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      Peripheral nerve conduits: technology update

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          Abstract

          Peripheral nerve injury is a worldwide clinical problem which could lead to loss of neuronal communication along sensory and motor nerves between the central nervous system (CNS) and the peripheral organs and impairs the quality of life of a patient. The primary requirement for the treatment of complete lesions is a tension-free, end-to-end repair. When end-to-end repair is not possible, peripheral nerve grafts or nerve conduits are used. The limited availability of autografts, and drawbacks of the allografts and xenografts like immunological reactions, forced the researchers to investigate and develop alternative approaches, mainly nerve conduits. In this review, recent information on the various types of conduit materials (made of biological and synthetic polymers) and designs (tubular, fibrous, and matrix type) are being presented.

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          Most cited references 133

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          Decellularization of tissues and organs.

          Decellularized tissues and organs have been successfully used in a variety of tissue engineering/regenerative medicine applications, and the decellularization methods used vary as widely as the tissues and organs of interest. The efficiency of cell removal from a tissue is dependent on the origin of the tissue and the specific physical, chemical, and enzymatic methods that are used. Each of these treatments affect the biochemical composition, tissue ultrastructure, and mechanical behavior of the remaining extracellular matrix (ECM) scaffold, which in turn, affect the host response to the material. Herein, the most commonly used decellularization methods are described, and consideration give to the effects of these methods upon the biologic scaffold material.
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            Neural tissue engineering: strategies for repair and regeneration.

            Nerve regeneration is a complex biological phenomenon. In the peripheral nervous system, nerves can regenerate on their own if injuries are small. Larger injuries must be surgically treated, typically with nerve grafts harvested from elsewhere in the body. Spinal cord injury is more complicated, as there are factors in the body that inhibit repair. Unfortunately, a solution to completely repair spinal cord injury has not been found. Thus, bioengineering strategies for the peripheral nervous system are focused on alternatives to the nerve graft, whereas efforts for spinal cord injury are focused on creating a permissive environment for regeneration. Fortunately, recent advances in neuroscience, cell culture, genetic techniques, and biomaterials provide optimism for new treatments for nerve injuries. This article reviews the nervous system physiology, the factors that are critical for nerve repair, and the current approaches that are being explored to aid peripheral nerve regeneration and spinal cord repair.
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              Collagen fibril formation.

              Collagen is most abundant in animal tissues as very long fibrils with a characteristic axial periodic structure. The fibrils provide the major biomechanical scaffold for cell attachment and anchorage of macromolecules, allowing the shape and form of tissues to be defined and maintained. How the fibrils are formed from their monomeric precursors is the primary concern of this review. Collagen fibril formation is basically a self-assembly process (i.e. one which is to a large extent determined by the intrinsic properties of the collagen molecules themselves) but it is also sensitive to cell-mediated regulation, particularly in young or healing tissues. Recent attention has been focused on "early fibrils' or "fibril segments' of approximately 10 microns in length which appear to be intermediates in the formation of mature fibrils that can grow to be hundreds of micrometers in length. Data from several laboratories indicate that these early fibrils can be unipolar (with all molecules pointing in the same direction) or bipolar (in which the orientation of collagen molecules reverses at a single location along the fibril). The occurrence of such early fibrils has major implications for tissue morphogenesis and repair. In this article we review the current understanding of the origin of unipolar and bipolar fibrils, and how mature fibrils are assembled from early fibrils. We include preliminary evidence from invertebrates which suggests that the principles for bipolar fibril assembly were established at least 500 million years ago.
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                Author and article information

                Journal
                Med Devices (Auckl)
                Med Devices (Auckl)
                Medical Devices: Evidence and Research
                Medical Devices (Auckland, N.Z.)
                Dove Medical Press
                1179-1470
                2014
                01 December 2014
                : 7
                : 405-424
                Affiliations
                [1 ]BIOMATEN, Center of Excellence in Biomaterials and Tissue Engineering, Middle East Technical University (METU), Ankara, Turkey
                [2 ]Department of Biotechnology, METU, Ankara, Turkey
                [3 ]Department of Bioengineering, Gumushane University, Gumushane, Turkey
                [4 ]Faculty of Engineering, Department of Medical Engineering, Acibadem University, Istanbul, Turkey
                [5 ]School of Medicine, Department of Histology and Embryology, Acibadem University, Istanbul, Turkey
                [6 ]Department of Chemistry, Faculty of Arts and Sciences, METU, Ankara, Turkey
                [7 ]Department of Biological Sciences, Faculty of Arts and Sciences, METU, Ankara, Turkey
                Author notes
                Correspondence: V Hasirci, BIOMATEN, Center of Excellence in Biomaterials and Tissue Engineering, Middle East Technical University (METU), Ankara, Turkey, Email vhasirci@ 123456metu.edu.tr

                *These authors have contributed equally to this work

                Article
                mder-7-405
                10.2147/MDER.S59124
                4257109
                25489251
                © 2014 Arslantunali et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Categories
                Review

                Biotechnology

                synthetic biomaterials, peripheral nerve injury, natural biomaterials

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