Assessment of luminal fillers in nerve guidance conduits for promoting regeneration following peripheral nerve injury Carol Vinskia, Tyler Medera,b, Bryan Brown, Ph.D.a,b,c Department of Bioengineering, bMcGowan Institute for Regenerative Medicine, c Renerva, LLC
a
Carol Vinski is a native Pittsburgher. Her passion for the improvement of medicine and healthcare motivates her to become a biomechanical engineer in the field of prosthetics.
Carol Vinski
Dr. Bryan Brown is an Associate Professor in the Department of Bioengineering with secondary appointments in the Department of Obstetrics, Gynecology, and Reproductive Sciences and the Clinical and Translational Science Institute at the University of Pittsburgh. He is also a Bryan Brown, Ph.D. core faculty member of the McGowan Institute for Regenerative Medicine where he serves as the Director of Educational Outreach. Dr. Brown is also an Adjunct Assistant Professor of Clinical Sciences at the Cornell University College of Veterinary Medicine and Chief Technology Officer of Renerva, LLC, a Pittsburgh-based start-up company.
Significance Statement
Autologous grafting, the current clinical standard to treat peripheral nerve injury (PNI), often results in unsatisfactory nerve healing and always causes a loss of feeling at the donor site. This study analyzes the most effective laboratory nerve guidance conduits and luminal fillers to act as an alternative solution to autografting.
Category Review Paper
Keywords: luminal fillers, nerve guidance conduits, nerve repair, biomechanics of nerves
102 Undergraduate Research at the Swanson School of Engineering
Abstract
Peripheral nerve injury (PNI) is a growing field of scientific research, and transected PNIs are difficult to repair due to the quick buildup of scar tissue blocking axon regeneration. Autologous grafting, the clinical standard of care, can cause loss of feeling at the donor site, and patients may not have enough viable donor tissue to complete this procedure depending on injury severity. To offer an effective alternative to autografting without loss of sensation, nerve guidance conduits (NGCs) are being explored but are not as successful as the clinical standard. Additives to NGC lumen (luminal fillers) are being researched to obtain results at least as successful as the autograft without its limitations. As of yet, no luminal fillers have entered into clinical use. The Brown Lab has previously developed a luminal filler derived from Porcine sciatic Nerve extracellular Matrix (PNM). To better understand how PNM performs in the context of NGC additives as a whole, the present study primarily examines reports of various luminal fillers to determine what characteristics predict success as a result of their application. Secondly, reports analyzing Schwann cell (SC) activity under variable biomechanical stimuli were considered as luminal fillers to provide a mechanical substrate which interacts with SCs. Overall, successful luminal fillers most often contained highly porous and permeable substrates with steep mechanical gradients for maximum SC activity. By utilizing this knowledge, successful luminal fillers and their respective conduits can be used to efficiently heal PNIs to maximize functional returns in patients.
