Artificial nerve guidance conduits (NGCs) are synthetic nerve grafts that are capable of providing the structural and nutritional support for nerve regeneration. The ideal NGCs have plenty of requirements on biocompatibility, mechanical strength, topological structure, and conductivity. Therefore, it is necessary to continuously improve the design of NGCs and establish a better therapeutic strategy for peripheral nerve injury in order to meet clinical needs. Although current NGCs have made certain process in the treatment of peripheral nerve injury, their nerve regeneration and functional outcomes on repairing long-distance nerve injury remain unsatisfactory. Herein, we review the nerve conduit design from four aspects, namely raw material selection, structural design, therapeutic factor loading and self-powered component integration. Moreover, we summarize the research progress of NGCs in the treatment of peripheral nerve injury, in order to facilitate the iterative updating and clinical transformation of NGCs.
Humans ; Peripheral Nerve Injuries/therapy* ; Guided Tissue Regeneration ; Nerve Regeneration/physiology* ; Sciatic Nerve

OBJECTIVE: To investigate the effect of folic acid coated-crosslinked urethane-doped polyester elastomer (fCUPE) nerve conduit in repairing long distance peripheral nerve injury. METHODS: Thirty-six 3-month-old male Sprague Dawley rats weighing 180-220 g were randomly assigned to 3 groups, each consisting of 12 rats: CUPE nerve conduit transplantation group (group A), fCUPE nerve conduit transplantation group (group B), and autologous nerve transplantation group (group C), the contralateral healthy limb of group C served as the control group (group D). A 20-mm-long sciatic nerve defect model was established in rats, and corresponding materials were used to repair the nerve defect according to the group. The sciatic function index (SFI) of groups A-C was calculated using the Bain formula at 1, 2, and 3 months after operation. The nerve conduction velocity (NCV) of the affected side in groups A-D was assessed using neuroelectrophysiological techniques. At 3 months after operation, the regenerated nerve tissue was collected from groups A-C for S-100 immunohistochemical staining and Schwann cell count in groups A and B to compare the level of nerve repair and regeneration in each group. RESULTS: At 3 months after operation, the nerve conduits in all groups partially degraded. There was no significant adhesion between the nerve and the conduit and the surrounding tissues, the conduit was well connected with the distal and proximal nerves, and the nerve-like tissues in the conduit could be observed when the nerve conduit stents were cut off. SFI in group A was significantly higher than that in group C at each time point after operation and was significantly higher than that in group B at 2 and 3 months after operation ( P<0.05). There was no significant difference in SFI between groups B and C at each time point after operation ( P>0.05). NCV in group A was significantly slower than that in the other 3 groups at each time point after operation ( P<0.05). The NCV of groups B and C were slower than that of group D, but the difference was significant only at 1 month after operation ( P<0.05). There was no significant difference between groups B and C at each time point after operation ( P>0.05). Immunohistochemical staining showed that the nerve tissue of group A had an abnormal cavo-like structure, light tissue staining, and many non-Schwann cells. In group B, a large quantity of normal neural structures was observed, the staining was deeper than that in group A, and the distribution of dedifferentiated Schwann cells was obvious. In group C, the nerve bundles were arranged neatly, and the tissue staining was the deepest. The number of Schwann cells in group B was (727.50±57.60) cells/mm ², which was significantly more than that in group A [(298.33±153.12) cells/mm ²] ( t=6.139, P<0.001). CONCLUSION The fCUPE nerve conduit is effective in repairing long-distance sciatic nerve defects and is comparable to autologous nerve grafts. It has the potential to be used as a substitute material for peripheral nerve defect transplantation.
Rats ; Animals ; Male ; Rats, Sprague-Dawley ; Polyesters ; Peripheral Nerve Injuries/surgery* ; Elastomers ; Urethane ; Sciatic Nerve/injuries* ; Carbamates ; Nerve Tissue ; Nerve Regeneration/physiology*

Enhancing remyelination after injury is of utmost importance for optimizing the recovery of nerve function. While the formation of myelin by Schwann cells (SCs) is critical for the function of the peripheral nervous system, the temporal dynamics and regulatory mechanisms that control the progress of the SC lineage through myelination require further elucidation. Here, using in vitro co-culture models, gene expression profiling of laser capture-microdissected SCs at various stages of myelination, and multilevel bioinformatic analysis, we demonstrated that SCs exhibit three distinct transcriptional characteristics during myelination: the immature, promyelinating, and myelinating states. We showed that suppressor interacting 3a (Sin3A) and 16 other transcription factors and chromatin regulators play important roles in the progress of myelination. Sin3A knockdown in the sciatic nerve or specifically in SCs reduced or delayed the myelination of regenerating axons in a rat crushed sciatic nerve model, while overexpression of Sin3A greatly promoted the remyelination of axons. Further, in vitro experiments revealed that Sin3A silencing inhibited SC migration and differentiation at the promyelination stage and promoted SC proliferation at the immature stage. In addition, SC differentiation and maturation may be regulated by the Sin3A/histone deacetylase2 (HDAC2) complex functionally cooperating with Sox10, as demonstrated by rescue assays. Together, these results complement the recent genome and proteome analyses of SCs during peripheral nerve myelin formation. The results also reveal a key role of Sin3A-dependent chromatin organization in promoting myelinogenic programs and SC differentiation to control peripheral myelination and repair. These findings may inform new treatments for enhancing remyelination and nerve regeneration.
Animals ; Axons ; Chromatin/metabolism* ; Gene Expression Profiling ; Myelin Sheath/metabolism* ; Nerve Regeneration/physiology* ; Rats ; Schwann Cells/metabolism* ; Sciatic Nerve/injuries*

To investigate the role of p38MAPK signal pathway in spinal cord and dorsal root ganglion (DRG) in rats with phantom limb pain and the effects of specific inhibitors.
 Methods: Healthy adult male SD rats (n=48) were cut off one side of the sciatic under anesthesia to establish a model of phantom limb pain. In addition, the healthy rats were taken as a sham group (group S, n=24). The animals were scored by observing the action of chewing (0=no chewing, 13=the worst chewing) after the operation and were sacrificed on the following day after the operation. The successful model of phantom limb pain were randomly divided into 2 groups: a phantom limb pain group (group P, n=24) and a phantom limb pain plus inhibitor group (group P+I, n=24). SB203580 was given to the rat at 0.8 mg/kg on every Monday until the rats were sacrificed, the rest of the rats received an equal amount of saline. Eight rats from each group were randomly taken for the determination of levels of P-p38MAPK in spinal cord and DRG before administration and on the 4th, 6th, 8th weekend following the administration, respectively.
 Results: In the sham group, no animal developed chewing. Meanwhile, rats in successful model of phantom limb pain group began chewing from the 2nd day after operation with scores at eight to eleven. The chewing scores in the P+I group were reduced after the treatment. Compared with group S, P-p38MAPK levels were elevated in groups of P and P+I (P<0.05 or P<0.01). Compared with group P, P-p38MAPK level was decreased in the group P+I (P<0.05 or P<0.01).
 Conclusion: P38MAPK signal pathway involves in the development of phantom limb pain.
Animals ; Disease Models, Animal ; Enzyme Inhibitors ; pharmacology ; Ganglia, Spinal ; enzymology ; Imidazoles ; pharmacology ; Male ; Mastication ; physiology ; Phantom Limb ; enzymology ; etiology ; physiopathology ; Pyridines ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; injuries ; Self Mutilation ; enzymology ; physiopathology ; Signal Transduction ; Spinal Cord ; enzymology ; p38 Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; metabolism

Spinal microglia and astrocytes play an important role in mediating behavioral hypersensitive state following peripheral nerve injury. However, little is known about the expression patterns of activated microglia and astrocytes in the spinal dorsal horn. The aim of the present study was to investigate the spatial distribution of microglial and astrocytic activation in cervical, thoracic, lumbar and sacral segments of spinal dorsal horn following chronic constriction injury (CCI) of sciatic nerve. The hind paw withdrawal threshold (PWT) of wild type (WT), CX3CR1(YFP) and GFAP(YFP) transgenic mice to mechanical stimulation was determined by von Frey test. Immunofluorescence staining was used to examine the spatial distribution of microglial and astrocytic activation in the spinal dorsal horn. Following CCI, all the WT, CX3CR1(YFP) and GFAP(YFP) mice developed robust allodynia in the ipsilateral paw on day 3 after CCI, and the allodynia was observed to last for 14 days. In comparison with sham groups, the PWTs of CCI group animals were significantly decreased (P < 0.01, n = 6). On day 14 after CCI, CX3CR1(YFP)-GFP immunofluorescence intensity was significantly increased in the ipsilateral lumbar spinal dorsal horn of the CX3CR1(YFP) mice (P < 0.01, n = 6), but no detectable changes were observed in other spinal segments. Increased GFAP(YFP)-GFP immunofluorescence intensity was observed in the ipsilateral thoracic, lumbar and sacral spinal segments of the GFAP(YFP) mice on day 14 after CCI. Iba-1 and GFAP immunofluorescence staining in WT mice showed the same result of microglia and astrocyte activation on day 14 after CCI. CX3CR1(YFP)-GFP and GFAP(YFP)-GFP immunofluorescence signal was colocalized with microglial marker Iba-1 and astrocytic marker GFAP, respectively. Interestingly, on day 3 after CCI, Iba-1-immunoreactivity was significantly increased in the ipsilateral thoracic, lumbar and sacral spinal segments of WT mice, whereas the significant upregulation of GFAP-immunoreactivity restrictedly occurred in the ipsilateral lumbar spinal segment. These results suggest that microglial and astrocytic activation may be involved in the development and maintenance of secondary allodynia in mice with neuropathic pain.
Animals ; Astrocytes ; physiology ; Disease Models, Animal ; Hyperalgesia ; Mice ; Mice, Transgenic ; Microglia ; physiology ; Neuralgia ; Peripheral Nerve Injuries ; Sciatic Nerve ; injuries ; Spinal Cord Dorsal Horn ; cytology ; Up-Regulation

There have been many attempts for regeneration of peripheral nerve injury. In this study, we examined the in vivo effects of non-differentiated and neuronal differentiated adipose-derived stem cells (ADSCs) in inducing the neuronal regeneration in the Sprague-Dawley (SD) rats undergoing nerve defect bridged with the PCL nanotubes. Then, we performed immunohistochemical and histopathologic examinations, as well as the electromyography, in three groups: the control group (14 sciatic nerves transplanted with the PCL nanotube scaffold), the experimental group I (14 sciatic nerves with the non-differentiated ADSCs at a density of 7x105 cells/0.1 mL) and the experimental group II (14 sciatic nerves with the neuronal differentiated ADSCs at 7x105 cells/0.1 mL). Six weeks postoperatively, the degree of the neuronal induction and that of immunoreactivity to nestin, MAP-2 and GFAP was significantly higher in the experimental group I and II as compared with the control group. In addition, the nerve conduction velocity (NCV) was significantly higher in the experimental group I and II as compared with the control group (P=0.021 and P=0.020, respectively). On the other hand, there was no significant difference in the NCV between the two experimental groups (P>0.05). Thus, our results will contribute to treating patients with peripheral nerve defects using PCL nanotubes with ADSCs.
Adipose Tissue/cytology ; Animals ; Cell Differentiation ; Electromyography ; Male ; Nanotubes ; *Nerve Regeneration ; Nerve Tissue Proteins/immunology ; Nestin/immunology ; Neural Conduction/physiology ; Peripheral Nerve Injuries/*surgery ; Phosphoprotein Phosphatases/immunology ; Polyesters/*therapeutic use ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve/injuries/surgery ; Stem Cell Transplantation/*methods ; Stem Cells/*cytology ; Tissue Engineering/methods

OBJECTIVETo investigate the changes of GABA-activated currents in isolated dorsal root ganglion neurons in rats with neuropathic pain.

METHODSThe neuropathic pain model was established by chronic constriction injury (CCI) 7 days before electrophysiological-recording. The rat DRG neurons were enzymatically dissociated. Whole-cell patch clamp technique was used to record GABA-activated currents. The changes of currents of injured side and opposite side were expected to compare with control group.

RESULTS(1) The currents of injured side of CCI group were notablely decreased compared with control group (GABA concentration, 0.1-1000 micromol/L). (2) By the contrast, opposite side currents of CCI group increased significantly compared with those in injured side and control group (GABA concentration, 0.01-1000 micromol/L).

CONCLUSIONThe data indicates that the chronic constriction injury change both the function of GABAA receptors of injury side and opposite side. The decrease of pre-synaptic inhibition of GABA may be the possible reason of neuropathic pain.

Animals ; Cell Separation ; Constriction ; Ganglia, Spinal ; pathology ; physiopathology ; Male ; Neuralgia ; etiology ; physiopathology ; Neurons ; metabolism ; physiology ; Patch-Clamp Techniques ; Rats ; Rats, Sprague-Dawley ; Receptors, GABA-A ; metabolism ; physiology ; Sciatic Nerve ; injuries

BACKGROUNDPeripheral nerve injury causes a high rate of disability and a huge economic burden, and is currently one of the serious health problems in the world. The use of nerve grafts plays a vital role in repairing nerve defects. Acellular nerve grafts have been widely used in many experimental models as a peripheral nerve substitute. The purpose of this study was to test the biomechanical properties of acellular nerve grafts.

METHODSThirty-four fresh sciatic nerves were obtained from 17 adult male Wistar rats (age of 3 months) and randomly assigned to 3 groups: normal control group, nerve segments underwent no treatment and were put in phosphate buffered saline (pH 7.4) and stored at 4°C until further use; physical method group, nerve segments were frozen at -196°C and then thawed at 37°C; and chemical method group, nerve segments were chemically extracted with the detergents Triton X-200, sulfobetaine-10 (SB-10) and sulfobetaine-16 (SB-16). After the acellularization process was completed, the structural changes of in the sciatic nerves in each group were observed by hematoxylin-eosin staining and field emission scanning electron microscopy, then biomechanical properties were tested using a mechanical apparatus (Endura TEC ELF 3200, Bose, Boston, USA).

RESULTSHematoxylin-eosin staining and field emission scanning electron microscopy demonstrated that the effects of acellularization, demyelination, and integrity of nerve fiber tube of the chemical method were better than that of the physical method. Biomechanical testing showed that peripheral nerve grafts treated with the chemical method resulted in some decreased biomechanical properties (ultimate load, ultimate stress, ultimate strain, and mechanical work to fracture) compared with normal control nerves, but the differences were not statistically significant (P > 0.05).

CONCLUSIONNerve treated with the chemical method may be more appropriate for use in implantation than nerve treated with the physical method.

Animals ; Biomechanical Phenomena ; Male ; Microscopy, Electron, Scanning ; Peripheral Nerve Injuries ; therapy ; Peripheral Nerves ; physiology ; ultrastructure ; Rats ; Rats, Wistar ; Sciatic Nerve ; physiopathology ; ultrastructure ; Tissue Engineering

Sciatic nerve injury is a common disease of peripheral nerve in clinic. After nerve injury, there are many dysfunctions in motoneurons and muscles following regeneration. Previous studies mostly investigated the aspects related to the injured nerve, and the effect on the recurrent inhibition (RI) pathway of spine following regeneration was not fully understood. Following reinnervation after temporary sciatic nerve crush, the functional alteration of RI was studied. In adult rats, RI between lateral gastrocnemius-soleus (LG-S) and medial gastrocnemius (MG) motor pools was assessed by conditioning monosynaptic reflexes (MSRs) elicited from the cut dorsal roots and recorded from either the LG-S or MG nerves by antidromic stimulation of the synergist muscle nerve. The following results were obtained. (1) The RI of MSRs in rats was almost lost (<5 weeks) after sciatic nerve crush. Although the RI partially recovered following reinnervation (6 weeks), it remained permanently depressed (up to 14 weeks). (2) Sciatic nerve crush on one side did not affect the contralateral RI. (3) Sciatic nerve crush did not induce any motoneuron loss revealed by immunohistochemistry. Peripheral nerve temporary disconnection causes long term alterations in RI pathway which make up motoneuron's function enhance for the alteration of muscle power and suggests that peripheral nerve injury induces long term plastic changes in the spinal motoneuron circuitry.
Animals ; Long-Term Synaptic Depression ; physiology ; Male ; Motor Neurons ; physiology ; Nerve Crush ; Nerve Regeneration ; physiology ; Neuronal Plasticity ; physiology ; Neurons, Afferent ; physiology ; Rats ; Rats, Wistar ; Reflex, Monosynaptic ; physiology ; Sciatic Nerve ; injuries ; physiopathology ; Spinal Cord ; physiopathology ; Spinal Nerve Roots ; physiopathology

Neuronal firing is crucial to the information processing in the nervous system. In order to make a further study of bifurcation scenarios, experiments were performed on neural pacemakers formed at the injured site of rat sciatic nerve subjected to chronic ligatures. We chose the conductance of voltage-dependent potassium ion channels as conditional parameter, and the extracellular calcium concentration as bifurcation parameter, to give a demonstration of how the firing pattern of neural pacemaker responses to dual parameter adjusting. Among 28 preparations observed, 21 were insensitive to dual parameter adjusting since no change of bifurcation scenario structure was detected. On the contrary, the residual 7 preparations showed dramatic bifurcation scenario shifting corresponding to different dual parameter configuration. Briefly, when concentration of 4-aminopyridine (4-AP), a voltage-dependent potassium ion channels blocker, was kept at different level and extracellular Ca2+ concentration was decreased gradually, different bifurcation scenarios of firing patterns were exhibited in an identical neural pacemaker. The two-parameter bifurcation scenarios of experimental neural pacemaker with different parameter configuration were also different. The results show that neural firing pattern is different when the parameter configuration is different, and the bifurcation scenario is a fundamental framework to identify the transitions between firing patterns.
4-Aminopyridine ; pharmacology ; Action Potentials ; physiology ; Animals ; Calcium ; metabolism ; Male ; Neurons ; physiology ; Periodicity ; Potassium Channels ; physiology ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; injuries ; physiopathology