Advances and clinical challenges for translating nerve conduit technology from bench to bed side for peripheral nerve re
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REVIEW
Advances and clinical challenges for translating nerve conduit technology from bench to bed side for peripheral nerve repair Poonam Meena1 · Anupama Kakkar1 · Mukesh Kumar1 · Nitin Khatri1 · Rakesh Kumar Nagar1 · Aarti Singh1 · Poonam Malhotra1 · Manish Shukla1 · Sumit Kumar Saraswat1 · Supriya Srivastava1 · Rajan Datt1 · Siddharth Pandey1 Received: 27 April 2020 / Accepted: 14 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Injuries to the peripheral nervous system remain a large-scale clinical problem. These injuries often lead to loss of motor and/or sensory function that significantly affects patients’ quality of life. The current neurosurgical approach for peripheral nerve repair involves autologous nerve transplantation, which often leads to clinical complications. The most pressing need is to increase the regenerative capacity of existing tubular constructs in the repair of large nerve gaps through development of tissue-engineered approaches that can surpass the performance of autografts. To fully realize the clinical potential of nerve conduit technology, there is a need to reconsider design strategies, biomaterial selection, fabrication techniques and the various potential modifications to optimize a conduit microenvironment that can best mimic the natural process of regeneration. In recent years, a significant progress has been made in the designing and functionality of bioengineered nerve conduits to bridge long peripheral nerve gaps in various animal models. However, translation of this work from lab to commercial scale has not been achieve. The current review summarizes recent advances in the development of tissue engineered nerve guidance conduits (NGCs) with regard to choice of material, novel fabrication methods, surface modifications and regenerative cues such as stem cells and growth factors to improve regeneration performance. Also, the current clinical potential and future perspectives to achieve therapeutic benefits of NGCs will be discussed in context of peripheral nerve regeneration. Keywords Peripheral nerve · Mesenchymal stem cells · Nerve guidance conduit · Schwann cell · Autograft · Sciatic nerve
Introduction Peripheral nerve injury remains a challenging clinical problem in terms of both incidence and severity. Injuries in the peripheral nervous system most commonly arise from industrial or military trauma, and less frequently, from degenerative conditions or congenital defects (Faroni et al. 2015). These injuries have limited treatment options and poor clinical outcomes, which results in an enormous devastating impact on socioeconomic burden on the society. Peripheral nerve injury causes common disability and a devastating impact on the patient’s quality of life. Indeed, annually more than 5 million cases of peripheral nerve injuries * Siddharth Pandey [email protected]; [email protected] 1
Department of Life Sciences, Datt Mediproducts Pvt. Ltd., Roz Ka Meo Industrial Area, District Mewat, Nuh 122103, District Haryana, Indi
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