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Advanced Materials in Medicine

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Polynerve – an advanced nerve guide conduit for peripheral nerve repair

Challenge we’re trying to solve

Traumatic peripheral nerve injury (PNI) is common and mainly affects the upper limbs of young economically active adults, of both genders. PNI presents serious economic consequences for the patient, and society as a whole, and despite modern microsurgical techniques, functional restoration is always incomplete. For the patient, the outcome is impaired hand sensation, reduced motor function alongside pain and cold intolerance; furthermore, the enduring nature of these symptoms frequently results in psychosocial morbidity and a lifelong impairment of well-being.

Current conduits available on the market have poor outcomes and are therefore not commonly used. The greatest reconstructive challenge lies with the approximately 1 in 5 PNI patients with a ‘nerve gap’, which is a nerve defect caused by the trauma, where direct repair of the two nerve stumps is not possible.  Nerve gaps may be reconstructed using autologous nerve grafts, which sacrifice sensory function in parts of the lower limb in an effort to restore critical function in the hand. The outcomes following nerve grafting are poor and worsen with increasing gap distance.

A new solution therefore would have significant impact on the success of peripheral nerve defect repair and improve patient outcomes.

How we approached it

Polynerve addresses a gap in the market, by aiming to provide a more effective repair strategy to improve outcomes for trauma patients. Furthermore, it has been specifically engineered to accommodate stem cell technologies for future translational research.

The solution developed is a polymer-based nerve guide channel, with parallel grooves on the inner cavity, specifically engineered to influence the orientation of the cells, called Schwann cells. The Schwann cells recognise the physical cues and align and migrate along the grooves, mimicking the formation of tracks that pave the way for regeneration in the body. This simple device is stitched into place providing a guidance tube for the regenerating peripheral nerve.

Who was involved

To undertake this research, an interdisciplinary approach was needed. Chief Investigator, Dr Adam Reid (FBMH), worked with Professor Julie Gough (FSE), Mr Ralph Murphy (FBMH) and Professor Giorgio Terenghi (FBMH).

Outcome

Currently, a Phase 1 Clinical Trial has been completed demonstrating safety of the device and recovery of hand sensory function. Next steps include seeking an industrial partner to license the technology and exploring a variety of biological and material-based improvements to existing conduit.