Growth factor and stem cell enhanced conduits in peripheral nerve regeneration and repair

Objective: Despite the capacity for spontaneous axonal regeneration, recovery after severe peripheral nerve injury remains variable and often very poor. In addition, autologous nerve grafts, considered to be the 'gold standard' in nerve repair technique, are plagued by restricted donor tissue availability and donor site morbidity. Our primary objective is to highlight new and emerging methods of nerve repair, which have the potential to significantly improve both the functional and behavioral outcome after clinical nerve injury. Methods: A critical analysis of nerve injury and regeneration literature concentrating on outcome measures from both immediate and chronically denervated experimental works was conducted. Results: Results of numerous works employing both growth factor and stem cell enhanced nerve guidance conduits have shown encouraging results. However, further research is needed to optimize guidance conduit dynamics, bioavailability and delivery of both growth factors and stem cells to enhance peripheral nerve regeneration and functional recovery. Discussion: This review discusses current animal and clinical growth factor and stem cell studies, specifically focusing on future bio-engineering approaches in developing a nerve guidance conduit in the future. [Neurol Res 2008; 30: 1030-1038]