Conductive Nerve Guidance Conduits Loaded With Adipose Mesenchymal Stem Cells for Peripheral Nerve Regeneration

Peripheral nerve injury (PNI) presents a significant clinical challenge due to the intrinsic limitations of nerve regeneration and poor functional recovery. Although nerve guidance conduits (NGCs) offer a promising alternative to autografts, their therapeutic efficacy is often constrained by insufficient bioactivity and electrical conductivity. To address these dual deficiencies, we engineered an electroactive living nerve conduit by integrating silk sericin (SS)-modified carbon nanotubes (SCNTs) with adipose-derived stem cells (ADSCs). The SCNTs serve as a conductive scaffold, whereas the ADSCs provide a sustained release of neurotrophic factors. This design creates a synergistic microenvironment to promote neuronal maturation and axonal regeneration. In an experimental rat model featuring a 10-mm sciatic nerve gap, ADSC/SCNT/RAM NGCs demonstrated regenerative performance comparable to autografts, facilitating axon connection and recovery of motor functions. Histological assessment revealed that the implanted ADSC/SCNT/RAM NGCs promoted the most extensive nerve and axon regeneration among all groups, as evidenced by the significantly higher counts of S100 calcium-binding protein B (S100-β)-positive cells (10,152 ± 986.00) and Neurofilament Protein 200 (NF200)-positive cells (11,517 ± 795.70). Corroborating these histological findings, functional analysis demonstrated that the ADSC/SCNT/RAM group achieved the highest sciatic nerve function index (SFI) at 12 weeks post-surgery (-58.06 ± 1.46), a value comparable to the Autograft group (-57.73 ± 1.80). This strategy proposes a promising tissue-engineered alternative to autografts for nerve repair.