Synthetic nerve graft containing collagen and synthetic Schwann cells inproves functional, electrophysiological, and histological parameters of peripheral nerve regeneration

Article type: Research Article

Authors: Keeley, Robert | Atagi, Tanya | Sabelman, Eric | Padilla, Jose | Kadlcik, Paula | Agras, Jean | Eng, Lawrence | Wiedman, Tien-Wen | Nguyen, Khoi | Sudekum, Anthony | Rosen, Joseph

Affiliations: Stanford Medical School, Department of Functional Restoration, NC-104 Hoover Pavilion, Stanford, CA 94305 (USA) | Veterans Affairs Medical Center, Rehabilitation, Research, and Development Center, 3801 Miranda Avenue, 640/153, Palo Alto, CA 94304 (USA) | Dartmouth Medical School and Veterans Affairs M&ROC, Research Service 405/151, White River Junction, VT 05009 (USA)

Note: [] Correspondence: R. Keeley, Stanford Medical School, Department of Functional Restoration, NC-104 Hoover Pavilion, Stanford, CA 94305, USA. Fax: (l)(415)725 6605.

Abstract: Current methods of peripheral nerve repair are to directly suture cut nerve stumps, or to bridge large gaps with an autograft repair. Autograft-associated problems include donor site morbidity and limited supply. Many of the present limitations of nerve repair might be overcome by expanding the patients own Schwann cells in vitro, then combining the cells with other neuro-tropic and -trophic materials into an Artificial Nerve Graft (ANG) for bridging a nerve gap. In this 4.5 month experiment, a rat peroneal nerve model with a 10 mm gap was used to evaluate the effect of live Schwann cells on peripheral nerve regeneration. Nerve gaps were repaired with cellular ANGs containing live Schwann cell, dead Schwann cell, or mixed fibroblast/Schwann cell populations suspended in a collagen I matrix, and with sutured autografts or ANGs containing just collagen or medium. Regenerated nerves were evaluated by walking track analysis, qualitative and quantitative histology, and electrophysiology. Overall, the autograft was the best repair method, while the ANG containing live Schwann cells was statistically superior to other ANG repair methods. This study demonstrates that an ANG containing cultured syngeneic Schwann cells improves functional, histological, and electrophysiological parameters of peripheral nerve regeneration.

Keywords: Schwann cell, Collagen type I, Biopolymer, Artificial nerve graft (ANG), Sutured autograft, Peripheral nerve repair, Nerve regeneration

DOI: 10.3233/RNN-1993-55606

Journal: Restorative Neurology and Neuroscience, vol. 5, no. 5-6, pp. 353-366, 1993