Experimental repair of phrenic nerve using a polyglycolic acid and collagen tube

Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
The Journal of thoracic and cardiovascular surgery (Impact Factor: 4.17). 04/2007; 133(3):726-32. DOI: 10.1016/j.jtcvs.2006.08.089
Source: PubMed


The feasibility of a nerve guide tube for regeneration of the phrenic nerve with the aim of restoring diaphragmatic function was evaluated in a canine model.
The nerve tube, made of woven polyglycolic acid mesh, had a diameter of 3 mm and was filled with collagen sponge. This polyglycolic acid-collagen tube was implanted into a 10-mm gap created by transection of the right phrenic nerve in 9 beagle dogs. The tubes were implanted without a tissue covering in 5 of the 9 dogs (group I), and the tubes were covered with a pedicled pericardial fat pad in 4 dogs (group II). Chest x-ray films, muscle action potentials, and histologic samples were examined 4 to 12 months after implantation.
All of the dogs survived without any complications. x-ray film examination showed that the right diaphragm was paralyzed and elevated in all dogs until 3 months after implantation. At 4 months, movement of the diaphragm in the implanted side was observed during spontaneous breathing in 1 dog of group I and in 3 dogs of group II. In the dogs showing diaphragm movement, muscle action potentials were evoked in the diaphragm muscle, indicating restoration of nerve function. Regeneration of the phrenic nerve structure was also examined on the reconstructed site using electron microscopy.
The polyglycolic acid-collagen tube induced functional recovery of the injured phrenic nerve and was aided by coverage with a pedicled pericardial fat pad.

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    • "Artificial nerve conduits constructed of numerous polymeric materials such as silicone (Lundborg et al., 1982), collagen (Archibald et al., 1995), chitosan (Freier et al., 2005; Ao et al., 2006), hyaluronic acid (Wang et al., 1998), poly(caprolactone) (PCL), poly(glycolic acid) (PGA), and poly(lactic acid) (PLA) (Nakamura et al., 2004; Yoshitani et al., 2007) have been investigated. Recently, an artificial nerve conduit composed of poly(lactic-co-glycolic acid) (PLGA) mesh filled with animal-derived collagen has been put into clinical use and has shown good performance (Nakamura et al., 2004). "
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    ABSTRACT: We developed a microfibrous poly(L-lactic acid) (PLLA) nerve conduit with a three-layered structure to simultaneously enhance nerve regeneration and prevent adhesion of surrounding tissue. The inner layer was composed of PLLA microfiber containing 25% elastin-laminin mimetic protein (AG73-(VPGIG)30) that promotes neurite outgrowth. The thickest middle layer was constructed of pure PLLA microfibers that impart the large mechanical strength to the conduit. A 10% poly(ethylene glycol) was added to the outer layer to prevent the adhesion with the surrounding tissue. The AG73-(VPGIG)30 compositing of an elastin-like repetitive sequence (VPGIG)30 and a laminin-derived sequence (RKRLQVQLSIRT: AG73) was biosynthesized using Escherichia coli. The PLLA microfibrous conduits were fabricated using an electrospinning procedure. AG73-(VPGIG)30 was successfully mixed in the PLLA microfibers, and the PLLA/AG73-(VPGIG)30 microfibers were stable under physiological conditions. The PLLA/AG73-(VPGIG)30 microfibers enhanced adhesion and neurite outgrowth of PC12 cells. The electrospun microfibrous conduit with a three-layered structure was implanted for bridging a 2.0-cm gap in the tibial nerve of a rabbit. Two months after implantation, no adhesion of surrounding tissue was observed, and the action potential was slightly improved in the nerve conduit with the PLLA/AG73-(VPGIG)30 inner layer.
    Frontiers in Chemistry 07/2014; 2:52. DOI:10.3389/fchem.2014.00052
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    • "225–235 [89] 150 k Braiding and dip-coating with collagen [90] [91] [92] [93] [94] PGC O O O O n m [η] "
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    ABSTRACT: Peripheral nerve regeneration is a complicated and long-term medical challenge that requires suitable guides for bridging nerve injury gaps and restoring nerve functions. Many natural and synthetic polymers have been used to fabricate nerve conduits as well as luminal fillers for achieving desired nerve regenerative functions. It is important to understand the intrinsic properties of these polymers and techniques that have been used for fabricating nerve conduits. Previously extensive reviews have been focused on the biological functions and in vivo performance of polymeric nerve conduits. In this paper, we emphasize on the structures, thermal and mechanical properties of these naturally derived synthetic polymers, and their fabrication methods. These aspects are critical for the performance of fabricated nerve conduits. By learning from the existing candidates, we can advance the strategies for designing novel polymeric systems with better properties for nerve regeneration.
    International Journal of Polymer Science 01/2010; 2010(1687-9422). DOI:10.1155/2010/138686 · 1.20 Impact Factor
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    ABSTRACT: The present study explored a new approach to the production of tubular conduits designed for peripheral nerve repair. Poly(L-lactic acid) (PLLA) and polycaprolactone (PCL) membranes were obtained after solvent evaporation and wrapped around a mandrel. The effectiveness of nerve regeneration was compared with that obtained with polyethylene and PCL extruded prostheses 30 and 60 days after surgery. The comparison between extruded and membrane-derived tubes clearly showed structural differences that were directly proportional to the hardness and transparency. An important factor to be considered is that the fiber count indicated that membrane-derived PCL tubes provided a significantly greater number of axons 30 days after repair. Sixty days after the procedure, the greatest regenerative performance was obtained with PCL, regardless of tube construction method. An intense imunolabeling of S100, type IV collagen, and laminin could be observed in the tissue obtained from membrane-derived PCL and PLLA groups, indicating that such constructs were able to positively stimulate Schwann cell responses. Overall, the results provided evidence that membrane-derived conduits are an alternative preparation method for tubular prostheses for peripheral nerve regeneration.
    Tissue Engineering Part A 05/2008; 14(5):595-606. DOI:10.1089/tea.2007.0271 · 4.70 Impact Factor
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