Nerve stem cells
Clinical strategies for repairing peripheral nerve injury are principally limited to suturing the proximal and distal stump for transection injuries, or the implantation of an autograft for gap injuries. The major drawback with autografting is the loss of donor nerve, and therefore guidance conduits are being used to entubulate and redirect proximal nerve growth.
A limited number of nerve guides are now available commercially, but regrowth distances are small. However, the local delivery of Schwann cells can increase nerve regeneration significantly – but using a patient’s own Schwann cells clinically is limited due to slow growth in culture and the need to biopsy a healthy donor nerve.
Stem cells from both adipose and bone marrow can be differentiated into Schwann-like cells, and have therefore been considered as an alternative cell source for enhancing nerve regeneration in both the central and peripheral nervous system.
Present research in nerve stem cells is addressing this and has found that ASCs from three different anatomical locations of fat – subcutaneous, perinephric (fat tissue surrounding the kidney) and the epididymis have different abilities in forming Schwann-like cells. This has been determined systematically by protein marker analysis, neurotrophin profile and a functional ability to stimulate neuronal cell outgrowth.
Our findings to date support the use of subcutaneous-ASCs or perinephrium-dASCs over epididymis-ASCs as an alternative approach to using primary Schwann cells for therapeutic delivery in the treatment of peripheral nerve injuries.