Hattori Tatsuya, Matsuyama Yukihiro, Sakai Yoshihito, Ishiguro Naoki, Hirata Hitoshi, Nakamura Ryogo
Department of Hand Surgery, Graduate School of Nagoya University, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
J Clin Neurosci. 2008 Feb;15(2):185-91. doi: 10.1016/j.jocn.2006.12.009. Epub 2007 Dec 19.
We evaluated the effects of chondroitinase ABC on axonal regeneration across peripheral nerve gaps. We compared axonal regeneration after 15-mm tibial nerve resection and repair with a silicone tube filled with type I collagen gel (negative control group), with a silicone tube filled with type I collagen gel containing chondroitinase ABC at three different concentrations (2.5 units/mL, 5 units/mL, 10 units/mL) (chondroitinase ABC groups), and with an autologous nerve segment (nerve autograft group). Electrophysiological and histological assessments were carried out 12 weeks after surgery. In the electrophysiological study, compound muscle action potentials (CMAPs) and nerve conduction velocities (NCVs) were recorded in all groups except the negative control group. Although both CMAPs and NCVs were highest in the nerve autograft group, there were no significant differences among the three chondroitinase ABC groups in either parameter. Histological findings were consistent with electrophysiological results. Based on these findings, we conclude that topical injection of chondroitinase ABC can significantly increase the critical length of nerve gap repair by tubulization or artificial nerve placement.
我们评估了软骨素酶ABC对周围神经间隙轴突再生的影响。我们比较了在15毫米胫神经切除并使用填充有I型胶原凝胶的硅胶管修复后的轴突再生情况(阴性对照组),与使用填充有含三种不同浓度(2.5单位/毫升、5单位/毫升、10单位/毫升)软骨素酶ABC的I型胶原凝胶的硅胶管修复后的轴突再生情况(软骨素酶ABC组),以及与自体神经段修复后的轴突再生情况(神经自体移植组)。术后12周进行电生理和组织学评估。在电生理研究中,除阴性对照组外,所有组均记录复合肌肉动作电位(CMAP)和神经传导速度(NCV)。虽然神经自体移植组的CMAP和NCV均最高,但在这两个参数上,三个软骨素酶ABC组之间均无显著差异。组织学结果与电生理结果一致。基于这些发现,我们得出结论,局部注射软骨素酶ABC可通过管道化或人工神经植入显著增加神经间隙修复的临界长度。