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Avoiding scar tissue formation of peripheral nerves with the help of an acellular collagen matrix

INTRODUCTION: Extensive scar tissue formation after peripheral nerve injury or surgery is a common problem. To avoid perineural scarring, implanting a mechanical barrier protecting the nerve from inflammation processes in the perineural environment has shown promising results for functional recovery...

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Autores principales: Aman, Martin, Mayrhofer-Schmid, Maximilian, Schwarz, Daniel, Bendszus, Martin, Daeschler, Simeon C., Klemm, Tess, Kneser, Ulrich, Harhaus, Leila, Boecker, Arne H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403074/
https://www.ncbi.nlm.nih.gov/pubmed/37540691
http://dx.doi.org/10.1371/journal.pone.0289677
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author Aman, Martin
Mayrhofer-Schmid, Maximilian
Schwarz, Daniel
Bendszus, Martin
Daeschler, Simeon C.
Klemm, Tess
Kneser, Ulrich
Harhaus, Leila
Boecker, Arne H.
author_facet Aman, Martin
Mayrhofer-Schmid, Maximilian
Schwarz, Daniel
Bendszus, Martin
Daeschler, Simeon C.
Klemm, Tess
Kneser, Ulrich
Harhaus, Leila
Boecker, Arne H.
author_sort Aman, Martin
collection PubMed
description INTRODUCTION: Extensive scar tissue formation after peripheral nerve injury or surgery is a common problem. To avoid perineural scarring, implanting a mechanical barrier protecting the nerve from inflammation processes in the perineural environment has shown promising results for functional recovery. This study investigates the potential of an acellular collagen-elastin matrix wrapped around a peripheral nerve after induction of scar tissue formation. MATERIALS AND METHODS: In the present study, 30 Lewis rats were separated into three groups and sciatic nerve scarring was induced with 2.5% glutaraldehyde (GA-CM) or 2.5% glutaraldehyde with a supplemental FDA-approved acellular collagen-elastin matrix application (GA+CM). Additionally, a sham group was included for control. Nerve regeneration was assessed by functional analysis using the Visual Statisc Sciatic Index (SSI) and MR neurography during the 12-week regeneration period. Histological and histomorphometry analysis were performed to evaluate the degree of postoperative scar tissue formation. RESULTS: Histological analysis showed an extensive scar tissue formation for GA-CM. Connective tissue ratio was significantly (p < 0.009) reduced for GA+CM (1.347 ± 0.017) compared to GA-CM (1.518 ± 0.057). Similarly, compared to GA+CM, MR-Neurography revealed extensive scar tissue formation for GA-CM with a direct connection between nerve and paraneural environment. Distal to the injury site, quantitative analysis presented significantly higher axon density (p = 0.0145), thicker axon diameter (p = 0.0002) and thicker myelinated fiber thickness (p = 0.0008) for GA+CM compared to GA-CM. Evaluation of functional recovery revealed a significantly faster regeneration for GA+CM. CONCLUSION: The supplemental application of an acellular collagen-elastin matrix showed beneficial effects in histological, radiological, and functional analysis. Therefore, applying a collagen-elastin matrix around the nerve after peripheral nerve injury or surgery may have beneficial effects on preventing scar tissue formation in the long run. This represents a feasible approach to avoid scar tissue formation in peripheral nerve surgery.
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spelling pubmed-104030742023-08-05 Avoiding scar tissue formation of peripheral nerves with the help of an acellular collagen matrix Aman, Martin Mayrhofer-Schmid, Maximilian Schwarz, Daniel Bendszus, Martin Daeschler, Simeon C. Klemm, Tess Kneser, Ulrich Harhaus, Leila Boecker, Arne H. PLoS One Research Article INTRODUCTION: Extensive scar tissue formation after peripheral nerve injury or surgery is a common problem. To avoid perineural scarring, implanting a mechanical barrier protecting the nerve from inflammation processes in the perineural environment has shown promising results for functional recovery. This study investigates the potential of an acellular collagen-elastin matrix wrapped around a peripheral nerve after induction of scar tissue formation. MATERIALS AND METHODS: In the present study, 30 Lewis rats were separated into three groups and sciatic nerve scarring was induced with 2.5% glutaraldehyde (GA-CM) or 2.5% glutaraldehyde with a supplemental FDA-approved acellular collagen-elastin matrix application (GA+CM). Additionally, a sham group was included for control. Nerve regeneration was assessed by functional analysis using the Visual Statisc Sciatic Index (SSI) and MR neurography during the 12-week regeneration period. Histological and histomorphometry analysis were performed to evaluate the degree of postoperative scar tissue formation. RESULTS: Histological analysis showed an extensive scar tissue formation for GA-CM. Connective tissue ratio was significantly (p < 0.009) reduced for GA+CM (1.347 ± 0.017) compared to GA-CM (1.518 ± 0.057). Similarly, compared to GA+CM, MR-Neurography revealed extensive scar tissue formation for GA-CM with a direct connection between nerve and paraneural environment. Distal to the injury site, quantitative analysis presented significantly higher axon density (p = 0.0145), thicker axon diameter (p = 0.0002) and thicker myelinated fiber thickness (p = 0.0008) for GA+CM compared to GA-CM. Evaluation of functional recovery revealed a significantly faster regeneration for GA+CM. CONCLUSION: The supplemental application of an acellular collagen-elastin matrix showed beneficial effects in histological, radiological, and functional analysis. Therefore, applying a collagen-elastin matrix around the nerve after peripheral nerve injury or surgery may have beneficial effects on preventing scar tissue formation in the long run. This represents a feasible approach to avoid scar tissue formation in peripheral nerve surgery. Public Library of Science 2023-08-04 /pmc/articles/PMC10403074/ /pubmed/37540691 http://dx.doi.org/10.1371/journal.pone.0289677 Text en © 2023 Aman et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Aman, Martin
Mayrhofer-Schmid, Maximilian
Schwarz, Daniel
Bendszus, Martin
Daeschler, Simeon C.
Klemm, Tess
Kneser, Ulrich
Harhaus, Leila
Boecker, Arne H.
Avoiding scar tissue formation of peripheral nerves with the help of an acellular collagen matrix
title Avoiding scar tissue formation of peripheral nerves with the help of an acellular collagen matrix
title_full Avoiding scar tissue formation of peripheral nerves with the help of an acellular collagen matrix
title_fullStr Avoiding scar tissue formation of peripheral nerves with the help of an acellular collagen matrix
title_full_unstemmed Avoiding scar tissue formation of peripheral nerves with the help of an acellular collagen matrix
title_short Avoiding scar tissue formation of peripheral nerves with the help of an acellular collagen matrix
title_sort avoiding scar tissue formation of peripheral nerves with the help of an acellular collagen matrix
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403074/
https://www.ncbi.nlm.nih.gov/pubmed/37540691
http://dx.doi.org/10.1371/journal.pone.0289677
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