified neural scaffold (nerve graft) for nerve regeneration. (A) Generation of cell-derived ECM-modified neural scaffolds. (B) Advantages of the ECM modifier within neural scaffolds. (C) Neuroprotective and neurotrophic effects of ECM-modified neural scaffolds.

Fig.5 Schematic showing the implications of a miRNA-based strategy in nerve injury and nerve regeneration. The indicated miRNAs have critical functions in neuronal survival, neurite outgrowth, and phenotype modulation in Schwann cells. Injection of miR-9 agomir or let-7 inhibitors into a nerve guidance conduit affects nerve regeneration.

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