NJCBM Mini Symposium on Nerve

Antonio Merolli

  • Portrait
  • Antonio Merolli, MD, FBSE
  • A Physical Basis for Spinal Cord Regeneration

Biography

Antonio Merolli has investigated in many fields of application of Biomaterials in Surgery. He has expertise in translational in-vivo models and histological analysis. In the past years he has expanded his interest in bone and nerve regeneration and is currently studying the role of artificial nerve-guides in regeneration of peripheral nerve, brachial plexus and spinal cord lesions. Dr. Merolli is the Clinical Editor of the Journal of Materials Science: Materials in Medicine (Springer-Nature) and Editor of the book “Biomaterials in Hand Surgery” (Springer). He is a Fellow in Biomaterials Science and Engineering (FBSE) and an active member of the American Society for Peripheral Nerve (ASPN). He is vice-Chair of the special interest group on Biomaterial-Tissue Interaction of the Society for Biomaterials (SFB). 

 

Abstract

Artificial nerve guides (conduits) have been used in the shape of rigid polymeric containers able to repair complete transections injuries of single peripheral nerves and of whole brachial plexus. Can a similar approach work in complete transection injuries of the spinal cord? We are testing this hypothesis in the rabbit, whose cord diameter falls in the range of conduits commonly used in peripheral nerve surgery.
Spinal cord injury (SCI) is a debilitating condition that affects every year up to 500,000 people worldwide with 17,000 new cases each year in the US alone. It can lead to severe motor, sensory and autonomic dysfunction so that neurological impairment, with permanent paraplegia, tetraplegia, loss of bladder control, etc., will greatly reduce quality of life. Recovery from traumatic SCI usually fails due to a cascade of cellular and molecular events that compromise neural tissue reconstitution by giving rise to glial scarring and cavity formation. For this reason, a lot of research has been done into molecular and cellular therapies in the past two decades.
There is no reparative surgical treatment for SCI, whether they are following a concussion or transection mechanisms, or they are acute or chronic. However, evidence supporting the possibility of regeneration in the spinal cord is accumulating (1). We are testing a new device-assisted surgical approach to provide a surgical option for SCI. It can incorporate any progress obtained by molecular and cellular therapies but, at the same time, leverages on the physical environment in which neural regeneration can occur. Establishing a biophysical environment which is favourable for axonal growth as soon as possible after injury is a useful and perhaps necessary starting point for the clinical success. Our implantable device provides an environment that 1)-stimulates and guides axonal regeneration and, at the same time, 2)-protects the injury site from fibroblastic and astroglial scar formation.