Bioactive nerve guides - anti-inflammatory and anti-scarring devices

点击翻译按钮获取中文摘要

Injury to peripheral nerves through trauma, and sometimes surgery, results in over 300,000 cases each year in the EU. In contrast to the central nervous system, proximal motor and sensory axons have some ability to repair. Individuals who sustain injury with no loss of tissue can be treated by directly suturing proximal and distal ends together, as end-end anastomosis. A fundamental understanding of the molecular and cellular responses to injury is essential when designing approaches for repair, especially for implantable nerve guide conduits (NGCs). We have reviewed NGC performance in detail1, with conclusions supporting biomaterials improvements in NGCs a realistic approach (e.g. versus cell therapy). NGCs are typically made from inert biomaterials (e.g. polyesters, collagen), and do not stimulate neuronal or Schwann cell adhesion, migration or differentiation for nerve repair. Consequently, existing devices are poor at supporting regeneration. A major challenge is to increase regeneration distance from a few millimetres to critical gap distances of 10-20 mm. For clinically practical improvement, simple innovations in the biomaterial chemistry, in combination with fabrication methods for making porous and flexible materials to reflect the mechanical properties of nerve are proposed and will be investigated in this project. In this project we also will address the problems of inflammation and scarring associated with nerve repair. Devices will therefore delivery key anti-inflammatories (a-MSH, IL-10) and/or an anti-scarring compound (M6P) known to improve functional repair. Devices will be evaluated in vitro, and in vivo in this PhD project, with a route to following on a clinical study of lingual nerve reconstruction.