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Cellular Therapies in Nerve Regeneration

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Plastic and Reconstructive Surgery

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Abstract

Currently, allogenic nerve transplantation is the only feasible treatment option for patients suffering from extensive peripheral nerve defects. However, it requires the use of immunosuppressive drugs to prevent allograft rejection. The most promising approach to obtain satisfactory sensory and functional restoration of large nerve defects is cellular therapy, which due to paracrine properties of cells can facilitate nerve regeneration and prevent nerve allograft rejection. Among cellular therapies that could be successfully applied in peripheral nerve regeneration are Schwann cells and mesenchymal stem cells/stromal cells (MSC), including bone marrow-derived mesenchymal stem cells, umbilical cord-derived mesenchymal stem cells, and adipose tissue-derived stem cells. MSC are a great candidate for supportive cellular therapy for nerve allograft transplantation due to their immunomodulatory properties.

Based on their experience in nerve repair, Siemionow’s group developed a new treatment modality of epineural sheath conduit augmented with bone marrow derived MSC. Epineural sheath is a biologic conduit created by removal of fascicles from the nerve. It is easily available from allogenic donor nerves, has low immunogenic potential, and expresses laminin B2, an extracellular matrix component crucial for axon growth. Combining epineural sheath biological conduit with MSC can facilitate regeneration of difficult to restore long-nerve defects.

This chapter describes currently tested and future sources of cellular therapies for nerve regeneration. It also presents a series of Siemionow’s group studies which led to development of in vitro created biological conduit of epineural sheath supported with bone marrow derived MSC and successfully tested this new conduit in vitro and in vivo.

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Authors and Affiliations

  1. Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL, USA

    Joanna Cwykiel MSc, Ewa Bryndza Tfaily PhD & Maria Z. Siemionow MD, PhD, DSc

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  1. Joanna Cwykiel MSc
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  2. Ewa Bryndza Tfaily PhD
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  3. Maria Z. Siemionow MD, PhD, DSc
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Correspondence to Maria Z. Siemionow MD, PhD, DSc .

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Editors and Affiliations

  1. Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, USA

    Maria Z. Siemionow

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Cwykiel, J., Tfaily, E.B., Siemionow, M.Z. (2015). Cellular Therapies in Nerve Regeneration. In: Siemionow, M. (eds) Plastic and Reconstructive Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-6335-0_76

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  • DOI: https://doi.org/10.1007/978-1-4471-6335-0_76

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