Publication: Peripheral nerve injury and regeneration
Authors
Terenghi, G.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
The process of nerve regeneration has been
studied extensively by traditional morphological
methods, but it is only recently that has been possible to
identify more precisely the contribution of different
nerve subpopulations. By studying different models of
nerve repair and regeneration, it is becoming apparent
that other tissue components are contributing to the
overall process. When muscle grafting is carried out to
repair an injured nerve, the regenerating axons are
migrating in parallel with Schwann cells to bridge the
nerve gap. The presence of Schwann cells is essential for
a successful nerve regeneration, most probably because
their production of different neuronal trophic factors.
This pattern is also repeated when fibronectin mats are
used for nerve repair, indicating the possibility to use
this new synthetic matrix for clinical application. If the
target organ is analysed after nerve repair, the recovery
of all nerve components is evident. However, the process
occurs at different times in separate s k i compartments,
and the regeneration of the autonomic innervation
appears to be preceded by that of the sensory nerves.
When looking at cutaneous nerve regeneration following
different type of injury, a common pattern of events
becomes apparent. In skin flaps, nerve regeneration
begins from the skin surrounding the wound edge, or
from the pedicle, and sensory nerves are the first to penetrate into the flap. Angiogenesis precedes
reinnervation of the flap, and initially regenerating fibres
appear to be associated with newly formed blood
vessels. This pattern is evident also in full-thickness
wounds and in suction blisters, where only the more
superficial cutaneous layer is disrupted. Furthermore, the
presence of keratinocytes appears to exert a directional
influence on both regenerating blood vessels and nerves,
which follow the regenerating keratinocytes when reepidermalisation
is taking place. These results would
indicate that there is a close relationship between nerve
fibres and blood vessels during regeneration, with a
substantial contribution to the process from other tissue
components and soluble factors from the surrounding
environment.
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