Composite poly(lactic-co-glycolic acid) and a decellularized extracellular matrix conduit with Schwann cells for enhanced nerve regeneration

Peripheral nerve injuries (PNIs) affect approximately one million people globally every year. While autologous nerve transplantation remains the gold standard for healing PNIs with large gaps, limitations such as donor site morbidity and limited nerve availability present challenges in clinical application, highlighting the need for innovative solutions based on synthetic biomaterials. In this study, we explored a composite nerve conduit that combines a poly(lactic-co-glycolic acid) (PLGA) shell and a decellularized extracellular matrix (dECM) seeded with Schwann cells (SCs). In particular, the dECM, derived from rat sciatic nerves, retains the native tissue structure and bioactive components. In vitro studies showed that SC-seeded dECM promotes cell viability, proliferation, and alignment. In vivo testing using a rat sciatic nerve defect model demonstrated that the PLGA/dECM-SC conduit significantly improved nerve regeneration compared with conduits without SCs, showing enhanced axonal growth, myelination, and motor function restoration comparable to autografts. This approach offers a promising alternative to autologous nerve grafts in the clinical treatment of PNIs.