Advanced Materials in Wireless, Implantable Electrical Stimulators that Offer Rapid Rates of Bioresorption for Peripheral Axon Regeneration
Advanced Materials in Wireless, Implantable Electrical Stimulators that Offer Rapid Rates of Bioresorption for Peripheral Axon Regeneration
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DOI：
10.1002/adfm.202102724
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发表时间：
2021-05-06
影响因子：
19
通讯作者：
Rogers, John A.
中科院分区：
文献类型：
--
作者：
Guo, Hexia;D'Andrea, Dom;Rogers, John A.
损伤的周围神经通常表现出不满意和不完整的功能结局，并且没有临床批准的治疗方法来改善再生。术后电刺激（ES）增加了轴突的再生，但实际的挑战，从延长手术室时间的成本到经皮导线放置相关的风险和陷阱，阻碍了广泛的临床应用。这项研究提出了一种可能的解决方案，即采用先进的生物可吸收材料，用于一种薄而柔韧的无线植入物，在手术后的短时间内精确控制受伤神经的ES。之后，快速、完整、安全的生物吸收模式自然、快速地将所有成分物质全部清除，无需手术提取。不同寻常的高生物吸收率源于使用独特的双层外壳，该外壳结合了两种不同的生物相容性形式的聚酸酐作为包封结构，以加速活性成分的吸收并限制碎片直到完全吸收。胫骨神经再吻合小鼠模型的结果表明，该系统提供了与传统有线刺激器相匹配的性能和疗效水平，但不需要延长手术时间或提取设备硬件。
Injured peripheral nerves typically exhibit unsatisfactory and incomplete functional outcomes, and there are no clinically approved therapies for improving regeneration. Post-operative electrical stimulation (ES) increases axon regrowth, but practical challenges, from the cost of extended operating room time to the risks and pitfalls associated with transcutaneous wire placement, have prevented broad clinical adoption. This study presents a possible solution in the form of advanced bioresorbable materials for a type of thin, flexible, wireless implant that provides precisely controlled ES of the injured nerve for a brief time in the immediate post-operative period. Afterward, rapid, complete, and safe modes of bioresorption naturally and quickly eliminate all of the constituent materials in their entirety, without the need for surgical extraction. The unusually high rate of bioresorption follows from the use of a unique, bilayer enclosure that combines two distinct formulations of a biocompatible form of polyanhydride as an encapsulating structure, to accelerate the resorption of active components and confine fragments until complete resorption. Results from mouse models of tibial nerve transection with re-anastomosis indicate that this system offers levels of performance and efficacy that match those of conventional wired stimulators, but without the need to extend the operative period or to extract the device hardware.