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Review - Vol. 23, 2017 |
Multiple uses of fibrin sealant for nervous system treatment following injury and disease
1 Graduate Program in Tropical Diseases, Botucatu Medical School, Univ Estadual Paulista (UNESP), Botucatu, SP, Brazil.
2 Center for the Study of Venoms and Venomous Animals (CEVAP), Univ Estadual Paulista (UNESP), Botucatu, SP, Brazil.
3 Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Laboratory of Nerve Regeneration, CEP 13083-970 Campinas, SP, Brazil.
4 Neuro Development Lab, School of Biosciences, University of Birmingham, Birmingham, England, UK.
5 The School of Medicine at Mucuri (FAMMUC), Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 39803-371 Teófilo Otoni, MG, Brazil.
ABSTRACT
Lesions to the nervous system often produce hemorrhage and tissue loss that are difficult, if not impossible, to repair. Therefore, scar formation, inflammation and cavitation take place, expanding the lesion epicenter. This significantly worsens the patient conditions and impairment, increasing neuronal loss and glial reaction, which in turn further decreases the chances of a positive outcome. The possibility of using hemostatic substances that also function as a scaffold, such as the fibrin sealant, reduces surgical time and improve postoperative recovery. To date, several studies have demonstrated that human blood derived fibrin sealant produces positive effects in different interventions, becoming an efficient alternative to suturing. To provide an alternative to homologous fibrin sealants, the Center for the Study of Venoms and Venomous Animals (CEVAP, Brazil) has proposed a new bioproduct composed of certified animal components, including a thrombin-like enzyme obtained from snake venom and bubaline fibrinogen. Thus, the present review brings up to date literature assessment on the use of fibrin sealant for nervous system repair and positions the new heterologous bioproduct from CEVAP as an alternative to the commercial counterparts. In this way, clinical and pre-clinical data are discussed in different topics, ranging from central nervous system to peripheral nervous system applications, specifying positive results as well as future enhancements that are necessary for improving the use of fibrin sealant therapy.
Key words: Central nervous system; Peripheral nervous system; Commercial fibrin sealant; New heterologous fibrin sealant; Nervous system injury; Fibrin tissue adhesive
Funding
The authors are thankful to São Paulo Research Foundation (FAPESP) for providing financial support (2009/53846-9, 2010/00729-2, 2011/23377-7, 2011/02889-0, 2012/22750-9, 2012/02689-3, 2012/08101-8, 2012/13514-0, 2012/20456-6, 2013/23030-2, 2013/04409-0, 2014/06892-3, 2014/11405-4) and to the National Council for Scientific and Technological Development (CNPq) (Proc. No. 300553/2013-9, 563582/2010-3). This work was also supported by the Coordination for the Improvement of Higher Education Personnel (CAPES) through Edital Toxinologia CAPES no. 063/2010, Process no. 230.38.006285/2011-21, AUXPE Toxinologia 1219/2011. RSF Jr. is a CNPq DTI fellow researcher (310395/2014-3).
Received: November 17, 2016.
Revised: February 23, 2017.
Accepted: March 14, 2017.
Correspondence: alroliv@unicamp.br