Nerve Regeneration: AVANCE Nerve Graft Grafts
Scientists at the University of Texas, working under the guidance of Dr. Christine Schmidt, have developed a detergent, the treatment of which eliminates immunogenic lipids from the surface of nerve fibers, making them suitable for transplantation. The detergent combination with an enzymatic preparation developed at the University of Florida is licensed by AxoGen (Alahua, Florida) and is used to create cell-free nerve grafts from cadaver tissue, called AVANCE Nerve Graft.
To date, about 100 patients of clinics in the USA have successfully undergone transplants of such material in order to restore sensitivity after damage to peripheral nerves that transmit sensory information between the human brain and muscles.
The AVANCE system is used to treat traumatic nerve injuries of the limbs and face in case of tissue ruptures, bullet wounds, household injuries, as well as to restore the innervation of the cavernous bodies after surgical removal of the prostate gland.
Traditionally, to treat such injuries, doctors remove a healthy nerve from the patient's body and implant it at the site of the injury. Such a procedure is expensive, requires two surgical interventions and is associated with the risk of loss of sensitivity and infection of the donor site.
The second possible alternative is the implantation of synthetic tubular grafts, but the possibilities of this procedure are limited to the restoration of only very minor injuries.
AVANCE nerve grafts provide a three-dimensional matrix that promotes nerve regeneration, and also, due to their natural origin, have great flexibility, which allows them to connect more significant gaps.
To create such transplants, donor nerves are freed from the lipid components of the cell that cause rejection reactions during transplantation using a detergent solution. Scientists spent four years creating a detergent, because the effect of the solution should be both strong enough to remove immunogenic factors and soft enough to preserve the fragile physical architecture of the nerve necessary for successful regeneration. Removal of immunogenic components is a very important factor, because it eliminates the need for long-term use of immunosuppressive drugs.
Additional enzymatic treatment proposed by researchers at the University of Florida and part of the AVANCE complex eliminates various factors that inhibit nerve regeneration.
Currently, researchers led by Kristina Schmidt are testing the possibility of using detergent-treated peripheral nerve transplants to repair spinal cord injuries.