Imaging fibrosis formation in peripheral nerve injury

The National Institute of Neurological Disorders and Stroke awarded The Washington University $427,625 under the Extramural Research Programs in the Neurosciences and Neurological Disorders program (CFDA 93.853) on September 1, 2026, for research on imaging fibrosis formation in peripheral nerve injury.

The award funds a two-year proof-of-principle study addressing fibrosis complications in surgical repair of severe peripheral nerve injuries. Research Aim 1 focuses on real-time visualization of fibrosis formation in damaged nerves using crash, transection, and nerve repair animal models (mice) with new optical contrast agents and an implanted optical window with specific optical probes for activated fibroblasts. Research Aim 2 investigates fibroblast proliferation in SARM1-deficient mice and mice treated with IL-10 to suppress degenerative and immune responses. The project develops optical imaging modalities to assess nerve damage and identify fibrotic tissue during surgery, aiming to improve surgical outcomes and reduce the need for additional nerve resection.

Performance occurs at The Washington University's St. Louis, Missouri location from September 1, 2026, through August 31, 2028. The award is classified as a Project Grant, the standard assistance type for this NINDS program. Washington University's Office of Sponsored Research Services receives the award as the administrative recipient for the university's research enterprise.

Abstract

Severe peripheral nerve injuries affect more than 100,000 people in the US. They lead to physical and emotional suffering, as well as substantial economic loss. Surgical intervention is necessary for functional recovery. However, the formation of the fibrotic tissue in the damaged nerve complicates the surgery and often requires additional nerve resection that decreases the chance of restoring the nerve function. The limited understanding of both the initialization of fibrosis caused by nerve injury and the progression of fibrosis has a significant impact on treatment outcomes. Furthermore, the existing technology GAP related to identification and assessment of fibrotic tissue during surgery is challenging and relies heavily on subjective judgment. Understanding of fibrosis formation to minimize fibrosis formation and objective intra-operative tools to accurately dissect fibrotic tissue are needed. Addressing these unmet medical needs, the major research goal of this proof of principle proposal is to visualize the dynamics of fibrosis in real-time in the animal models of nerve injury, suppress fibrosis formation, and develop optical imaging modalities to assess the damage. Toward this goal, aim 1 focuses on visualization of fibrosis formation in damaged nerves using crash, transection and nerve repair animal mouse models with new optical contrast agents. Longitudinal visualization of fibrotic formation will be achieved through an implanted optical window and specific optical probes for activated fibroblasts. Aim 2 aims to investigate the proliferation of fibroblasts in the absence of suppressed degenerative and immune response in SARM1-deficient mice and in mice treated with IL-10. Suppressing fibrotic formation after the injury and image-guided resection of fibrotic tissue during surgery can greatly improve the treatment of nerve injuries and has a strong clinical potential to enhance surgical outcomes and improve patient recovery by preventing fibrosis and preserving viable nerve tissue.