Olabisi Ronke, Chamberlain Connie S, Petr Sarah, Steiner Samuel, Consigny Daniel, Best Thomas M, Vanderby Ray, Schultz Ed, Noonan Kenneth J
K4/732 Clinical Science Center, University of Wisconsin, 600 Highland Avenue, Madison, Wisconsin 53792, USA.
J Orthop Res. 2009 Mar;27(3):310-7. doi: 10.1002/jor.20734.
Distraction osteogenesis is a highly successful method of bone formation, yet muscle fibrosis and contractures can result in significant morbidity. In the current study, we investigate the efficacy of botulinum toxin A in preventing fibrosis and potentially increasing muscle development in distracted muscles. Fifteen New Zealand White rabbits underwent tibial distraction at 1.5 mm/day until a 20% gain was achieved. Treatment groups were divided by drug (saline or botulinum toxin) and target muscle (gastrocnemius or tibialis anterior). Two additional control animals received no treatment. Bromeodeoxyuridine was delivered continuously throughout the 8-week experiment, and following muscle harvest. Tissues were stained for BrdU, Pax-7, vimentin, and haematoxylin and eosin staining. Mitotic activity increased in all distracted animals; however, in the animals receiving botulinum toxin A injections into the gastrocnemius, the antagonist tibialis anterior suffered up to 9% less fibrosis than distraction alone (p = 0.024). Use of botulinum A toxin did not appear to promote or improve neogenesis of muscle fibers, nor did it decrease fibrosis in the injected muscles. It appears from this study, and a previously published study on the effects of this toxin on muscle function, that botulinum A toxin maybe of some benefit in decreasing morbidity in the antagonist muscle but not the muscle injected with the toxin.
牵引成骨是一种非常成功的骨形成方法，但肌肉纤维化和挛缩会导致严重的发病率。在本研究中，我们研究了A型肉毒杆菌毒素在预防纤维化以及潜在增加牵引肌肉的肌肉发育方面的疗效。15只新西兰白兔以每天1.5毫米的速度进行胫骨牵引，直至实现20%的增长。治疗组根据药物（生理盐水或肉毒杆菌毒素）和目标肌肉（腓肠肌或胫骨前肌）进行划分。另外两只对照动物未接受治疗。在整个8周的实验过程中以及肌肉取材后持续给予溴脱氧尿苷。对组织进行BrdU、Pax-7、波形蛋白染色以及苏木精和伊红染色。所有牵引动物的有丝分裂活性均增加；然而，在接受向腓肠肌注射A型肉毒杆菌毒素的动物中，拮抗肌胫骨前肌的纤维化程度比单纯牵引减少了9%（p = 0.024）。使用A型肉毒杆菌毒素似乎并未促进或改善肌纤维的新生，也未减少注射肌肉中的纤维化。从本研究以及先前发表的关于该毒素对肌肉功能影响的研究来看，A型肉毒杆菌毒素可能在降低拮抗肌的发病率方面有一定益处，但对注射毒素的肌肉则没有作用。
