Building a tunnel made of hard and soft materials to guide the reconnection of severed nerve endings may be the first step toward helping patients regain feeling and movement.
This is the claim of Pennsylvania State University (Penn State) researchers who have published their results in Advanced Healthcare Materials.
According to Penn State, spontaneous nerve regeneration is limited to small lesions within the injured peripheral nerve system and is actively suppressed within the central nervous system.
When a nerve in the peripheral nervous system is cut slightly, nerve endings can regenerate and reconnect. However, if the distance between the two endings is too far, the growth can go off course and fail to connect.
The researchers are said to have developed a novel hybrid conduit that consisted of a hydrogel as an external wall along with an internal wall made of an electrically active conducting polymer to serve as a tunnel that guides the regrowth and reconnection of the severed nerve endings.
Mohammad Reza Abidian, assistant professor of biomedical engineering, Penn State, said that the method could offer advantages over current surgeries that are used to reconnect severed nerves.
‘Autografts are currently the gold standard for bridging nerve gaps,’ said Abidian. ‘This is an operation that takes the nerve from another portion of the body — for instance — from a tendon, and then it is grafted onto the injured nerve.’
However, the operation can be painful and there are often mismatches in size between the severed nerve endings and the new grafted portion of the nerve, Abidian said.
The researchers used agarose, a hydrogel that is permeable and more likely to be accepted by the body.
However, because the hydrogel expands in water and fluids, the expansion would collapse the tunnel and reduce the ability of the nerve endings to regenerate and connect, Abidian said.
The team created a second design by adding a conducting polymer, poly(3,4-ethylenedioxythiophene) — PEDOT — to the design to form a wall that can mechanically support and reinforce the hydrogel. PEDOT is a stable material that can conduct electricity to help electrical signals pass through the nerve.
To make sure nutrients and oxygen would reach the regenerating nerve endings, the team created a spiral PEDOT design that maintained the structural integrity of the wall, but allowed some nutrients and air to reach the nerve.
The researchers tested the three designs — plain hydrogel, hydrogel with fully coated PEDOT wall and hydrogel with a partially coated PEDOT wall — by implanting the device in 10mm nerve gaps in rats and measuring the muscle mass and strength of muscle contractions at the end of the nerves, a method that can indicate whether the separated nerve has reconnected.
According to Abidian, the spiral PEDOT design generated significantly more muscle mass than the other designs, although it did not generate as much muscle mass as the autograft, which was used as the control design in the study.
The pictures of the spiral PEDOT design showed that the health of the nerve itself was nearly indistinguishable from a nerve photographed after an autograft operation.