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Study reveals new features of human peripheral nerve degeneration

20 April 2020

UCL researchers have studied tissue from patients with nerve injuries to provide new insights into molecular signals that control the response of human peripheral nerves to damage.

Nerve injuries are debilitating, causing loss of movement and sensation and, in many cases chronic pain and disability. Treatments for nerve injury are limited and improving outcomes for people affected is an important research focus in the field of regenerative medicine. 

Previous studies using animal models have helped researchers to understand nerve damage, revealing a sequence of events whereby the tissue environment changes to be supportive of regeneration for a limited period, then fades over time.

Based on this information, new therapies are being developed that attempt to improve the regenerative capacity of damaged nerves, but translation of these new approaches is hampered by a lack of understanding about how closely the human nerve damage situation matches that in the animal models. 

A team of scientists and clinicians from the UCL Centre for Nerve Engineering successfully overcame some of the challenges of studying human nerve injuries in order to investigate whether the key cellular and molecular changes known to occur in animal models were also present in humans. Samples retrieved during surgical nerve procedures were analysed both in terms of gene expression and microscopy to reveal the way in which the cells within human nerves changed over time. 

The lead author Matthew Wilcox said “Our study shows the molecular signalling through which neural cells reprogram to support regeneration in acutely injured human nerves. It also indicates that the supportive cellular environment is transient and deteriorates during chronic nerve injury. Being able to understand how the timing of changes in human nerves relates to previous rodent models is an exciting step for this research field.”

Dr James Phillips, UCL Centre for Nerve Engineering and UCL School of Pharmacy, said “This study benefitted from input provided by experts from across the UCL community of nerve research. The findings will help the development of new therapies to improve nerve repair and provide new information which may help clinicians to optimise the timing of surgical nerve reconstruction.”

Mr Tom Quick, consultant nerve repair surgeon said “It’s been so rewarding to work with my scientist colleagues in this joint research to work towards the aims our patients identified for us.”

Graphic showing three sets of nerve images.

The images show human nerve cross sections with immunostaining to detect Schwann cells (brown) and a key marker of nerve regeneration in rodents; p75 neurotrophin receptor (red). Left image: Healthy nerve. Middle image: Nerve sample 30-days following injury. Right image: Nerve sample 294-days following injury.

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