Abstract:
Nerve injuries present a substantial challenge within the medical domain due to their prevalent occurrence and significant impact. In nerve injuries, a range of physiopathological and metabolic responses come into play to stabilize and repair the resulting damage. A critical concern arises from the disruption of connections at neuromuscular junctions, leading to profound degeneration and substantial loss of muscle function, thereby hampering motor tasks. While end-to-end neurorrhaphy serves as the established technique for treating peripheral nerve injuries, achieving comprehensive morphofunctional recovery remains a formidable challenge. In pursuit of enhancing the repair process, alternative and supportive methods are being explored. A promising candidate is the utilization of heterologous fibrin biopolymer, a sealant devoid of human blood components. Notably, this biopolymer has showcased its prowess in establishing a stable and protective microenvironment at the site of use in multiple scenarios of regenerative medicine. Hence, this scoping review is directed towards assessing the effects of associating heterologous fibrin biopolymer with neurorrhaphy to treat nerve injuries, drawing upon findings from prior studies disseminated through PubMed/MEDLINE, Scopus, and Web of Science databases. Further discourse delves into the intricacies of the biology of neuromuscular junctions, nerve injury pathophysiology, and the broader utilization of fibrin sealants in conjunction with sutures for nerve reconstruction procedures. The association of the heterologous fibrin biopolymer with neurorrhaphy emerges as a potential avenue for surmounting the limitations associated with traditional sealants while also mitigating degeneration in nerves, muscles, and NMJs post-injury, thereby fostering a more conducive environment for subsequent regeneration. Indeed, queries arise regarding the long-term regenerative potential of this approach and its applicability in reconstructive surgeries for human nerve injuries.
摘要:
神经损伤由于其普遍发生和重大影响而在医学领域内提出了实质性挑战。在神经损伤中,一系列生理病理和代谢反应发挥作用,以稳定和修复由此产生的损害。一个关键的问题是神经肌肉接头处的连接中断,导致严重的退化和肌肉功能的大量丧失,从而阻碍了运动任务。虽然端到端神经吻合术是治疗周围神经损伤的既定技术,实现全面的形态功能恢复仍然是一个巨大的挑战。为了提高修复过程,正在探索替代和支持方法。一个有希望的候选是利用异源纤维蛋白生物聚合物,没有人体血液成分的密封剂。值得注意的是,这种生物聚合物已经展示了其在多种再生医学使用场所建立稳定和保护性微环境的能力。因此,本研究旨在评估将异源纤维蛋白生物聚合物与神经吻合治疗神经损伤的效果。借鉴先前通过PubMed/MEDLINE传播的研究结果,Scopus,和WebofScience数据库。进一步的论述深入探讨了神经肌肉接头生物学的复杂性,神经损伤病理生理学,以及更广泛地利用纤维蛋白封闭剂和缝合线进行神经重建手术。异源纤维蛋白生物聚合物与神经吻合的联系成为克服传统封闭剂相关限制的潜在途径,同时减轻神经退化。肌肉,和NMJ受伤后,从而为随后的再生培养更有利的环境。的确,人们对这种方法的长期再生潜力及其在人类神经损伤重建手术中的适用性提出了质疑。