生物材料导管修复面神经损伤与再生  

Regeneration of facial nerve injury repaired by biomaterial nerve conduits

作　　者：徐聪[1,2,3] 赵赫 孙岩 Xu Cong;Zhao He;Sun Yan(Second Clinical Medical College,Binzhou Medical University,Yantai 264000,Shandong Province,China;Department of Otorhinolaryngology,Head andNeck Surgery,Yantai Yuhuangding Hospital,Qingdao University,Yantai 264000,Shandong Province,China;Shandong Provincial Clinical Research Center forOtorhinolaryngologic Diseases,Yantai 264000,Shandong Province,China)

机构地区：[1]滨州医学院第二临床医学院,山东省烟台市264000 [2]青岛大学附属烟台毓璜顶医院耳鼻咽喉头颈外科,山东省烟台市264000 [3]山东省耳鼻喉疾病临床医学研究中心,山东省烟台市264000

出　　处：《中国组织工程研究》2023年第7期1089-1095,共7页Chinese Journal of Tissue Engineering Research

基　　金：山东省自然科学基金(ZR2021MH378),项目负责人:孙岩;烟台市科技计划项目(2021MSGY046),项目负责人:孙岩。

摘　　要：背景:自体神经移植是目前修复受损面神经、治疗面瘫的首选治疗方式,但供体神经有限,并会对供体部位造成一定的损伤。生物材料导管是组织工程的一项重要分支,通过连接神经断端,为神经提供物理屏障及三维再生通道,是最有潜力的面神经修复方法。目的:对近年来用于修复面神经损伤的生物材料应用进展进行综述。方法:以“biomaterials,nerve conduits,facial nerve”为英文检索词,以“生物材料、神经导管、面神经”为中文检索词,检索自建库至2022年1月收录在PubMed与中国知网数据库的相关文献,依据纳入和排除标准,最终纳入相关文献68篇进行综述。结果与结论:①目前用于修复面神经损伤的神经导管生物材料,大致分为脱细胞材料及可降解材料;脱细胞材料主要包括动脉、静脉及肌肉等,可降解材料主要包括胶原蛋白、聚乙醇酸、聚己内酯、丝蛋白、壳聚糖及石墨烯等。②静脉及胶原蛋白是目前研究最多的2种材料,与干细胞和神经营养因子结合后,其促进面神经再生效果明显增强,但距离自体神经移植的效果仍有一定差距。③石墨烯性质更加活泼,更易与神经营养物质结合,具有抗炎、促进M2巨噬细胞增多的作用,有利于损伤的面神经愈合再生,是目前最有发展潜力的修复面神经损伤的生物材料之一。④文章总结了各种生物材料搭载干细胞、生长因子或雕刻微图案后对面神经损伤修复的效果发现,“多组合”是神经导管发展的趋势,其结合细胞和生长因子,能有效促进面神经再生,但由于生物材料之间的吸附率及释放率差异较大,容易导致资源浪费且作用时间短。⑤在神经导管上雕刻纵行微通道可为神经元再生提供引导方向,加快轴突再生速度,是未来用于修复面神经损伤的神经导管研究的重点方向。BACKGROUND:Autologous nerve transplantation is the first choice for repairing the damaged facial nerve and treating facial paralysis,but the donor nerve is limited and will cause certain damage to the donor site.Biomaterial catheter is an important branch of tissue engineering.It provides physical barrier and three-dimensional regeneration channel for the nerve by connecting the nerve broken end,and it is the most potential facial nerve repair method.OBJECTIVE:To review the application progress of biomaterials used to repair facial nerve injury in recent years.METHODS:“biomaterials,nerve conduits,facial nerve”were used as the Chinese and English search terms.Relevant articles were searched on CNKI and PubMed from inception to January 2022.According to the inclusion and exclusion criteria,68 relevant articles were finally included.RESULTS AND CONCLUSION:(1)At present,biological material nerve conduits used for facial nerve injury can be roughly divided into acellular materials and degradable materials.Acellular materials mainly include arteries,veins,and muscles,while degradable materials mainly include collagen,polyglycolic acid,polycaprolactone,silk protein,chitosan,and graphene.(2)Vein and collagen are the two materials most studied at present.Atier combining with stem cells and neurotrophic factors,their nerve regeneration effect is significantly enhanced,but there is still a certain gap between them and autologous nerve transplantation.(3)Graphene is more active and more easily combined with neurotrophic substances.It has anti-infammatory effects and promotes the increase of M2 macrophages,which is conducive to nerve healing and regeneration.It is one of the most promising biomaterials at present.(4)The effects of various biomaterials loaded with stem cells,growth factors or sculpted micropatierns on the repair of facial nerve injury were summarized.“Multiple combination”is the trend of nerve conduit development.The combination of cells and growth factors can effectively promote nerve regeneration,but

关 键 词：面神经 神经导管 生物材料 神经损伤 多组合 干细胞 生长因子 纵行微通道 

分 类 号：R459.9[医药卫生—治疗学] R741[医药卫生—临床医学] R319