Aging-Related Changes in the Injury Response of the Peripheral Nervous System

Peripheral nerve injury (PNI) significantly impairs patients' quality of life, with elderly individuals experiencing particularly severe consequences due to aging-related declines in neuronal injury response and repair capabilities. Processes of the generation and transmission of injury signals, axonal disruption, initiation of regeneration, and the elongation of regenerating axons, as well as the subsequent reinnervation by these axons, are all significantly influenced by aging. These alterations are closely associated with changes in mitochondrial function, neuronal transport systems, a persistent inflammatory milieu, and various microenvironmental non-neuronal cells. Therefore, this review synthesized the pivotal role of aging in the multifaceted regulation of the nervous system following PNI and highlighted promising molecular regulatory mechanisms in the signaling pathways. Furthermore, it identified critical areas for future research, including unresolved questions in age-associated injury responses, potential targets for pharmacological intervention, and emerging therapeutic strategies meriting consideration for research and development.