Fundamentals and Current Strategies for Peripheral Nerve Repair and Regeneration
A body of evidence indicates that peripheral nerves have an extraordinary yet limited capacity to regenerate after an injury. Peripheral nerve injuries have confounded professionals in this field, from neuroscientists to neurologists, plastic surgeons, an
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Cristiana R. Carvalho, Rui L. Reis, and Joaquim M. Oliveira
Abstract
peripheral nerve anatomy and overview the challenges and scientific evidences related to peripheral nerve injury and repair mechanisms. The most relevant reports dealing with the use of both synthetic and natural-based biomaterials used in tissue engineering strategies when treatment of nerve injuries is envisioned are also discussed in depth, along with the state-of-the-art approaches in this field.
A body of evidence indicates that peripheral nerves have an extraordinary yet limited capacity to regenerate after an injury. Peripheral nerve injuries have confounded professionals in this field, from neuroscientists to neurologists, plastic surgeons, and the scientific community. Despite all the efforts, full functional recovery is still seldom. The inadequate results attained with the “gold Keywords standard” autograft procedure still encourage a dynamic and energetic research around the Peripheral nerve regeneration · Tissue world for establishing good performing tissue- engineering · Biomaterials engineered alternative grafts. Resourcing to nerve guidance conduits, a variety of methods have been experimentally used to bridge peripheral nerve gaps of limited size, up to 12.1 Introduction 30–40 mm in length, in humans. Herein, we aim to summarize the fundamentals related to The most significant advances in peripheral nerve repair and regeneration have been achieved over the last years with the improvement of technoC. R. Carvalho · R. L. Reis · J. M. Oliveira (*) 3B’s Research Group, I3Bs – Research Institute on logical tools. However, the study of nerve and its Biomaterials, Biodegradables and Biomimetics, regenerative potential initiated in earlier times, Headquarters of the European Institute of Excellence possibly in the ancient Greek period [1]. on Tissue Engineering and Regenerative Medicine, Nevertheless, the establishment of the basic University of Minho, Guimarães, Portugal notions and modern concepts of nerve repair and ICVS/3B’s – PT Government Associated Laboratory, regeneration were only developed in the twentiGuimarães, Portugal eth century with the emergence of the neurosurThe Discoveries Centre for Regenerative and gery field [2]. Precision Medicine, Headquarters at University of Minho, Guimarães, Portugal Peripheral nerve injuries (PNIs) usually e-mail: [email protected]; rgreis@ involve sensory and motor neurons and frequently i3bs.uminho.pt; [email protected]
© Springer Nature Singapore Pte Ltd. 2020 H. J. Chun et al. (eds.), Bioinspired Biomaterials, Advances in Experimental Medicine and Biology 1249, https://doi.org/10.1007/978-981-15-3258-0_12
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result in axonal loss and demyelination, depending on the severity of the injury. Under ideal conditions, regeneration of a nerve cable is followed by remyelination, thus allowing a certain degree of sensory and functional recovery to be achieved. In the clinics, PNI repair is based on the knowledge of physiological regenerative processes
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