title: Chitosan-film enhanced chitosan nerve guides for long-distance regeneration of peripheral nerves.
abstract: Biosynthetic nerve grafts are developed in order to complement or replace autologous nerve grafts for peripheral nerve reconstruction. Artificial nerve guides currently approved for clinical use are not widely applied in reconstructive surgery as they still have limitations especially when it comes to critical distance repair. Here we report a comprehensive analysis of fine-tuned chitosan nerve guides (CNGs) enhanced by introduction of a longitudinal chitosan film to reconstruct critical length 15 mm sciatic nerve defects in adult healthy Wistar or diabetic Goto-Kakizaki rats. Short and long term investigations demonstrated that the CNGs enhanced by the guiding structure of the introduced chitosan film significantly improved functional and morphological results of nerve regeneration in comparison to simple hollow CNGs. Importantly, this was detectable both in healthy and in diabetic rats (short term) and the regeneration outcome almost reached the outcome after autologous nerve grafting (long term). Hollow CNGs provide properties likely leading to a wider clinical acceptance than other artificial nerve guides and their performance can be increased by simple introduction of a chitosan film with the same advantageous properties. Therefore, the chitosan film enhanced CNGs represent a new generation medical device for peripheral nerve reconstruction.
authors.affiliation: Institute of Neuroanatomy, Hannover Medical School, Hannover, Germany and Center for Systems Neuroscience (ZSN), Hannover, Germany.
authors.forename: Cora
authors.initials: C
authors.lastname: Meyer
authors.affiliation: Department of Translational Medicine - Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Stenberg
authors.affiliation: Department of Cell Biology, Physiology, and Immunology, Institute of Neurosciences, Universitat Autonoma de Barcelona and CIBERNED, Bellaterra, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Gonzalez-Perez
authors.affiliation: Institute of Neuroanatomy, Hannover Medical School, Hannover, Germany and Center for Systems Neuroscience (ZSN), Hannover, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Wrobel
authors.affiliation: Department of Clinical and Biological Sciences, and Cavalieri Ottolenghi Neuroscience Institute, University of Turin, Turin, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Ronchi
authors.affiliation: Department of Cell Biology, Physiology, and Immunology, Institute of Neurosciences, Universitat Autonoma de Barcelona and CIBERNED, Bellaterra, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Udina
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University Hospital, Kanazawa, Japan.
authors.forename: Seigo
authors.initials: S
authors.lastname: Suganuma
authors.affiliation: Department of Clinical and Biological Sciences, and Cavalieri Ottolenghi Neuroscience Institute, University of Turin, Turin, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Geuna
authors.affiliation: Department of Cell Biology, Physiology, and Immunology, Institute of Neurosciences, Universitat Autonoma de Barcelona and CIBERNED, Bellaterra, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Navarro
authors.affiliation: Department of Translational Medicine - Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden.
authors.forename: Lars B
authors.initials: LB
authors.lastname: Dahlin
authors.affiliation: Institute of Neuroanatomy, Hannover Medical School, Hannover, Germany and Center for Systems Neuroscience (ZSN), Hannover, Germany. Electronic address: Grothe.Claudia@mh-hannover.de.
authors.forename: Claudia
authors.initials: C
authors.lastname: Grothe
authors.affiliation: Institute of Neuroanatomy, Hannover Medical School, Hannover, Germany and Center for Systems Neuroscience (ZSN), Hannover, Germany.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Haastert-Talini
mesh_terms: D000818:Animals; D048271:Chitosan / Q000494:pharmacology / Q000627:therapeutic use*; D003929:Diabetic Neuropathies / Q000188:drug therapy* / Q000503:physiopathology; D009416:Nerve Regeneration / Q000187:drug effects*; D051381:Rats; D017208:Rats, Wistar
chemical_list: D048271:Chitosan
keywords: Chitosan film; Chitosan nerve guide; Diabetic condition; Functional recovery; Nerve morphometry; Regenerative matrix