Systematically engineered electrospun conduit based on PGA/collagen/bioglass nanocomposites: The evaluation of morphological,mechanical, and bio‐properties

Peripheral nerve injury can considerably affect the daily life of affected people through reduced function and permanent deformation of the nerve. One of the conventional treatments used for the management of the disease is the application of autograft, which is recognized as a golden standard method; however, the process of gaining access to autograft has posed a significant challenge to its use. Nerve guidance channels (conduits), which are made in different methods, can act as an alternative therapy for patients that have undergone nerve injury; but, achieving these conduits has always been a major dilemma to be applied for patients with nerve injury. In this study, a novel conduit based on polymer blend nanocomposites of polyglycolic acid (PGA), collagen, and nanobioglass (NBG) were prepared by electrospinning technique and then compared with PGA/collagen and PGA conduits that were made in previous studies. Additionally, their various properties were characterized by scanning electron microscopy (SEM), X‐ray diffraction (XRD), contact angle, dynamic mechanical thermal analysis (DMTA), tensile strength, Fourier‐transform infrared (FTIR), and the porosity and degradation. The results showed that the mechanical, chemical, biocompatibility, and biodegradability properties of PGA/collagen/NBG conduits were more favorable in comparison with other materials. According to 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide (MTT) assay and 4′,6‐diamidino‐2‐phenylindole (DAPI) staining technique, nanofibrous electrospun PGA/collagen/NBG conduits are more suitable for cell adhesion and proliferation in comparison with either PGA or PGA/collagen conduits and can have potential for nerve regeneration.     

Advances in Large Gap Peripheral Nerve Injury Repair and Regeneration with Bridging Nerve Guidance Conduits

Peripheral nerve injury is a common complication of accidents and diseases. The traditional autologous nerve graft approach remains the gold standard for the treatment of nerve injuries. While sources of autologous nerve grafts are very limited and difficult to obtain. Nerve guidance conduits are widely used in the treatment of peripheral nerve injuries as an alternative to nerve autografts and allografts. However, the development of nerve conduits does not meet the needs of large gap peripheral nerve injury. Functional nerve conduits can provide a good microenvironment for axon elongation and myelin regeneration. Herein, the manufacturing methods and different design types of functional bridging nerve conduits for nerve conduits combined with electrical or magnetic stimulation and loaded with Schwann cells, etc., are summarized. It summarizes the literature and finds that the technical solutions of functional nerve conduits with electrical stimulation, magnetic stimulation and nerve conduits combined with Schwann cells can be used as effective strategies for bridging large gap nerve injury and provide an effective way for the study of large gap nerve injury repair. In addition, functional nerve conduits provide a new way to construct delivery systems for drugs and growth factors in vivo.     

Electroactive Composite of FeCl3‐Doped P3HT/PLGA with Adjustable Electrical Conductivity for Potential Application in Neural Tissue Engineering

Conducting polymers (CPs) is one of intelligent biomaterials with the specific properties of reversible redox states, which have a significant effects on the cell behaviors and nerve tissue regeneration. However, the effects of CPs with different electrical conductivity on the behaviors of nerve cells are rarely reported. Therefore, a kind of Poly(3‐hexylthiophene) (P3HT) with certain molecular weight is synthesized by Kumada catalyst transfer polymerization (KCTP) method and employed to prepare bioabsorbable and electroactive intelligent composites of Poly(3‐hexylthiophene)/Poly(glycolide‐lactide) (P3HT/PLGA). FeCl₃ doping electroactive membranes with different electrical conductivities are prepared to investigate the cell behaviors. On the substrate with higher electrical conductivity, the proliferation of rat adrenal pheochromocytoma cells (PC12 cells) is significantly promoted and neurite length is increased obviously. In particular, the most significant improvements are the neuron gene expression of Synapsin 1 and microtubule‐associated protein 2 (MAP2) by the composites with high conductivity. These results suggest that P3HT/PLGA with suitable electrical conductivity have a positive role in promoting neural growth and differentiation, which is promising for advancing potential application of nerve repair and regeneration.     

Degradation of covalently cross-linked carboxymethyl chitosan and its potential application for peripheral nerve regeneration

Chitosan has been widely used in a variety of biomedical applications including peripheral nerve repair because of its excellent mechanical properties and biocompatibility. However, chitosan itself has a very slow degradation rate, and its molecules degrade in an uncontrollable manner. We hypothesized that the cross-linking of carboxymethyl chitosan (CM-chitosan), which is soluble in water, would result in a higher degradation rate in lysozyme solutions, while retaining its excellent mechanical properties and nerve cell affinity. In this study, we characterized the constructed matrix formed using a combination of carboxymethylation of chitosan chains and thereafter 1-ethyl-3(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC) cross-linking. Specifically, after EDC cross-linking, the hydrophilicity and elastic modulus of the CM-chitosan films decreased. These changes are beneficial in the application of chitosan derivatives for nerve repair. The porous conduits degraded to 30% in weight during eight weeks of incubation in lysozyme solution (pH 7.4, 37 °C). In addition, the cross-linked CM-chitosan films enhanced the spread of Neuro-2a cells and provided a good proliferation substratum for Neuro-2a cells, as compared to chitosan films. Therefore, cross-linking with EDC is a promising way to modify chitosan derivatives for peripheral nerve regeneration.     

Development of a Piezoelectric PVDF‐TrFE Fibrous Scaffold to Guide Cell Adhesion,Proliferation, and Alignment

Severe peripheral nervous system injuries currently hold limited therapeutic solutions. Existing clinical techniques such as autografts, allografts, and newer nerve guidance conduits have shown variable outcomes in functional recovery, adverse immune responses, and in some cases low or minimal availability. This can be attributed in part to the lack of chemical, physical, and electrical cues directing both nerve guidance and regeneration. To address this pressing clinical issue, electrospun nanofibers and microfibers composed of piezoelectric polyvinylidene flouride‐triflouroethylene (PVDF‐TrFE) have been introduced as an alternative template for tissue engineered biomaterials, specifically as it pertains to their relevance in soft tissue and nerve repair. Here, biocompatible scaffolds of PVDF‐TrFE are fabricated and their ability to generate an electrical response to mechanical deformations and produce a suitable regenerative microenvironment is examined. It is determined that 20% (w/v) PVDF‐TrFE in (6:4) dimethyl formamide (DMF):acetone solvent maintains a desirable piezoelectric coefficient and the proper physical and electrical characteristics for tissue regeneration. Further, it is concluded that scaffolds of varying thickness promoted the adhesion and alignment of Schwann cells and fibroblasts. This work offers a prelude to further advancements in nanofibrous technology and a promising outlook for alternative, autologous remedies to peripheral nerve damage.     

Microfluidics embedded with microelectrodes for electrostimulation of neural stem cells proliferation

The regeneration of the injured nerve and recovery of its function have brought attention in the medical field. Electrical stimulation(ES) can enhance the cellular biological behavior and has been widely studied in the treatment of neurological diseases. Microfluidic technology can provide a cell culture platform with the well-controlled environment. Here a novel microfluidic/microelectrode composite microdevice was developed by embedding the microelectrodes to the microfluidic platform, in whic...     

Carbon-based conductive rubber composite for 3D printed flexible strain sensors

Polymeric-based flexible electronic devices are in high demand due to its wide range of applications. Natural rubber (NR) shows a great potential as matrix phase for flexible conductive polymer composites with its high elasticity and fatigue resistance. In this study, a new 3D printable conductive NR (CNR) composite was developed for strain sensor applications. Different contents of conductive carbon black (CCB) were mixed with NR latex to investigate the effect of the filler content on electrical and mechanical properties of the composites. The best-known CNR composite with the CCB content of 12 phr was selected in order to produce the feedstock for the stereolithography process (SLA). The morphological, electrical, and mechanical properties of cast and 3D-printed samples were investigated and compared. Although the 3D-printed CNR sample had slightly lower conductivity than the cast one, it possessed comparable tensile strength and elongation at break, with values of 12.4 MPa and 703%, respectively. In addition, electrical responses of the CNR samples were investigated to demonstrate the electromechanical property of the material as a strain sensor. The 3D-printed CNR sample exhibited the highest electromechanical sensitivity with a gauge factor (GF) of 361.4 (ε = 210%–300%) and showed good repeatability for 500 cycles. In conclusion, the development of this 3D printable functional material with great sensing capability will pave the way for innovative designs of personalized sensing textiles and other smart wearable devices.     

Tissue engineering and peripheral nerve regeneration (III) -- Sciatic nerve regeneration with PDLLA nerve guide

The biodegradation rate and biocompatibility of poly(d, l -lactide) (PDLLA) in vivo were evaluated. The aim of this study was to establish a nerve guide constructed by the PDLLA with 3-D microenvironment and to repair a 10 mm of sciatic nerve gap in rats. The process of the nerve regeneration was investigated by histological assessment, electrophysiological examination, and determination of wet weight recovery rate of the gastrocnemius muscle. After 3 weeks, the nerve guide had changed from a transparent to an opaque status. The conduit was degraded and absorbed partly and had lost their strength with breakage at the 9th week of postoperation. At the conclusion of 12 weeks, proximal and distal end of nerves were anastomosed by nerve regeneration and the conduit vanished completely. The results suggest that PDLLA conduits may serve for peripheral nerve regeneration and PDLLA is a sort of hopeful candidate for tissue engineering.     

In vivo evaluation of a biodegradable EDC/NHS-cross-linked gelatin peripheral nerve guide conduit material

Peripheral nerve regeneration has been evaluated using a biodegradable nerve conduit, which is made of a 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC)/N-hydroxysuccinimide (NHS) cross-linked gelatin. The EDC/NHS crosslinked gelatin (ENG) conduit is brownish in appearance, and is concentric and round with a smooth outer surface and inner lumen. After subcutaneous implantation on the dorsal side of a rat, the degraded ENG conduit only evoked a mild tissue response, with the formation of a thin tissue capsule surrounding the conduit. Biodegradability of the ENG conduit and its effectiveness as a guidance channel has been examined by its use to repair a 10 mm gap in the rat sciatic nerve. As a result, the tubes degraded throughout the implantation period, but still remained circular with a thin round lumen until they were completely integrated with the enclosed nerves. Successful regeneration through the gap occurred in all the conduits over the three experimental periods of 4, 8, and 12 weeks. Histological observation showed that numerous myelinated axons had crossed through the gap region even at the shortest implantation period of 4 weeks. Peak amplitude, area under the muscle action potential curve, and nerve conductive velocity all showed an increase as a function of the recovery period, which indicates that the nerve had undergone adequate regeneration. These results indicate the superiority of the ENG materials and suggest that the novel ENG conduits provide a promising tool for neuro-regeneration.     

Degradation behaviors of nerve guidance conduits made up of silk fibroin in vitro and in vivo

We have developed a new design of nerve guidance conduits (NGCs) made up of silk fibroin (SF), referred to as SF-NGCs, by a well-established method. The present study aimed to comprehensively investigate the degradation behaviors of SF-NGCs versus SF fibers. After they were allowed to incubate in the protease XIV solution or to be subcutaneously implanted in rabbits, SF-NGCs and SF fibers were subjected to degradation level measurement, mass loss assessment and gel electrophoresis, or light and electron microscopy and mass loss assessment for testing the dynamic course of in vitro or in vivo degradation. The results collectively indicated that SF-NGCs were able to degrade at a significantly increasing rate as compared to SF fibers, thus meeting the requirements of peripheral nerve regeneration. Furthermore, based on the possible involvement pathway in the in vivo degradation of SF-NGCs, the time-dependent changes in the mRNA level of lysosome-related genes (Hip1R, cathepsin D, and tPA) in subcutaneous implantation site within 24-week period post-implantation was determined by real-time RT-PCR, and the resulting data might contribute to our understanding of the molecular aspects that affect in vivo degradation and absorption of SF-NGCs.     

Degradable Poly(amidoamine) Hydrogels as Scaffolds for In Vitro Culturing of Peripheral Nervous System Cells

This paper reports on the synthesis and physico‐chemical, mechanical, and biological characterization of two sets of poly(amidoamine) (PAA) hydrogels with potential as scaffolds for in vivo peripheral nerve regeneration. They are obtained by polyaddition of piperazine with N,N′‐methylenebis(acrylamide) or 1,4‐bis(acryloyl)piperazine with 1,2‐diaminoethane as cross‐linking agent and exhibit a combination of relevant properties, such as mechanical strength, biocompatibility, biodegradability, ability to induce adhesion and proliferation of Schwann cells (SCs) preserving their viability. Moreover, the most promising hydrogels, that is those deriving from 1,4‐bis(acryloyl)piperazine, allow the in vitro growth of the sensitive neurons of the dorsal root ganglia, thus getting around a critical point in the design of conduits for nerve regeneration.

     

Tissue engineering and peripheral nerve regeneration (III)

The biodegradation rate and biocompatibility of poly (d, / -lactide) (PDLLA)in vivo were evaluated. The aim of this study was to establish a nerve guide constructed by the PDLLA with 3-D microenvironment and to repair a 10 mm of sciatic nerve gap in rats. The process of the nerve regeneration was investigated by histological assessment, electrophysiological examination, and determination of wet weight recovery rate of the gastrocnemius muscle. After 3 weeks, the nerve guide had changed from a transparent to an opaque status. The conduit was degraded and absorbed partly and had lost their strength with breakage at the 9th week of postoperation. At the conclusion of 12 weeks, proximal and distal end of nerves were anastomosed by nerve regeneration and the conduit vanished completely. The results suggest that PDLLA conduits may serve for peripheral nerve regeneration and PDLLA is a sort of hopeful candidate for tissue engineering.     

Polymer Scaffolds for Biomedical Applications in Peripheral Nerve Reconstruction

The nervous system is a significant part of the human body, and peripheral nerve injury caused by trauma can cause various functional disorders. When the broken end defect is large and cannot be repaired by direct suture, small gap sutures of nerve conduits can effectively replace nerve transplantation and avoid the side effect of donor area disorders. There are many choices for nerve conduits, and natural materials and synthetic polymers have their advantages. Among them, the nerve scaffold should meet the requirements of good degradability, biocompatibility, promoting axon growth, supporting axon expansion and regeneration, and higher cell adhesion. Polymer biological scaffolds can change some shortcomings of raw materials by using electrospinning filling technology and surface modification technology to make them more suitable for nerve regeneration. Therefore, polymer scaffolds have a substantial prospect in the field of biomedicine in future. This paper reviews the application of nerve conduits in the field of repairing peripheral nerve injury, and we discuss the latest progress of materials and fabrication techniques of these polymer scaffolds.     

Methylcobalamin‐Loaded PLCL Conduits Facilitate the Peripheral Nerve Regeneration

The feasible fabrication of nerve guidance conduits (NGCs) with good biological performance is important for translation in clinics. In this study, poly(d ,l ‐lactide‐co‐caprolactone) (PLCL) films loaded with various amounts (wt; 5%, 15%, 25%) of methylcobalamin (MeCbl) are prepared, and are further rolled and sutured to obtain MeCbl‐loaded NGCs. The MeCbl can be released in a sustainable manner up to 21 days. The proliferation and elongation of Schwann cells, and the proliferation of Neuro2a cells are enhanced on these MeCbl‐loaded films. The MeCbl‐loaded NGCs are implanted into rats to induce the regeneration of 10 mm amputated sciatic nerve defects, showing the ability to facilitate the recovery of motor and sensory function, and to promote myelination in peripheral nerve regeneration. In particular, the 15% MeCbl‐loaded PLCL conduit exhibits the most satisfactory recovery of sciatic nerves in rats with the largest diameter and thickest myelinated fibers.     

Fabrication and characterization of chitosan-gelatin/single-walled carbon nanotubes electrospun composite scaffolds for cartilage tissue engineering applications

Cartilage is a connective tissue with a slow healing rate due to lack in blood circulation and slow metabolism. Designing tissue engineering scaffolds modified based on its specific features can assist its natural regeneration process. In this study, the chitosan-gelatin/single-walled carbon nanotubes functionalized by COOH (SWNTs-COOH) nanocomposite scaffolds were fabricated through electrospinning. The effect of each component and different duration of cross-linking were assessed in terms of morphology, porosity, chemical structure, thermal behavior, mechanical properties, wettability, biodegradability, and in vitro cell culture study. Adding SWNTs-COOH decreased fiber diameter, water contact angle and degradation rate while increased tensile strength, hydrophilicity, stability and cell viability, due to their high intrinsic electrical conductivity, and mechanical properties and the presence of COOH functional groups in its structure. All the sample presented a porosity percentage of more than 80%, which is essential for tissue engineering scaffolds. The presence SWNTs-COOH did not have any adverse effect on cytocompatibility. The optimal cross-linking time increased the stability of the scaffolds in PBS. It can be concluded that the chitosan-gelatin/1wt% SWNTs-COOH scaffold can be appropriate for cartilage tissue engineering applications.     

Degradation behaviors of electrospun fibrous composites of hydroxyapatite and chemically modified poly(dl-lactide)

It is essential to individually tailor the biodegradability of electrospun fibers and their composites to meet the requirements of specific application. Electrospun poly(dl-lactide) (PDLLA) fibers grafted with functional groups were obtained to induce in situ mineralization of hydroxyapatite (HA), and HA/PDLLA composites were fabricated through hot-pressing of mineralized fibers after layer-by-layer deposition. The degradation behaviors during up to 1 year incubation were clarified for functionalized PDLLA fibers, mineralized HA/PDLLA fibers and hot-pressed composites. The carboxyl and amino groups of electrospun fibers indicated enhancement and alleviation of the autocatalysis effect on the polyester hydrolysis, respectively. The distribution of HA within fiber matrices led quick and strong water absorption, and caused neutralization of the weak acid environment and alleviation of the autocatalysis effect. Due to the location of mineralized HA on the surface of functionalized fibers, significant HA loss and preferential removal of amorphous and low-crystalline apatitic phase were determined during the degradation process. The hot-pressed composites indicated dense structure, small pore size and fusion on the fiber surface, leading significantly lower degradation rate than electrospun fibers and mineralized fibers. Higher degradation rate of matrix polymers and HA loss were shown for hot-pressed composites from mineralized fibers than those from blend electrospun HA/PDLLA fibers. The obtained results should provide solid basis for further applications of functionalized PDLLA fibers, mineralized fibers and fibrous composites in biomedical areas.     

Novel bone substitute composed of oligomeric proanthocyanidins-crosslinked gelatin and tricalcium phosphate

A biodegradable GTP composite composed of OPCs crosslinked gelatin with tricalcium phosphate was prepared as a novel bone substitute. The effects of the degree of crosslinking on the swelling ratio, in vitro degradation rate, and morphology of the GTP composite are discussed. Adding OPCs to GP and GTP composites markedly reduced the degradation rate, indicating that OPCs are good crosslinking reagents for gelatin. Cytotoxic tests demonstrated that OPCs, gelatin and tricalcium phosphate released from GTP composite promoted the proliferation of MG-63 cells. Results of this study suggest that the nontoxic GTP composite is suitable for use as a large defect bone substitute.     

Biodegradability of conducting chitosan-g-polycaprolactone/polypyrrole conduits

Conducting chitosan-g-polycaprolactone(CPC)/polypyrrole(PPy) conduits were fabricated for potential applications in nerve repair. Their mechanical and conducting properties as well as in vitro and in vivo degradation behaviors were mainly examined. It was found that some CPC/PPy conduits showed significantly stronger tensile and lateral compressive strength in the wet state, and notably higher conductivity in the overall tested PPy-load range, in comparison with chitosan/PPy conduits. After being consecutively exposed to PBS systems for various periods up to 10 weeks, the CPC/PPy conduits exhibited relatively slow degradation compared to chitosan/PPy conduits, and their degradation behaviors were measurably mediated by the composition of CPCs. The pH values of media corresponding to some selected CPC/PPy conduits did not significantly deviate from the initial pH value due to the buffering effect of chitosan component. After being implanted into rabbits for various periods, it was observed that the explanted chitosan/PPy conduits could only sustain a very low compressive load after 6-week degradation, and most of them were partially or fully collapsed after 8-week or longer degradation and showed very low conductivity. In contrast to these observations, some explanted CPC/PPy conduits were able to maintain enough strong mechanical strength in the wet state for the required period, and still showed acceptable conducting properties after 10-week in vivo degradation. Results suggested that some CPC/PPy conduits having proper compositional proportions could serve as desirable candidates to bridge nerve gaps in vivo.     

Tissue engineering and peripheral nerve regeneration (Ⅲ)——Sciatic nerve regeneration with PDLLA nerve guide

The biodegradation rate and biocompatibility of poly(d, / -lactide) (PDLLA) in vivo were evaluated. The aim of this study was to establish a nerve guide constructed by the PDLLA with 3-D microenvironment and to repair a 10 mm of sciatic nerve gap in rats. The process of the nerve regeneration was investigated by histological assessment, electrophysiological examination, and determination of wet weight recovery rate of the gastrocnemius muscle. After 3 weeks, the nerve guide had changed from a transparent to an opaque status. The conduit was degraded and absorbed partly and had lost their strength with breakage at the 9th week of postoperation. At the conclusion of 12 weeks, proximal and distal end of nerves were anastomosed by nerve regeneration and the conduit vanished completely. The results suggest that PDLLA conduits may serve for peripheral nerve regeneration and PDLLA is a sort of hopeful candidate for tissue engineering.     

电刺激治疗神经系统损伤疾病：研究进展与展望

Nervous system injury can disrupt communications between neurons, leading to loss of basic nerve functions and even paralysis. The clinical prognosis of nervous system injury is usually poor. This adversely affects the physical and mental health of patients and their families, and causes serious economic losses to the society. Due to slow and incomplete healing, the regenerative capacity of the nervous system is limited. Despite development of various biomedical treatment options such as, stem cell transplantation, neurotrophic factors and scaffold application, it is still very difficult to achieve adequate therapeutic effects that can benefit clinical practice. It is worth noting that nervous system components are closely related to electric fields (EFs), and a fundamental property of neurons is plasticity in response to endogenous and exogenous electrical stimulations. Electrical stimulation has been applied by researchers to induce nerve repair. This review summarizes the progress in research on EFs on neurons and applications of EFs in the treatment of peripheral nerve system and central nerve system injuries, focusing on the methods and effects of electrical stimulation. Research using direct, alternating, and pulsed EFs, with various parameters, has all demonstrated its positive effects on nerve healing and motor function recovery. Research on nanogenerators (NGs), a novel electrical stimulation technology that can convert mechanical energy into electrical energy, has achieved great progress in recent years. In biomedicine, NGs can collect the mechanical energy of human motion and convert it into electrical stimulations without requiring an external power supply, which can lead to significant innovations in electrical stimulation therapy. This review also discusses the recent applications of NGs in the treatment of nervous system diseases. NGs can be used to fabricate miniature, ultra-thin, flexible, and biodegradable healthcare devices according to different application scenarios such as in vivo or in vitro. NGs have enabled specific applications in deep brain stimulation, peripheral nerve stimulation, muscle stimulation, and sensory substitution to restore nervous system function. In order to apply electrical stimulation therapy in the clinical setting and improve the quality of life of patients with neurological injuries, further research into stimulation devices and their settings and parameters is highly desirable.