Advanced medical devices for peripheral nerve regeneration using resorbable scaffolds

The peripheral nerve injuries, which represent the most common types of traumatic lesions affecting the nervous system, are highly invalidating for the patients, besides being a huge social burden [1]. This study aims to develop and evaluate potential advanced scaffolds for peripheral nerve regeneration by combining natural and synthetic materials with stem cells. For this purpose, Neural Crest-Derived Dental Follicle Stem Cells (FENCs) were used, due to their remarkable neurogenic differentiation capabilities [2, 3, 4]. Both commercially available and newly synthesized scaffolds were tested, and two types of culture media were used: proliferative and differentiative. Extensive in vitro analyses were conducted to evaluate the differentiation potential of FENCs both on their own and in combination with the various scaffold types. These analyses included XTT Cell Viability Assay, quantitative Reverse Transcription Polymerase Chain Reaction (qRT-PCR), immunofluorescence and Scanning Electron Microscopy (SEM) imaging. The natural biomaterials tested were Neuragen (Integra® LifeSciences), Endoform (Aroa® Biosurgery), and Hyaluronic Acid (HA)-based material, while the synthetic biomaterials were Tisseos (Biomedical Tissues) and a Poly(lactic-co-glycolic acid) (PLGA)-based material. According to the collected data, the PLGA-based material emerged as the most promising candidate for promoting peripheral neural differentiation among the tested biomaterials. Among the materials analyzed, the PLGA-Based material consistently showed the highest potential for inducing early neural differentiation and fostering progression toward mature neuronal and neuroepithelial-like phenotypes. Its performance, across both proliferative and differentiative conditions, underscores its suitability for further development in peripheral nerve regeneration. In contrast, other materials, such as Endoform and Tisseos showed some promise, but mechanical properties or inconsistent differentiation results limited them. Despite these encouraging results, the peripheral nerve regeneration device is still in the research phase. Further optimization is required to refine the differentiation protocols, enhance the homogeneity of the cell populations, and validate the findings through extended biological evaluations, including proteomic analyses. This study underscores the potential of FENCs in regenerative medicine and highlights the importance of integrating multidisciplinary strategies for the development of advanced medical devices in tissue engineering approaches.