The Immune Response and Implications for Nerve Repair

Abstract

This chapter aims to provide an overview of the host response to allografts or tissue-engineered constructs containing allogeneic cells in peripheral nerve repair, and potential approaches for promoting the survival of nerve grafts. A large body of current research aims to improve surgical approaches for nerve repair beyond that of the autograft. Potential approaches include nerve allografts, or tissue-engineered nerve constructs which could provide an unlimited source of donor tissue for nerve injury repair. This field requires an interdisciplinary approach to the design of novel therapies, and consideration of the immune response to transplants should not be overlooked. There are many benefits of including living donor cells within transplanted nerve conduits which can improve axonal guidance, vascularization, and promote the release of growth factors to increase regeneration. It is most likely that donor cells or tissues will be of allogeneic origin, with associated implications for eliciting an immune response on transplantation. The following sections provide a summary of the immune response to nerve grafts for consideration in the development of approaches to nerve repair, including some approaches currently under investigation for preventing rejection of transplants