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使用渗透泵局部给予脑源性神经营养因子后通过神经自体移植实现神经再生。

Nerve regeneration through nerve autografts after local administration of brain-derived neurotrophic factor with osmotic pumps.

作者信息

Hontanilla Bernardo, Aubá Cristina, Gorría Oscar

机构信息

Department of Plastic and Reconstructive Surgery, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain.

出版信息

Neurosurgery. 2007 Dec;61(6):1268-74; discussion 1274-5. doi: 10.1227/01.neu.0000306106.70421.ed.

Abstract

OBJECTIVE

To determine whether or not administration of brain-derived neurotrophic factor (BDNF) with osmotic pumps at the site of the proximal stump of a peripheral nerve autograft can improve peripheral nerve regeneration.

METHODS

The tibialis branch of the sciatic nerve was transected and grafted with a 20-mm nerve autograft. Wistar rats (Harlan iberica, Barcelona, Spain) (n = 70) were divided into four groups: a nongrafted control group (Group I, n = 10), a grafted but nontreated control group (Group II, n = 20), a grafted saline-treated group (Group III, n = 20), and a grafted and BDNF-treated group (Group IV, n = 20). BDNF was delivered at a rate of 6 microg/day for 2 weeks after nerve repair using osmotic pumps subcutaneously implanted with a connecting tube, the distal end of which faced the proximal stump of the nerve graft. The animals were euthanized at 6 weeks. Spinal motoneurons were quantified as well as axons at the tibialis branch 5 mm distal to the distal nerve repair site. Neuron size was categorized as large (>25 microm) or small (<25 microm).

RESULTS

The statistical comparisons between the mean number of neurons in Groups II and III showed no statistical differences (P = 0.27), but there were statistically significant differences between Groups II and IV (P = 0.02) and III and IV (P = 0.02). Labeling of neurons in the group treated with BDNF represents 76% of neurons found on the nonoperated control Group I, which, in turn, is superior to the 51% of neurons found in the nontreated autograft Groups II and III. Regarding the size of motoneurons, there were no statistically significant differences between groups (P > 0.1). Finally, there were no statistically significant differences among Groups II, III, and IV regarding the number of distal axons.

CONCLUSION

BDNF delivered through osmotic pumps was found to have a significant capacity for improving the presence of motoneurons in the ventral spinal horn and, thus, capacity to improve nerve regeneration through nerve autografts. However, in this study, BDNF did not specifically protect against injury to motoneurons, depending on the soma size.

摘要

目的

确定在周围神经自体移植近端残端部位用渗透泵给予脑源性神经营养因子(BDNF)是否能改善周围神经再生。

方法

切断坐骨神经的胫支并用20毫米的神经自体移植物进行移植。将Wistar大鼠(西班牙巴塞罗那的Harlan iberica公司提供)(n = 70)分为四组:非移植对照组(I组,n = 10)、移植但未处理的对照组(II组,n = 20)、移植并用生理盐水处理的组(III组,n = 20)以及移植并用BDNF处理的组(IV组,n = 20)。在神经修复后,使用皮下植入连接管的渗透泵以每天6微克的速率给予BDNF,持续2周,连接管的远端朝向神经移植物的近端残端。在6周时对动物实施安乐死。对脊髓运动神经元进行定量,并对神经修复远端部位5毫米处胫支的轴突进行定量。将神经元大小分为大(>25微米)或小(<25微米)。

结果

II组和III组神经元平均数之间的统计学比较无统计学差异(P = 0.27),但II组和IV组之间(P = 0.02)以及III组和IV组之间(P = 0.02)存在统计学显著差异。用BDNF处理的组中神经元的标记数占未手术对照组I组中发现的神经元的76%,这又优于未处理的自体移植组II组和III组中发现的51%的神经元。关于运动神经元的大小,各组之间无统计学显著差异(P > 0.1)。最后,II组、III组和IV组在远端轴突数量方面无统计学显著差异。

结论

发现通过渗透泵给予BDNF具有显著能力改善脊髓腹角运动神经元的存在,从而具有通过神经自体移植改善神经再生的能力。然而,在本研究中,BDNF并未根据胞体大小特异性地保护运动神经元免受损伤。

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