Peripheral Neve Regeneration in Vivo with Tubular Prostheses

We have developed a quantitative model which allows assessment of the number of primary motor and sensory neurons which regenerate an axon through a tubular prosthesis bridging a 4–5 mm gap of peripheral nerve (1). Labeled somas of motor and sensory neurons are quantified following retrograde transport of horseradish peroxidase (HRP) applied to the distal stump beyond the bridged transection site. The number of myelinated axons at mid-guide level is also quantified. We have studied biodegradable and nin-biodegradable materials as well as the effects on nerve regeneration of basement membrane materials, and specific proteins added to the nerve guide., Adding a laminin-oontaining gel (Matrigel, Collaborative Research, MA) to the lumen of polyethylene tubes increases the rate of nerve regeneration as well as the maximum distance that can be successfully bridged. Similar effects are seen with collagen-based nerve guides when the laminin-cxitaining gel is incorporated into the tube wall. Addition of highly purified acidic fibroblast growth factor (aFGF) to the lumen of polyethylene tubes filled with collagen significantly increases the number of myelinated axons at mid-tube level and the number of primary sensory neurons labeled with HRP. We coxpared collagen-based nerve guides of different wall porosities. Tubes freely permeable to bovine serum albumin (BSA) contain significantly more myelinated axons (4 week survival) than identical collagen tubes permeable to glucose-size molecules. These and additional experiments demonstrate that manipulation of the extracellular microenvironment of regenerating PNS axons can significantly enhance the early regenerative response.