Incorporation Of Vascular Endothelial Growth Factor And Pleiotrophin Into A Multiluminal Biosynthetic Nerve Implant For The Repair Of Peripheral Nerve Long Gap Defects

Abstract

To repair a fully transected nerve without putting undue tension on the nerve stumps, and too circumvent many of the obvious problems of using harvested nerve grafts synthetic nerve guides have been used in the clinical setting. Thus far this strategy has met with minimal success for the repair of short defects (i.e. 1 - 2.5 cm) while any defect larger than 3 cm have failed. We hypothesize that neurotorphic support, early vascularization, and contact guidance are needed to successfully regenerate a nerve across a long-gap defect. To this end we proposed a biosynthetic nerve implant (BNI) with a multiluminal design that could be incorporated with different neurotrophic factors. Pleiotrophin (PTN) and Vascular Endothelial Growth Factor (VEGF) have been demonstrated to exhibit growth promoting effects on neurons in the central nervous and peripheral nervous systems as well as other cell types within the nerve bundle, e.g. Schwann cells, fibroblasts, and endothelial cells.