Treatment methods for peripheral nerve injuries (a literature review)
DOI:
https://doi.org/10.14739/2310-1210.2023.4.273073Keywords:
mesenchymal stem cells, injury, peripheral nerveAbstract
Aim: to analyze modern professional literature and summarize data on treatment methods for peripheral nerve injuries, taking into account the mechanisms of positive effects.
The article presents an overview of possible methods for treatment of peripheral nerve injuries, fundamental classifications of peripheral nerve injuries, their differences are considered, pathophysiological mechanisms and the probability of spontaneous recovery depending on the degree of injury, general principles and conditions for successful regeneration of the peripheral nerve. Options, combinations, advantages and disadvantages of such surgical methods for peripheral nerve injury treatment as neurorrhaphy, autotransplantation and allotransplantation are described in detail, such terms as “small”, “large” and “critical” gaps between the nerve stumps are specified. Classifications and characteristics of conduits are described, types of synthetic conduits are considered. The use of drugs, Schwann cells, growth and neurotrophic factors, neural, embryonic and mesenchymal stem cells of various origins, exosomes of mesenchymal stem cells in the so-called “stem cell-free therapy” in treating this pathology is mentioned. Genetically modified mesenchymal stem cells, optokinetics are also noted, such physical methods for peripheral nerve injury treatment as short-term low-frequency electrical stimulation of the nerve, magnetic stimulation, low-intensity ultrasound, photobiomodulation therapy, photochemical bonding are discussed, indicating some mechanisms of their positive effects.
Conclusions. Improving the quality of life and reducing the degree of disability in patients with injuries of the main nerve trunks depends on the combined use of a number of surgical, bioengineering and regenerative technologies. These involve the restoration of the anatomical continuity of the nerve, including through the use of natural or artificial elements, cellular technologies and the management of regenerative processes. Therefore, every time, a surgeon is facing a major challenge to create a combination of various means from the indicated basic components for the treatment of nerve damage in managing a particular patient. However, such a treatment approach requires proper competences of surgeons as well as specific material and technical bases in order to bring down the level of social tension in patients with injuries of the main nerve trunks.
References
Fornasari, B. E., El Soury, M., Nato, G., Fucini, A., Carta, G., Ronchi, G., Crosio, A., Perroteau, I., Geuna, S., Raimondo, S., & Gambarotta, G. (2020). Fibroblasts Colonizing Nerve Conduits Express High Levels of Soluble Neuregulin1, a Factor Promoting Schwann Cell Dedifferentiation. Cells, 9(6), 1366.
Kubiak, C. A., Grochmal, J., Kung, T. A., Cederna, P. S., Midha, R., & Kemp, S. W. P. (2020). Stem-cell-based therapies to enhance peripheral nerve regeneration. Muscle & nerve, 61(4), 449-459.
Modrak, M., Talukder, M. A. H., Gurgenashvili, K., Noble, M., & Elfar, J. C. (2020). Peripheral nerve injury and myelination: Potential therapeutic strategies. Journal of neuroscience research, 98(5), 780-795.
Mao, Q., Nguyen, P. D., Shanti, R. M., Shi, S., Shakoori, P., Zhang, Q., & Le, A. D. (2019). Gingiva-Derived Mesenchymal Stem Cell-Extracellular Vesicles Activate Schwann Cell Repair Phenotype and Promote Nerve Regeneration. Tissue engineering. Part A, 25(11-12), 887-900.
Moattari, M., Kouchesfehani, H. M., Kaka, G., Sadraie, S. H., & Naghdi, M. (2018). Evaluation of nerve growth factor (NGF) treated mesenchymal stem cells for recovery in neurotmesis model of peripheral nerve injury. Journal of cranio-maxillo-facial surgery, 46(6), 898-904.
Yousefi, F., Lavi Arab, F., Nikkhah, K., Amiri, H., & Mahmoudi, M. (2019). Novel approaches using mesenchymal stem cells for curing peripheral nerve injuries. Life sciences, 221, 99-108.
Zhang, R. C., Du, W. Q., Zhang, J. Y., Yu, S. X., Lu, F. Z., Ding, H. M., Cheng, Y. B., Ren, C., & Geng, D. Q. (2021). Mesenchymal stem cell treatment for peripheral nerve injury: a narrative review. Neural regeneration research, 16(11), 2170-2176.
Seddon, H. J. (1943). Three types of nerve injury. Brain, 66(4), 237-288. https://doi.org/10.1093/brain/66.4.237
Bojanic, C., To, K., Zhang, B., Mak, C., & Khan, W. S. (2020). Human umbilical cord derived mesenchymal stem cells in peripheral nerve regeneration. World journal of stem cells, 12(4), 288-302.
Sunderland, S. A. (1951). Classification of peripheral nerve injures producing loss of function. Brain, 74(4), 491-516. https://doi.org/10.1093/brain/74.4.491
Alvites, R., Rita Caseiro, A., Santos Pedrosa, S., Vieira Branquinho, M., Ronchi, G., Geuna, S., Varejão, A., & Colette Maurício, A. (2018). Peripheral nerve injury and axonotmesis: State of the art and recent advances. Cogent Medicine, 5(1), 1466404. https://doi.org/10.1080/2331205x.2018.1466404
Fu, S. Y., & Gordon, T. (1997). The cellular and molecular basis of peripheral nerve regeneration. Molecular neurobiology, 14(1-2), 67-116. https://doi.org/10.1007/BF02740621
Duffy, P., McMahon, S., Wang, X., Keaveney, S., O'Cearbhaill, E. D., Quintana, I., Rodríguez, F. J., & Wang, W. (2019). Synthetic bioresorbable poly-α-hydroxyesters as peripheral nerve guidance conduits; a review of material properties, design strategies and their efficacy to date. Biomaterials science, 7(12), 4912-4943. https://doi.org/10.1039/c9bm00246d
Gordon, T. (2020). Peripheral Nerve Regeneration and Muscle Reinnervation. International journal of molecular sciences, 21(22), 8652. https://doi.org/10.3390/ijms21228652
Kaiser, R., Ullas, G., Havránek, P., Homolková, H., Miletín, J., Tichá, P., & Sukop, A. (2017). Current concepts in peripheral nerve injury repair. Acta chirurgiae plasticae, 59(2), 85-91.
Liu, C., Fan, L., Tian, Z., Wen, H., Zhou, L., Guan, P., Luo, Y., Chan, C., Tan, G., Ning, C., Rong, L., & Liu, B. (2021). Self-curling electroconductive nerve dressing for enhancing peripheral nerve regeneration in diabetic rats. Bioactive materials, 6(11), 3892-3903. https://doi.org/10.1016/j.bioactmat.2021.03.034
Jiang, L., Jones, S., & Jia, X. (2017). Stem Cell Transplantation for Peripheral Nerve Regeneration: Current Options and Opportunities. International journal of molecular sciences, 18(1), 94.
Lopes, B., Sousa, P., Alvites, R., Branquinho, M., Sousa, A. C., Mendonça, C., Atayde, L. M., Luís, A. L., Varejão, A. S. P., & Maurício, A. C. (2022). Peripheral Nerve Injury Treatments and Advances: One Health Perspective. International journal of molecular sciences, 23(2), 918.
Hussain, G., Wang, J., Rasul, A., Anwar, H., Qasim, M., Zafar, S., Aziz, N., Razzaq, A., Hussain, R., de Aguilar, J. G., & Sun, T. (2020). Current Status of Therapeutic Approaches against Peripheral Nerve Injuries: A Detailed Story from Injury to Recovery. International journal of biological sciences, 16(1), 116-134.
Wang, J. P., Liao, Y. T., Wu, S. H., Chiang, E. R., Hsu, S. H., Tseng, T. C., & Hung, S. C. (2020). Mesenchymal stem cells from a hypoxic culture improve nerve regeneration. Journal of tissue engineering and regenerative medicine, 14(12), 1804-1814.
Rao, Z., Lin, Z., Song, P., Quan, D., & Bai, Y. (2022). Biomaterial-Based Schwann Cell Transplantation and Schwann Cell-Derived Biomaterials for Nerve Regeneration. Frontiers in cellular neuroscience, 16, 926222.
Mitsuzawa, S., Zhao, C., Ikeguchi, R., Aoyama, T., Kamiya, D., Ando, M., Takeuchi, H., Akieda, S., Nakayama, K., Matsuda, S., & Ikeya, M. (2020). Pro-angiogenic scaffold-free Bio three-dimensional conduit developed from human induced pluripotent stem cell-derived mesenchymal stem cells promotes peripheral nerve regeneration. Scientific reports, 10(1), 12034.
De la Rosa, M. B., Kozik, E. M., & Sakaguchi, D. S. (2018). Adult Stem Cell-Based Strategies for Peripheral Nerve Regeneration. Advances in experimental medicine and biology, 1119, 41-71. https://doi.org/10.1007/5584_2018_254
Cui, Y., Yao, Y., Zhao, Y., Xiao, Z., Cao, Z., Han, S., Li, X., Huan, Y., Pan, J., & Dai, J. (2018). Functional collagen conduits combined with human mesenchymal stem cells promote regeneration after sciatic nerve transection in dogs. Journal of tissue engineering and regenerative medicine, 12(5), 1285-1296.
Meena, P., Kakkar, A., Kumar, M., Khatri, N., Nagar, R. K., Singh, A., Malhotra, P., Shukla, M., Saraswat, S. K., Srivastava, S., Datt, R., & Pandey, S. (2021). Advances and clinical challenges for translating nerve conduit technology from bench to bed side for peripheral nerve repair. Cell and tissue research, 383(2), 617-644.
Lavorato, A., Raimondo, S., Boido, M., Muratori, L., Durante, G., Cofano, F., Vincitorio, F., Petrone, S., Titolo, P., Tartara, F., Vercelli, A., & Garbossa, D. (2021). Mesenchymal Stem Cell Treatment Perspectives in Peripheral Nerve Regeneration: Systematic Review. International journal of molecular sciences, 22(2), 572.
Leite, A. P. S., Pinto, C. G., Tibúrcio, F. C., Sartori, A. A., de Castro Rodrigues, A., Barraviera, B., Ferreira, R. S., Junior, Filadelpho, A. L., & Matheus, S. M. M. (2019). Heterologous fibrin sealant potentiates axonal regeneration after peripheral nerve injury with reduction in the number of suture points. Injury, 50(4), 834-847. https://doi.org/10.1016/j.injury.2019.03.027
Armaiz Flores, A., & Wang, H. (2018). The Use and Delivery of Stem Cells in Nerve Regeneration: Preclinical Evidence and Regulatory Considerations. Annals of plastic surgery, 80(4), 448-456.
Rhode, S. C., Beier, J. P., & Ruhl, T. (2021). Adipose tissue stem cells in peripheral nerve regeneration-In vitro and in vivo. Journal of neuroscience research, 99(2), 545-560.
Zhang, Q., Nguyen, P. D., Shi, S., Burrell, J. C., Cullen, D. K., & Le, A. D. (2018). 3D bio-printed scaffold-free nerve constructs with human gingiva-derived mesenchymal stem cells promote rat facial nerve regeneration. Scientific reports, 8(1), 6634.
Li, Q., Li, T., Cao, X. C., Luo, D. Q., & Lian, K. J. (2016). Methylprednisolone microsphere sustained-release membrane inhibits scar formation at the site of peripheral nerve lesion. Neural regeneration research, 11(5), 835-841.
Tseng, K. C., Li, H., Clark, A., Sundem, L., Zuscik, M., Noble, M., & Elfar, J. (2016). 4-Aminopyridine promotes functional recovery and remyelination in acute peripheral nerve injury. EMBO molecular medicine, 8(12), 1409-1420.
Carvalho, C. R., Oliveira, J. M., & Reis, R. L. (2019). Modern Trends for Peripheral Nerve Repair and Regeneration: Beyond the Hollow Nerve Guidance Conduit. Frontiers in bioengineering and biotechnology, 7, 337.
McGregor, C. E., & English, A. W. (2019). The Role of BDNF in Peripheral Nerve Regeneration: Activity-Dependent Treatments and Val66Met. Frontiers in cellular neuroscience, 12, 522.
Sayad Fathi, S., & Zaminy, A. (2017). Stem cell therapy for nerve injury. World journal of stem cells, 9(9), 144-151.
Wang, Y., Yin, P., Bian, G. L., Huang, H. Y., Shen, H., Yang, J. J., Yang, Z. Y., & Shen, Z. Y. (2017). The combination of stem cells and tissue engineering: an advanced strategy for blood vessels regeneration and vascular disease treatment. Stem cell research & therapy, 8(1), 194. https://doi.org/10.1186/s13287-017-0642-y
Yin, K., Wang, S., & Zhao, R. C. (2019). Exosomes from mesenchymal stem/stromal cells: a new therapeutic paradigm. Biomarker research, 7, 8.
Maqsood, M., Kang, M., Wu, X., Chen, J., Teng, L., & Qiu, L. (2020). Adult mesenchymal stem cells and their exosomes: Sources, characteristics, and application in regenerative medicine. Life sciences, 256, 118002.
Hu, F., Zhang, X., Liu, H., Xu, P., Doulathunnisa, Teng, G., & Xiao, Z. (2017). Neuronally differentiated adipose-derived stem cells and aligned PHBV nanofiber nerve scaffolds promote sciatic nerve regeneration. Biochemical and biophysical research communications, 489(2), 171-178.
Yu, Z., Men, Y., & Dong, P. (2017). Schwann cells promote the capability of neural stem cells to differentiate into neurons and secret neurotrophic factors. Experimental and therapeutic medicine, 13(5), 2029-2035.
Cai, S., Tsui, Y. P., Tam, K. W., Shea, G. K., Chang, R. S., Ao, Q., Shum, D. K., & Chan, Y. S. (2017). Directed Differentiation of Human Bone Marrow Stromal Cells to Fate-Committed Schwann Cells. Stem cell reports, 9(4), 1097-1108. https://doi.org/10.1016/j.stemcr.2017.08.004
Carina, V., Costa, V., Raimondi, L., Pagani, S., Sartori, M., Figallo, E., Setti, S., Alessandro, R., Fini, M., & Giavaresi, G. (2017). Effect of low-intensity pulsed ultrasound on osteogenic human mesenchymal stem cells commitment in a new bone scaffold. Journal of applied biomaterials & functional materials, 15(3), e215-e222.
Wani, A. L. (2017). Understanding adult neurogenesis beyond its role in learning and memory formation. Educacion Medica, 18(2), 144-147.
Zuo, K. J., Gordon, T., Chan, K. M., & Borschel, G. H. (2020). Electrical stimulation to enhance peripheral nerve regeneration: Update in molecular investigations and clinical translation. Experimental neurology, 332, 113397.
Lanier, S. T., Hill, J. R., Dy, C. J., & Brogan, D. M. (2021). Evolving Techniques in Peripheral Nerve Regeneration. The Journal of hand surgery, 46(8), 695-701.
Paskal, A. M., Paskal, W., Pietruski, P., & Wlodarski, P. K. (2019). Polyethylene Glycol: The Future of Posttraumatic Nerve Repair? Systemic Review. International journal of molecular sciences, 20(6), 1478.
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