神经移植物血运重建的生物工程方法:目前的概念和未来的方向。

IF 4.6 3区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Clifford Pereira, Sabrina Valentina Lazar, Aijun Wang
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引用次数: 2

摘要

外周神经损伤(PNI)是民用和军用损伤中最常见的神经损伤,在美国每年有超过360,000例PNI手术。神经组织的节段性缺损导致神经间隙,无法进行无张力的初级修复,在这种情况下,采用间位自体或脱细胞异体神经移植物来弥补间隙。移植物缺血时间是获得满意神经再生的关键因素。为了维持雪旺细胞的生长,快速的神经移植物血运重建是必不可少的,而雪旺细胞的生长又对轴突再生至关重要。目前,自体神经移植被认为是治疗节段性神经间隙的金标准,但也存在一些缺点,如供体组织供应有限、手术时间增加和供体部位发病率。因此,容易获得的、现成的同种异体神经移植物或支架正在被研究,因为它们具有诸如几乎无限来源、多种尺寸以匹配受体神经以及无供体部位发病率等优点。新的,令人兴奋的进展,组织工程,以增加神经移植物或导管的血运重建已被调查。策略包括促血管生成间充质干细胞、细胞外囊泡、功能化支架、生物活性肽和三维生物打印。本文讨论了这些生物工程的进展和未来的策略,旨在加强神经移植和支架血运重建。本文分类为:神经系统疾病>生物医学工程神经系统疾病>分子与细胞生理学。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bioengineering approaches for nerve graft revascularization: Current concepts and future directions.

Peripheral nerve injury (PNI) is the most common neurological injury in civilian and military injuries, with over 360,000 PNI procedures performed in the US yearly. Segmental loss of nerve tissue results in a nerve gap precluding a tension-free primary repair, and in these cases, interpositional autologous or acellular nerve allografts are used to bridge the gap. Graft ischemia time is a critical factor in achieving satisfactory nerve regeneration. Rapid nerve graft revascularization is essential in order to sustain Schwann cell growth which in turn is crucial for axonal regeneration. Currently, nerve autografts are considered the gold standard for segmental nerve gaps but are associated with several disadvantages such as limited supply of expendable donor tissue, increased operative time, and donor site morbidity. Hence, readily available, off-the-shelf nerve allografts or scaffolds are being investigated since they provide advantages such as a virtually limitless sourcing, a wide variety of sizes to match recipient nerves, and no donor site morbidity. New, exciting advances in tissue engineering to augment revascularization of nerve allografts or conduits have been investigated. Strategies include pro-angiogenic mesenchymal stem cells, extracellular vesicles, functionalized scaffolds, bioactive peptides, and three-dimensional bioprinting. This article discusses these bioengineering advances and future strategies aimed at enhancing nerve graft and scaffold revascularization. This article is categorized under: Neurological Diseases > Biomedical Engineering Neurological Diseases > Molecular and Cellular Physiology.

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来源期刊
WIREs Mechanisms of Disease
WIREs Mechanisms of Disease MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
11.40
自引率
0.00%
发文量
45
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