Day C S, Riano F, Tomaino M M, Buranatanitkit B, Somogyi G, Sotereanos D, Huard J
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, PA 15213, USA.
J Reconstr Microsurg. 2001 Jan;17(1):51-7. doi: 10.1055/s-2001-12689.
Despite modern microsurgical techniques, functional outcomes following brachial-plexus reconstruction and peripheral-nerve repair are usually unsatisfactory, because irreversible muscle atrophy develops before reinnervation occurs. Insulin growth factor-1 (IGF-1) has been shown to improve muscle regeneration after injury, and may have a role in muscle preservation following denervation. This study evaluated the histologic, immunohistochemical, and electrophysiologic differences between normal and denervated muscle over an 8-week time period, and also evaluated the effects of injecting IGF-1 into denervated muscle. Denervated mice gastrocnemius muscles demonstrated a decrease in muscle diameter, a decrease in muscle weight, early nuclear proliferation, and a decrease in fast twitch and maximum tetanic strength, compared to normal gastrocnemius muscle up to 8 weeks following denervation. Four weeks after denervated muscle was injected with IGF-1 at time zero, however, relative preservation of muscle diameter and weight, and maintenance of electrophysiologic contractile properties were observed. These preliminary data suggest that IGF-1 may prevent muscle atrophy secondary to denervation.
尽管有现代显微外科技术,但臂丛神经重建和周围神经修复后的功能结果通常不尽人意,因为在神经再支配发生之前就会出现不可逆的肌肉萎缩。胰岛素生长因子-1(IGF-1)已被证明能改善损伤后的肌肉再生,并且可能在去神经支配后的肌肉保存中发挥作用。本研究评估了8周时间内正常肌肉和去神经支配肌肉之间的组织学、免疫组织化学和电生理差异,还评估了向去神经支配肌肉注射IGF-1的效果。与去神经支配后长达8周的正常腓肠肌相比,去神经支配的小鼠腓肠肌表现出肌肉直径减小、肌肉重量减轻、早期核增殖以及快肌纤维和最大强直收缩力下降。然而,在去神经支配的肌肉于零时注射IGF-1四周后,观察到肌肉直径和重量相对保持,以及电生理收缩特性得以维持。这些初步数据表明,IGF-1可能预防去神经支配继发的肌肉萎缩。