Bontioti Eleana, Dahlin Lars B
Department of Hand Surgery, Evgenidio Hospital, Athens, Greece.
Int Rev Neurobiol. 2009;87:251-68. doi: 10.1016/S0074-7742(09)87012-8.
End-to-side (ETS) nerve repair is used in selected clinical cases. The mechanisms, by which regeneration into the attached nerve segment is initiated and occur, are still not fully understood. Based on numerous experimental studies, different mechanisms have been suggested by which regenerating axons are recruited, such as contamination from the proximal nerve segment, collateral sprouting, and terminal regenerating sprouting from the donor nerve. A variety of experimental models, most commonly in the lower and upper extremity of rats, and techniques have been used to shed light on the mechanisms. Retrograde labeling techniques have revealed that collateral sprouting do occur, but is probably, at least as observed in long-term experiments, less important over time. Pruning of branching nerve fibers, induced by the collateral sprouting, is an additional mechanism in this context. Experiments have also focused on the stimuli, including the question of epineurial or perineurial windows, that trigger the sprouting of axons form the donor nerve, which can detected by the use of markers of cellular injury. In the present article, we review studies contributing to clarifications of mechanisms of end-to-side nerve repair, including used experimental techniques. We also stress the importance of the plastic brain.
端侧（ETS）神经修复用于特定临床病例。再生进入附着神经节段并发生的机制仍未完全明确。基于大量实验研究，已提出不同机制来解释再生轴突的募集方式，例如来自近端神经节段的污染、侧支芽生以及供体神经的终末再生芽生。人们采用了多种实验模型（最常见于大鼠的下肢和上肢）及技术来阐明这些机制。逆行标记技术已揭示侧支芽生确实会发生，但可能至少在长期实验中观察到，随着时间推移其重要性会降低。在此背景下，由侧支芽生诱导的分支神经纤维修剪是另一种机制。实验还聚焦于刺激因素，包括关于神经外膜或神经束膜开窗是否会触发供体神经轴突发芽的问题，这可以通过使用细胞损伤标记物来检测。在本文中，我们回顾有助于阐明端侧神经修复机制的研究，包括所使用的实验技术。我们还强调可塑性大脑的重要性。
