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Chapter category: Tissue Engineering

Encouraging Regeneration of Host Neurones: The Use of Peripheral Nerve Bridges, Glial Cells or Biomaterials

Chapter authors:
Antal Nógrádi

Recent results challenged the dogma that regeneration of CNS axons is impossible. These findings stimulated the interest of experimental neurobiologists and led to re- search that improved our understanding of the rules that control regeneration of structures in the mammalian spinal cord after injury or disease. Therapeutic approaches can target either the acute management of the injured spinal cord to protect it from the secondary, autodestructive lesions, such as edema, inflammation, necrosis etc. and/or after the acute phase of the injury the functional restoration of the patients’ lost functions.1 This restoration can be at present attempted only by using functional methods or restorative neurology. In experimental conditions of partial or complete spinal cord injury the restoration of lost spinal cord function was thought to be possible by using neuronal grafts to injured spinal cord to act as so-called “relay-bridges” or to release neurotransmitters (for details see chapters 3 and 5). The evaluation of the effects of various cellular components taken from either the PNS or the CNS on regeneration are also discussed in this chapter. Nonneuronal PNS elements and various materials have been used for decades to establish proper connections between lesioned and disconnected parts of the spinal cord and to restore the anatomical continuity and possibly the functional integrity between the separated elements of the cord. Most of these efforts simply wanted to build a “bridge” between the disconnected parts of the severed cord along which nerve fibres could pass and bridge the injured area. These experiments focused on encouraging the limited regenerative capacity of spinal cord neurones. Though initially there were some promising results obtained by several laboratories, the number of different approaches shows how desperate these attempts were to achieve any improvement in the sad outcome of a trauma to the spinal cord. In this chapter we discuss the results of these attempts and their possible use for the management of patients with injured spinal cord.

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