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Nerve Guidance Conduits (NGCs) are crucial for reducing trauma during nerve repair, directing axonal growth, and preventing scar tissue formation. In this study, tubular functional NGCs were developed based on vertically aligned electrospun poly(lactic-co-glycolic acid) (PLGA) nanofibers (vNGC). They were functionalized by conjugating them with bioactive mimetic peptides: a laminin-derived peptide (LD-BP) to promote vascularization, and nerve growth factor (NGF-BP) and brain-derived neurotrophic factor (BDNF-BP) mimetic peptides to support neural differentiation. The vascular differentiation of HUVECs in response to LD-BP, and the neuronal differentiation of PC12 cells in response to NGF-BP and BDNF-BP, were assessed. The results demonstrated that this approach enabled the fabrication of tubular vNGCs with various diameters, and that vertically aligned PLGA nanofibers significantly improved their structural integrity. Furthermore, BP-conjugated vNGCs outperformed non-conjugated control groups in promoting both vascular and neural differentiation. Importantly, peptide conjugation did not induce cytotoxicity or significantly alter the biodegradability of the vNGCs, supporting their suitability for biomedical applications. Finally, bifunctional vNGCs (BiF-vNGCs), conjugated with LD-BP, NGF-BP, and BDNF-BP, were tested in a rat model of sciatic nerve injury. The BiF-vNGCs showed superior performance compared to unmodified vNGC, Control and s-Control groups, effectively promoting vascularization and neural regeneration in vivo, offering a viable alternative to conventional nerve regeneration methods. Show less

This research evaluated the efficacy of Withaferin A-conjugated mesoporous silica nanoparticles (WA-MSNs) in accelerating the restoration of neural tissue and improving the recovery of sensory and motor functions following a sciatic nerve injury (SNI) in male Wistar rats. WA-MSNs were evaluated for encapsulation efficiency, drug release, particle size, surface charge, and molecular interactions. A rat SNI model was created, and subjects were treated with WA-MSNs, free WA, unloaded MSNs, or received no treatment. The sham group was also included for comparison. Regeneration was measured through the sciatic functional index (SFI), Hargreaves test, and electrophysiology (CMAP and NCV). Complementary assessments included sciatic nerve histomorphometry, assessment of gastrocnemius muscle mass, and Enzyme-Linked Immunosorbent Assay (ELISA) for inflammatory cytokines and neurotrophic factors. WA-MSNs achieved a 74.6% encapsulation efficiency and provided sustained drug release over 72 h. DLS analysis showed a monodisperse colloidal system, with an average hydrodynamic diameter of approximately 198 nm and a zeta potential of -22.4 mV. WA-MSN-treated rats exhibited significantly faster motor and sensory recovery compared to controls (p < 0.001), with electrophysiological parameters approaching those of sham-treated rats. Histological analysis revealed improved axonal morphology, myelination, and recovery of gastrocnemius muscle mass. ELISA results showed modulation of cytokine profiles, characterized by a marked reduction in (IL-1β, IL-6, TNF-α), and substantial elevation in the levels of (IL-10, TGF-β), and elevated neurotrophic factors (NGF, BDNF, NT-3). WA-MSNs significantly promote functional and histological nerve regeneration after SNI by modulating inflammation and enhancing neurotrophic support. These findings support WA-MSNs as a promising therapeutic approach for clinical peripheral nerve repair. Show less

Symptomatic neuromas result from disorganized nerve growth at the site of amputation, causing pain that affects recovery and quality of life. In patients with diabetes mellitus (DM), nerve regeneration is impaired, compounded by comorbidities such as obesity, hypertension, and hyperlipidemia. Surgical approaches including targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) have shown promise for managing symptomatic neuroma, but their effectiveness in diabetic patients is uncertain due to unique challenges in nerve regeneration. This narrative review explores the protective effects of DM on symptomatic neuroma formation and to evaluate the implications for surgical intervention. A systematic search of PubMed was conducted, and relevant studies discussing symptomatic neuroma formation in amputees were included. Symptomatic neuromas were reported in 9.5-50% of amputees involving 9.5% of upper extremity, and 3.8% of lower extremity amputees. Younger age and proximal amputations were identified as significant risk factors. While it is suggested that Interleukin (IL)-10 and brain-derived neurotropic factor (BDNF) levels are involved in protecting against symptomatic neuroma formation, IL-1β and IL-6 promote neuroma formation. Although evidence is mixed, some evidence suggests that DM and diabetic peripheral neuropathy decrease symptomatic neuroma formation by impairing axonal regeneration, altering the extracellular matrix and modulating inflammatory responses. Although surgical approaches such as TMR and RPNI have shown potential in reducing neuroma-related pain, further studies are needed to ensure that this benefit extends to diabetic patients whose disease puts them at increased risk of postoperative complications. Additional studies are required to confirm these findings and optimize surgical strategies for high-risk patient populations. Show less