Peripheral nerve injuries affect millions of people every year. After trauma or surgery, patients often require autologous nerve grafting, which is the „gold standard“, but nevertheless a complex and demanding surgical procedure with low chances of success. The choice of graft type and optimal regeneration conditions are crucial for the final result.Scientists of the Ludwig-Boltzmann-Institute in Vienna rise to the challenge by utilizing Spark Wave Technology which is, due to its cell activating effect in various tissues, a highly emergent technology in the field of regenerative medicine (e. g. in urology and orthopaedics).
The researchers found that Spark Wave treatment improves peripheral nerve regeneration in an experimental rat model, where the animals received a homotopic autograft in the right sciatic nerve, fixed with an epineural suture (Hausner et al., 2012). Further investigations, aiming at the underlying mechanisms, showed that Spark Wave treatment activates Schwann cells, which are the principal supporting glial cells in the peripheral nervous system that facilitate regeneration (Schuh et al., 2016).
With these recent advances in understanding the underlying mechanisms of Spark Wave Therapy in peripheral nerve regeneration, the group established a femoral nerve model in rats and analyzed the regeneration capacity of motor or sensory nerve grafts in vivo, in either a homotopic or heterotopic design. Additionally, the Schwann cell activation of motor, sensory and mixed nerves was analyzed in vitro (Hercher et al., 2018).
The in vivo data indicate that a heterotopic nerve grafting model is inferior to a homotopic, phenotypically matched graft. Notably, Spark Wave Therapy was able to activate Schwann cells and to accelerate peripheral nerve regeneration in both conditions which finally resulted in an improved functional recovery of the hind limbs (Hercher et al., 2018).
The Team of the Ludwig Boltzmann Institute for experimental and clinical traumatology impressively demonstrated that Spark Wave Therapy enhances peripheral nerve regeneration and has great optimizing potential for surgical treatment after peripheral nerve injuy in future.
Clinical studies at the Meidling and Lorenz Böhler Hospitals are on their way. We wish all the best and we are now very excited about the outcome!
References:
- Hausner, T., Pajer, K., Halat, G., Hopf, R., Schmidhammer, R., Redl, H., & Nógrádi, A. (2012). Improved rate of peripheral nerve regeneration induced by extracorporeal shock wave treatment in the rat. Experimental Neurology, 236(2), 363–370. https://doi.org/10.1016/j.expneurol.2012.04.019
- Schuh, C. M. A. P., Hercher, D., Stainer, M., Hopf, R., Teuschl, A. H., Schmidhammer, R., & Redl, H. (2016). Extracorporeal shockwave treatment: A novel tool to improve Schwann cell isolation and culture. Cytotherapy, 18(6), 760–770. https://doi.org/10.1016/j.jcyt.2016.03.002
- Hercher D. et al. (2018). Abstract published at the BRM in Bologna and at the TERMIS World Congress in Kyoto 2018).
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