Decellularized nerve graft [Neurosurgery Wiki]

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====== Decellularized nerve graft ======

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A **decellularized [[nerve graft]]** refers to a [[nerve tissue]] that has undergone a process of [[decellularization]], which involves removing the cellular components while preserving the [[extracellular matrix]] (ECM). This process leaves behind the structural framework of the nerve, including [[collagen]], [[elastin]], and other important components that provide the [[scaffold]]ing necessary for [[nerve regeneration]].

The decellularization process typically involves the use of detergents, [[enzyme]]s, or other chemical agents to break down the cells without damaging the ECM. Once decellularized, the [[nerve graft]] can be used as a biological scaffold for [[nerve repair]] or [[reconstruction]] in nerve injuries, promoting the [[regeneration]] of nerve fibers through the preserved matrix. The idea is to provide a natural, biocompatible environment for regenerating nerves, which can help reduce immune rejection and support the growth of new nerve tissue.

These grafts are being studied and used in both preclinical and clinical settings, particularly for peripheral nerve injuries, and are considered a promising option for nerve repair when autologous nerve grafts (using the patient's nerves) are not available or suitable.
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A study explores the [[efficacy]] of a [[neural graft]] constructed using [[adipose mesenchymal stem cell]]s (ADSC), acellular microtissues (MTs), and [[chitosan]] in the treatment of [[peripheral nerve defect]]s.

[[Stem cell therapy]] with acellular MTs provided a suitable [[microenvironment]] for [[axonal regeneration]] and compensated for the lack of repair cells in the neural ducts of male 8-week-old [[Sprague Dawley rat]]s.

[[In vitro]], acellular MTs retained the intrinsic [[extracellular matrix]] and improved the narrow microstructure of acellular nerves, thereby enhancing cell functionality. In vivo, neuroelectrophysiological studies, gait analysis, and [[sciatic nerve]] histology demonstrated the regenerative effects of active acellular MT. The Chitosan + Acellular-MT + ADSC group exhibited superior myelin sheath quality and improved neurological and motor function recovery.

Active acellular-MTs pre-cellularized with ADSC hold promise as a safe and effective clinical treatment method for peripheral nerve defects
((Zhang Z, Li M, Cheng G, Wang P, Zhou C, Liu Y, Duan X, Wang J, Xie F, Zhu Y, Zhang J. A [[chitosan]]/[[acellular matrix]]-based [[neural graft]] carrying [[mesenchymal stem cell]]s to promote [[peripheral nerve repair]]. Stem Cell Res Ther. 2024 Dec 31;15(1):503. doi: 10.1186/s13287-024-04093-5. PMID: 39736729.)).
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The study on the chitosan/acellular matrix-based neural graft carrying mesenchymal stem cells presents a promising approach for enhancing peripheral nerve repair. The combination of adipose-derived stem cells (ADSC) and acellular microtissues (MTs) encapsulated in chitosan scaffolds demonstrated positive outcomes in both in vitro and in vivo models, showing improved nerve regeneration, myelin sheath quality, and functional recovery. These results suggest that this innovative graft could provide a potential solution for treating peripheral nerve defects.

However, the study's impact is limited by certain weaknesses, such as the lack of detailed control groups, short-term follow-up, and insufficient mechanistic insights into the regeneration process. Further studies, including long-term evaluations, larger sample sizes, and a more thorough understanding of the cellular mechanisms, are necessary to confirm the clinical applicability and safety of this approach in humans. Despite these limitations, the study lays a promising foundation for future research in [[regenerative medicine]] and [[peripheral nerve repair]].