Optimizing Peripheral Nerve Regeneration: Surgical Techniques, Biomolecular and Regenerative Strategies—A Narrative Review DOI Open Access
Andreea Grosu-Bularda,

Cristian-Vladimir Vancea,

Florin-Vlad Hodea

et al.

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(8), P. 3895 - 3895

Published: April 20, 2025

Peripheral nerve injury disrupts the function of peripheral nervous system, leading to sensory, motor, and autonomic deficits. While nerves possess an intrinsic regenerative capacity, complete sensory motor recovery remains challenging due unpredictable nature healing process, which is influenced by extent injury, age, timely intervention. Recent advances in microsurgical techniques, imaging technologies, a deeper understanding microanatomy have enhanced functional outcomes repair. Nerve initiates complex pathophysiological responses, including Wallerian degeneration, macrophage activation, Schwann cell dedifferentiation, axonal sprouting. Complete disruptions require surgical intervention restore continuity function. Direct repair gold standard for clean transections with minimal gaps. However, cases larger gaps or when direct not feasible, alternatives such as autologous grafting, vascularized grafts, conduits, allografts, transfers may be employed. Autologous grafts provide excellent biocompatibility but are limited donor site morbidity availability. Vascularized used large poorly recipient beds, while conduits serve promising solution smaller utilized neither nor grafting possible, often involving re-routing intact regional play pivotal role regeneration bridging gaps, significant advancements made material composition design. Emerging trends include use 3D bioprinting personalized gene therapy targeted growth factor delivery, nanotechnology nanofiber-based stem therapy. Advancements molecular sciences provided critical insights into cellular biochemical mechanisms underlying repair, therapies that enhance regeneration, remyelination, injuries. This review explores current strategies therapeutic management injuries, highlighting their indications, benefits, limitations, emphasizing need tailored approaches based on severity patient factors.

Language: Английский

Hydrogels for Peripheral Nerve Repair: Emerging Materials and Therapeutic Applications DOI Creative Commons

Oana Taisescu,

Venera Cristina Dinescu, Alexandra Daniela Rotaru-Zavaleanu

et al.

Gels, Journal Year: 2025, Volume and Issue: 11(2), P. 126 - 126

Published: Feb. 9, 2025

Peripheral nerve injuries pose a significant clinical challenge due to the complex biological processes involved in repair and their limited regenerative capacity. Despite advances surgical techniques, conventional treatments, such as autografts, are faced with limitations like donor site morbidity inconsistent functional outcomes. As such, there is growing interest new, novel, innovative strategies enhance regeneration. Tissue engineering/regenerative medicine its use of biomaterials an emerging example strategy. Within realm tissue engineering, functionalized hydrogels have gained considerable attention ability mimic extracellular matrix, support cell growth differentiation, even deliver bioactive molecules that can promote repair. These be engineered incorporate factors, peptides, stem cells, creating conducive microenvironment for cellular axonal Recent advancements materials well biology led development sophisticated hydrogel systems, not only provide structural support, but also actively modulate inflammation, recruitment, stimulate neurogenesis. This review explores potential peripheral repair, highlighting composition, biofunctionalization, mechanisms action. A comprehensive analysis preclinical studies provides insights into efficacy these promoting growth, neuronal survival, regeneration, and, ultimately, recovery. Thus, this aims illuminate promise transformative tool field bridging gap between complexity feasibility.

Language: Английский

Citations

1
Nerve Healing and Future Directions DOI

Christopher Jou,

Anisha Sonti,

Austin Kennemer

et al.

Operative Techniques in Orthopaedics, Journal Year: 2025, Volume and Issue: unknown, P. 101178 - 101178

Published: March 1, 2025

Language: Английский

Citations

0
Clinical evaluation of a novel disposable neurostimulator used to accelerate regeneration of injured peripheral nerves in the hand DOI Creative Commons
Christopher J. Coroneos,

Carolyn Lévis,

Michael P. Willand

et al.

Bioelectronic Medicine, Journal Year: 2025, Volume and Issue: 11(1)

Published: April 25, 2025

Abstract Background Preclinical and early clinical evidence demonstrates that electrical stimulation (ES) applied for one hour following surgical nerve intervention enhances axonal regeneration functional outcomes. Wide implementation however, has been hindered by a lack of suitably designed stimulators. The aim this pilot study was to investigate sensory recovery, safety, tolerability, RCT feasibility the use novel single-use stimulator deliver ES therapy in an acute transection cohort. Methods Patients with complete proper digital were included trial. An investigational version PeriPulse TM used intraoperative electrode implantation 1-hour delivered postoperatively. Patient tolerance assessed during visual-analogue pain scores collected at first post-operative visit. At 3- 6-months post-op, recovery quality life using 2-point discrimination, monofilament tests, Disability Arm, Shoulder, Hand (DASH) questionnaire, respectively. Results A total 10 patients enrolled. Intraoperative placement did not impact operating room time, taking less than 5 minutes implement. There no related adverse events. Participants reported tolerable reports pain. visit had mean score 0.6 (range 0 - 1.9). Pressure threshold detection significantly improved between baseline, 3 months 6 months. greater proportion treated (87.5%) hand pressure thresholds (diminished light touch or diminished protective sensation) compared historical comparator group. DASH over timeline. experienced minimal postoperative disability. Conclusions prototype delivery perioperative safe, well-tolerated, usable. Sensory demonstrated larger is feasible. Trial Registration NCT04732936; 2021 01 29

Language: Английский

Citations

0
Peripheral Nerve Protection Strategies: Recent Advances and Potential Clinical Applications DOI Creative Commons
Weronika Radecka,

Wiktoria Nogalska,

Maria Siemionow

et al.

Journal of Functional Biomaterials, Journal Year: 2025, Volume and Issue: 16(5), P. 153 - 153

Published: April 24, 2025

Peripheral nerve injuries (PNIs) are a significant clinical challenge, often resulting in persistent sensory and motor deficits despite surgical repair. Autologous grafts remain the gold standard for repair; however, outcomes frequently suboptimal due to donor site morbidity inconsistent functional recovery. A major obstacle regeneration is formation of postoperative adhesions fibrosis, which impede healing necessitate revision surgeries. Nerve protectors from biological, synthetic, hybrid materials offer promising tissue engineering strategy enhance regeneration. These applied as protective barrier when severed without gap, allowing direct They provide mechanical support reduce scarring. Biocompatible biological wraps, including vascularized fat flaps, vein collagen-based materials, human amniotic membrane (hAM), porcine small intestinal submucosa (PSIS), chitosan, modulate immune responses promote vascularization. Synthetic alternatives, like polycaprolactone (PCL), stability with controlled degradation. Hybrid such PCL-amnion, combine benefits both. Despite optimistic results, heterogeneity study methodologies hinders comparisons standardization. This review highlights latest developments their applications, limitations, future potential, guiding clinicians selecting most appropriate peripheral

Language: Английский

Citations

0
The Potential Role of Adipose-Derived Stem Cells in Regeneration of Peripheral Nerves DOI Creative Commons
PM Sunil, Sivan Padma Priya, Nada Tawfig Hashim

et al.

Neurology International, Journal Year: 2025, Volume and Issue: 17(2), P. 23 - 23

Published: Feb. 6, 2025

Peripheral nerve injuries are common complications in surgical and dental practices, often resulting functional deficiencies reduced quality of life. Current treatment choices, such as autografts, have limitations, including donor site morbidity suboptimal outcomes. Adipose-derived stem cells (ADSCs) shown assuring regenerative potential due to their accessibility, ease harvesting propagation, multipotent properties. This review investigates the therapeutic ADSCs peripheral regeneration, focusing on use bioengineered conduits supportive microenvironments. The analysis is constructed published case reports, organized reviews, clinical trials from Phase I III that investigate managing injuries, emphasizing both orofacial applications. findings highlight advantages promoting secretion angiogenic neurotrophic factors, support for cellular persistence, supplementing scaffold-based tissue repair. capabilities offer a novel approach augmenting repair recovery. accessibility adipose minimally invasive nature ADSC further encourage its prospective application an autologous cell source medicine. Future research needed ascertain standardized protocols optimize outcomes, paving way become mainstay regeneration.

Language: Английский

Citations

0
In vitro evaluation of dental pulp stem cells for sciatic nerve regeneration: foundations for future in vivo applications DOI Creative Commons
Bruna Lopes, Ana Catarina Sousa, Patrícia Sousa

et al.

Frontiers in Cell and Developmental Biology, Journal Year: 2025, Volume and Issue: 13

Published: Feb. 19, 2025

Peripheral nerve injuries, resulting from trauma or medical interventions, present significant clinical challenges due to their severe physiological and functional impacts. Despite various therapeutic approaches, optimal methods for promoting regeneration remain difficult obtain. This study is a preliminary step towards the future use of chitosan guide conduits combined with human dental pulp stem cells conditioned media promote regrowth in rat model sciatic damage. Preliminary characterization medium identified key regenerative biomarkers using Multiplexing LASER Bead analysis. The cells' cytocompatibility Reaxon® biomaterial was confirmed through viability metabolic assays PrestoBlue assay, along scanning electron microscopy energy-dispersive X-ray spectroscopy analyses. These vitro assessments validated potential combinations regeneration. Future vivo experiments will involve applying these model, evaluate efficacy. research aims establish as viable treatments peripheral injury, offering promising directions applications.

Language: Английский

Citations

0
Research and application of conductive nanofiber nerve guidance conduits for peripheral nerve regeneration: a narrative review DOI

Almas Chaudry,

Jinglei Wu, Hongsheng Wang

et al.

Advanced technology in neuroscience ., Journal Year: 2025, Volume and Issue: 2(1), P. 47 - 57

Published: Feb. 6, 2025

Autologous nerve grafting has long been considered the gold standard treatment for repairing peripheral injury. However, it faces challenges such as limited availability of donor nerves and complications at site. As a result, there an ongoing shift toward use novel biomaterials. Conductive nanofiber guidance conduits appear to be optimal solution due their excellent mechanical stability, structure, electrical stimulation properties, which can help restore original neural microenvironment. This review article focuses on in-depth investigation breakthroughs in conductive regeneration. It summarizes various materials that have used development conduits, including carbon nanofibers, multiwalled nanotubes, reduced graphene oxide, nanoparticles, polymers polypyrrole, polyaniline, polydioxothiophene. Furthermore, this also addresses contributions manufacturing strategies, hybrid electrospinning surface coating, electrical, mechanical, biological properties conduits. covers practical applications these improving cell function facilitating tissue repair. Although application prospects are promising, remain controlling ensure biocompatibility. Future research will focus addressing limitations optimize therapeutic technology, ultimately providing better outcomes patients with

Language: Английский

Citations

0
Optimizing Peripheral Nerve Regeneration: Surgical Techniques, Biomolecular and Regenerative Strategies—A Narrative Review DOI Open Access
Andreea Grosu-Bularda,

Cristian-Vladimir Vancea,

Florin-Vlad Hodea

et al.

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(8), P. 3895 - 3895

Published: April 20, 2025

Peripheral nerve injury disrupts the function of peripheral nervous system, leading to sensory, motor, and autonomic deficits. While nerves possess an intrinsic regenerative capacity, complete sensory motor recovery remains challenging due unpredictable nature healing process, which is influenced by extent injury, age, timely intervention. Recent advances in microsurgical techniques, imaging technologies, a deeper understanding microanatomy have enhanced functional outcomes repair. Nerve initiates complex pathophysiological responses, including Wallerian degeneration, macrophage activation, Schwann cell dedifferentiation, axonal sprouting. Complete disruptions require surgical intervention restore continuity function. Direct repair gold standard for clean transections with minimal gaps. However, cases larger gaps or when direct not feasible, alternatives such as autologous grafting, vascularized grafts, conduits, allografts, transfers may be employed. Autologous grafts provide excellent biocompatibility but are limited donor site morbidity availability. Vascularized used large poorly recipient beds, while conduits serve promising solution smaller utilized neither nor grafting possible, often involving re-routing intact regional play pivotal role regeneration bridging gaps, significant advancements made material composition design. Emerging trends include use 3D bioprinting personalized gene therapy targeted growth factor delivery, nanotechnology nanofiber-based stem therapy. Advancements molecular sciences provided critical insights into cellular biochemical mechanisms underlying repair, therapies that enhance regeneration, remyelination, injuries. This review explores current strategies therapeutic management injuries, highlighting their indications, benefits, limitations, emphasizing need tailored approaches based on severity patient factors.

Language: Английский

Citations

0