Translational development of a 3D bioactive nerve conduit for peripheral nerve repair, through application of topographical cues and stem cell support

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Using Biotechnology to Improve the Outcome Following Devastating Nerve Injuries Major nerve injuries can occur during birth, from accidental trauma, or as the result of cancer treatments. Unfortunately they are common (1-2 people in every 1000 each year), mainly affect young patients, and cause permanent disability. Many patients never return to gainful employment and all suffer long and painful recovery times. These injuries rank alongside cerebral palsy and spinal injury in terms of disability, and the effect on the lives of patients and their families. This in turn translates as a significant economic cost to society, both through medical interventions and loss of active members of workforce population. Furthermore, nerve repair limits what can be achieved with face or hand transplantation, and prevents useful transplantation of voiceboxes or legs, as the rate of healing is much slower and less successful than that of other types of tissue (e.g. skin/bone).Reconstructive microsurgeons can repair damaged nerves, but even under the best circumstances many nerve fibres fail to cross the site of surgical repair or grow back to give function. If the damaged segment of the nerve is more than 1cm long, a sensory nerve must be borrowed from elsewhere in the body to bridge the gap, this causes scarring and permanent numbness at the donor site where this is taken from. Recovery is always very slow (~18 months), painful, and inadequate, since <50% of nerve cells actually regrow through traditional nerve repairs. It is vital that we discover what controls nerve healing and it is well recognised that we need to develop new technologies to improve surgical outcomes for these patients. Promising work is underway at the University of Glasgow and it's collaborating laboratories on this important topic.Recent scientific advances in laboratory petri-dishes demonstrate that nerves heal better if the contour (topography) of the surface on they're growing on has tiny grooves to guide them - that knowledge has been applied to make tiny patterned tubes to use to direct the growth of repaired nerves. The tubes could also be used to deliver other useful treatments that will help the nerve fibres to grow better - for example a lot of research has been done by our laboratories and others, to show that stem cells taken from patient's fat (removed by liposuction), or safe drug treatments will also improve biological conditions for nerve healing. This project will combine these developments into a 3-D tube (conduit), that will be used to repair damaged nerves. The research will be undertaken at the world class research facilities in the Centre for Cell Engineering, University of Glasgow, and our partner laboratory in Sweden with detailed input from international experts (surgeons and scientists) in the field of nerve repair. By combining guidance cues, stem cells and drug treatments we believe we can enhance nerve healing, and improve quality of life for patients in the future. Clinical applications of this exciting biotechnology are widespread and include nerve injury following civilian/military trauma, cancer treatments, birth injury, and face, limb, or voicebox transplants.