Peripheral nerve injury (PNI) results in debilitating loss of limb function and oftentimes disabling pain. In addition to personal hardship, PNI places considerable demands on rehabilitation resources and creates an enormous socioeconomic burden.
Even with modern surgical procedures and advanced instrumentation, nerve regeneration and functional recovery following nerve repair is far from satisfactory. One of the major challenges is the narrow window of opportunity beyond which the capacity of a nerve to regrow declines and the extent of functional recovery marginalizes.
Huan Wang, M.D., Ph.D. and her colleagues focus on developing strategies to expand the time window of opportunity and improve functional outcomes after nerve reconstruction.
- Using tissue-engineering technology to deliver growth factors to the nerve repair site. This ensures sustained release of neurotrophic factors and hence provides a more favorable milieu for regeneration.
- Supplementing functioning Schwann cells derived from nerves prepared in an in vitro system or induced from stem cells of the adipose tissue to counteract the lack of healthy Schwann cells at the nerve repair site. These cells can optimize the regeneration microenvironment and guide the extension of growing nerve fibers.
- Developing novel animal models to delineate the nature and time course of denervation muscle changes; identifying the key indicators of muscle receptivity, including electromyographic changes, muscle fiber type, neuromuscular junction changes and changes of myogenic genes; and evaluating the impact of these changes on nerve regeneration and the potential success of a nerve repair.
Significance to patient care
Dr. Wang’s research aims to determine the extent of detrimental changes following nerve injury and the prognostic factors that help physicians more accurately predict an individual patient's chances for success with different surgical interventions. This will also shed light on identifying key factors that hinder nerve regeneration and lead to interventions to overcome these obstacles.