Acellular nerve allografts in peripheral nerve regeneration: A comparative study

Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, Campus Box 8238, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA.
Muscle & Nerve (Impact Factor: 2.28). 08/2011; 44(2):221-34. DOI: 10.1002/mus.22033
Source: PubMed


Processed nerve allografts offer a promising alternative to nerve autografts in the surgical management of peripheral nerve injuries where short deficits exist.
Three established models of acellular nerve allograft (cold-preserved, detergent-processed, and AxoGen-processed nerve allografts) were compared with nerve isografts and silicone nerve guidance conduits in a 14-mm rat sciatic nerve defect.
All acellular nerve grafts were superior to silicone nerve conduits in support of nerve regeneration. Detergent-processed allografts were similar to isografts at 6 weeks postoperatively, whereas AxoGen-processed and cold-preserved allografts supported significantly fewer regenerating nerve fibers. Measurement of muscle force confirmed that detergent-processed allografts promoted isograft-equivalent levels of motor recovery 16 weeks postoperatively. All acellular allografts promoted greater amounts of motor recovery compared with silicone conduits.
These findings provide evidence that differential processing for removal of cellular constituents in preparing acellular nerve allografts affects recovery in vivo.

Download full-text


Available from: Matthew Macewan
    • "An over-critical sized lesion gap of 20 mm was intentionally chosen for the present study to stress the importance of microstructures in the design of nerve guides. Gap sizes of less than 15 mm are more commonly chosen for testing nerve guides for their effectiveness in promoting axon regeneration across the gap [18] [24]. Zhang and colleagues demonstrated a similar approach as the current study, using a gap size of 15 mm. "
    [Show abstract] [Hide abstract]
    ABSTRACT: An increasing number of biomaterial nerve guides has been developed that await direct comparative testing with the 'gold-standard' autologous nerve graft in functional repair of peripheral nerve defects. In the present study, 20 mm rat sciatic nerve defects were bridged with either a collagen-based micro-structured nerve guide (Perimaix) or an autologous nerve graft. Axons regenerated well into the Perimaix scaffold and, the majority of these axons grew across the 20 mm defect into the distal nerve segment. In fact, both the total axon number and the number of retrogradely traced somatosensory and motor neurons extending their axons across the implant was similar between Perimaix and autologous nerve graft groups. Implantation of Schwann cell-seeded Perimaix scaffolds provided only a beneficial effect on myelination within the scaffold. Functional recovery supported by the implanted, non-seeded Perimaix scaffold was as good as that observed after the autologous nerve graft, despite the presence of thinner myelin sheaths in the Perimaix implanted nerves. These findings support the potential of the Perimaix collagen scaffold as a future off-the-shelf device for clinical applications in selected cases of traumatic peripheral nerve injury.
    No preview · Article · Oct 2015 · Biomaterials
  • Source
    • "Should too many axons fail to reach the distal stump, a swelling or neuroma is created [Chhabra et al., 2010]. Upon crossing the distance of the lesion and entering the band of von Bungner, the axonal growth cone elongates along the basal lamina filled with Schwann cells and immune cells [Moore et al., 2011; Thompson, 2006]. The rate of axonal growth within the nerve distal to the lesion is 2 to 4 mm per day. "

    Full-text · Article · Jan 2015
  • Source
    • "Peripheral nerve injury is a common disease, the proliferation of glia and extraneural connective tissue in peripheral nerve defect may hinder the growth of anagenetic axon or misguide the growth cone of axon; thus, the anagenetic axon cannot reach the target organ or even results in the formation of neuroma at the nerve stumps [1]; therefore, the defect of nerve must be bridged by graft to induce the nerve regeneration. As the golden standard of the peripheral nerve defects therapy, the autologous nerve graft was effective for nerve repair, but the source of autologous nerve graft was limited and the application of this graft was limited by several elements such as the injury to donor for graft acquisition and the limited length for nerve defect repairment [2]. Other methods, such as nerve allograft, nonnerve tissue graft, and artificial nerve tissue graft, had been used, but their effect was not satisfactory [3]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To investigate the effect of tissue engineering nerve on repair of rat sciatic nerve defect. Methods: Forty-five rats with defective sciatic nerve were randomly divided into three groups. Rats in group A were repaired by acellular nerve grafts only. Rats in group B were repaired by tissue engineering nerve. In group C, rats were repaired by autogenous nerve grafts. After six and twelve weeks, sciatic nerve functional index (SFI), neural electrophysiology (NEP), histological and transmission electron microscope observation, recovery ratio of wet weight of gastrocnemius muscle, regenerated myelinated nerve fibers number, nerve fiber diameter, and thickness of the myelin sheath were measured to assess the effect. Results: After six and twelve weeks, the recovery ratio of SFI and wet weight of gastrocnemius muscle, NEP, and the result of regenerated myelinated nerve fibers in groups B and C were superior to that of group A (P < 0.05), and the difference between groups B and C was not statistically significant (P > 0.05). Conclusion: The tissue engineering nerve composed of acellular allogenic nerve scaffold and Schwann cells-like cells can effectively repair the nerve defect in rats and its effect was similar to that of the autogenous nerve grafts.
    Full-text · Article · Jul 2014 · Neural Plasticity
Show more