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The foreign body response and morphometric changes associated with mesh-style peripheral nerve cuffs
Michael B Christensen1, Patrick A Tresco1
1Department of Bioengineering, College of Engineering, University of Utah, 36 S Wasatch Dr, Rm 3100, Salt Lake City, UT 84112, United States.
Acta Biomaterialia
|December 11, 2017
Summary
Silicone nerve cuffs cause less inflammation and nerve damage than mesh designs. This study compares silicone and mesh nerve cuffs, finding silicone superior for peripheral nerve applications.
Area of Science:
- Biomaterials Science
- Neuroscience
- Surgical Implants
Background:
- Nerve cuffs are used for neural interfacing, with silicone being the standard material.
- The foreign body response (FBR) and nerve morphometric changes associated with different nerve cuff designs are not well-documented.
- Understanding these effects is crucial for optimizing neural implant design.
Purpose of the Study:
- To compare the foreign body response (FBR) and nerve morphometric changes induced by silicone and metallic mesh nerve cuffs in the rat sciatic nerve.
- To evaluate the impact of parylene coating on metallic mesh nerve cuffs.
- To correlate inflammatory responses with observed nerve morphometric alterations.
Main Methods:
- Implantation of silicone, uncoated metallic mesh, and parylene-coated metallic mesh nerve cuffs in the rat sciatic nerve.
- Histological and morphometric analysis of the nerve tissue and implant interface two months post-implantation.
- Assessment of inflammatory markers including macrophage and foreign body giant cell presence.
- Quantification of nerve fiber density and diameter distribution.
Main Results:
- All implanted cuffs elicited a persistent inflammatory response with macrophages and foreign body giant cells.
- Mesh cuffs, particularly uncoated ones, showed a higher prevalence of foreign body giant cells.
- Mesh cuffs led to significant reductions in nerve fiber packing density and a greater loss of large diameter fibers compared to silicone cuffs.
- Foamy macrophages were more abundant in the endoneurial space of mesh-implanted nerves.
Conclusions:
- Silicone nerve cuffs demonstrate a more favorable biocompatibility profile compared to metallic mesh designs.
- Mesh nerve cuffs induce a greater inflammatory response and more pronounced detrimental morphometric changes in the peripheral nerve.
- These findings suggest that material choice and design significantly influence the biological response to nerve cuffs, with silicone being preferable in the absence of penetrating injury.
