Newsletter: new research from the CNE

Newsletter: new research from the CNE

For this issue we have talked to Matthew Wilcox, a PhD researcher at the UCL Centre for Nerve Engineering (CNE) whose work aims to “identify problems in the clinic and harness the expertise at the CNE to solve them”. We wanted to discuss with him his most recently published work called “Characterising cellular and molecular features of human peripheral nerve degeneration”, which is a momentous paper that hopes to inform the current clinical standard of care, where ”clinicians must often rely on clinical observations and past experience when making decisions about treatment options available to the patient.” In particular, the work identified markers of regenerative mechanisms that may provide clinicians with valuable information about “when to operate or prescribe a particular form of rehabilitative therapy in order to optimise functional outcome following nerve injury.”

Nerve regeneration, is seen by researchers and clinicians, as a series of cellular and chemical processes that all need to occur in a particular order to ensure it is successful. One can view it as a journey from A (injury) to Z (recovery) and between the two there are a series of stages, following the analogy, pit stops (B) and errands (C) for it to be successful. However, there are many impediments to the journey, dependent on the severity of the injury. Therefore, therapies are prescribed to try to overcome those limitations or attempt to prevent barriers from developing, such as scaring.

The regeneration journey and all the therapies tested are, commonly, studied using rodent models, however, until this paper, there was no concrete proof the journey in rodents maps to the journey in humans. This was not known because it is difficult to examine the underlying processes of nerve regeneration in humans. With that in mind Matthew enrolled patients treated at the Royal National Orthopaedic Hospital, which donated tissue that is extracted during routine procedures. From this tissue the study uncovered that “the cells and molecules that control nerve regeneration in human”, or the nerve regeneration journey in humans, “demonstrated a similar pattern of expression to that shown previously in rodents”. Breaking down that sentence, this means that the changes within nerve cells known to take place in animal models of nerve injury were also triggered in humans with injured nerves. However, states Matthew, “what was more important was that it was possible to uncover new information about the time course of these changes”. Therefore, this uncovered the time it, usually, takes to go between stages of regeneration providing clinicians with a clearer map of when particular interventions should be prescribed. This opens the door for the possibility to, in the future, develop therapies, which target specific stages of regeneration. There is also the potential to reconsider previously tested therapeutic strategies, which may have a greater effect if targeted to the right stage post-injury.

At the end of our conversation, Matthew made sure to acknowledge that “It has been a real privilege to work with patients”, as this study was only possible due to patients’ willingness to participate. This is one of the many strategies Matthew is investigating to develop improved measurements of nerve regeneration. These studies exploit new technologies to extract information from MRI scans and neurophysiological assessments (tests that measure the electrical properties of nerves and muscles) to measure changes following nerve injury. If you want to learn more about this branch of CNE research, please follow the links at the bottom of the page to the CNE website and Matthew’s webpage. If you are interested in getting involved in research, make sure to contact Matthew or the clinical team leader, Mr. Tom Quick.

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