Validation of a new method for human nerve decellularization: toward a new tool in peripheral nerve reconstructive surgery.

Defects of the peripheral nervous system are extremely frequent in trauma and surgeries and have high socioeconomic costs. In case of peripheral nerve injury, the first approach is primary neurorrhaphy, which is direct nerve repair with epineural microsutures of the two stumps. However, this is not feasible in case of stump retraction or in case of tissue loss (gap > 2 cm), where the main surgical options are autologous grafts, allogenic grafts, or nerve conduits. While the gold standard is the autograft, it has disadvantages related to its harvesting, with an inevitable donor site morbidity and functional deficit. Fresh nerve allografts have therefore become a viable alternative option, but they require immunosuppression, which is often contraindicated. Acellular Nerve Allografts (ANA) represent a valid alternative, they do not need immunosuppression and appear to be safe and effective based on recent studies. The purpose of this study is to propose and develop an innovative method of nerve decellularization (Rizzoli method), conforming to cleanroom requirements in order to perform the direct tissue manipulation step and the nerve decellularization process within five hours, so as to accelerate the detachment of myelin and cellular debris, without detrimental effects on nerve architecture. In this study, the safety and the efficacy of the new method are evaluated in vitro and in vivo by histological, immunohistochemical, and histomorphometric studies in rabbits and humans. The new method is rapid, safe, and cheaper if compared with available commercial ANAs. The present study shows that the method, previously optimized in vitro and in vivo on animal model presented by our group, can be applied on human nerve samples. This work represents the first step in providing a novel, safe, and inexpensive tool for use by European tissue banks to democratize the use of nerve tissue transplantation for nerve injury reconstruction.

Analytical approaches for the measurement of sulfide in biological and pharmaceutical fields

Hydrogen sulfide (H2S) is a widely recognized gasotransmitter, with key roles in physiological and pathological processes. The accurate quantification of H2S and reactive sulfur species (RSS) may hold important implications for the diagnosis and prognosis of various diseases. However, H2S species quantification in biological matrices is still a challenge. Among the sulfide detection methods, monobromobimane (MBB) derivatization coupled with reversed phase high-performance liquid chromatography (RP-HPLC) is one of the most reported. However, it is characterized by a complex preparation and time-consuming process, which may alter the actual H2S level. Moreover, quantitative validation has still not been described based on a survey of previously published works. In this study, we developed and validated an improved analytical protocol for the MBB RP-HPLC method. Main parameters like MBB concentration, temperature, reaction time, and sample handling were optimized, and the calibration method was further validated using leave-one-out cross-validation (CV) and tested in a clinical setting. The method shows high sensitivity and allows the quantification of H2S species, with a limit of detection (LOD) of 0.5 µM and a limit of quantification (LOQ) of 0.9 µM. Additionally, this model was successfully applied in measurements of H2S levels in the serum of patients subjected to inhalation with vapors rich in H2S. In addition, a properly procedure was established for H2S release with the modified MBB HPLC-FLD method. The proposed analytical approach demonstrated the slow-release kinetics of H2S from the multilayer Silk-Fibroin scaffolds with the combination of different H2S donor’s concentration with respect to the weight of PLGA nanofiber. In the end, some efforts were made on sulfide measurements by using size exclusion chromatography fluorescence/ultraviolet detection and inductively coupled plasma-mass spectrometry (SEC-FLD/UV-ICP/MS). It’s intended as a preliminary study in order to define the feasibility of a separation-detection-quantification platform to analyze biological samples and quantify sulfur species.