Chaiyasate Kongkrit, Schaffner Adam, Jackson Ian T, Mittal Vijay
Department of Surgery, Providence Hospital and Medical Centers, 16001 W. Nine Mile Road, Southfield, MI 48075, USA.
J Invest Surg. 2009 Nov-Dec;22(6):401-5. doi: 10.3109/08941930903410775.
The limited availability of donor sites for nerve grafts and the morbidity associated with their harvesting serve as motivating factors to actively conduct research to find alternatives to the status quo. Experimental and clinical studies have shown that a vein segment used to bridge a peripheral nerve defect leads to a functional nerve repair. Both FK-506 and b-FGF have been reported to enhance peripheral nerve regeneration. This study compared the effects of FK-506 with that of b-FGF on peripheral nerve regeneration in a rat autogenous vein graft conduit model.
The main trunk of the right sciatic nerve was transected and bridged by an autogenous vein in 30 rats. Small osmotic pumps were placed just proximal to the anastomoses. Groups of 10 rats were assigned to receive saline solution, b-FGF (2,000 units), or FK-506 (0.5 mg/kg/day) via the osmotic pumps for 2 weeks. Sciatic nerve regeneration was evaluated by sensory function, walking track analysis, electrophysiologic studies, and light microscopic evaluation.
On post-operative day 90, there was a statistically significant difference (p <.005) in nerve regeneration between the rats who received saline compared with those who received FK-506 or b-FGF. This was determined using sensory function tests, sciatic function index, and electrophysiologic studies. The number of nerve axons, as determined by histological analysis, revealed there were significantly more nerve fibers which were regenerated in both experimental groups (FK-506 and b-FGF) when compared with rats who received saline. There was no statistically significant difference in the number of nerve axons that regenerated in rats injected with FK-506 vs. rats injected with b-FGF.
FK-506 and b-FGF promote similar nerve regeneration in rats compared with control.
神经移植物供体部位有限,且获取供体部位存在相关并发症,这些因素促使人们积极开展研究以寻找替代现状的方法。实验和临床研究表明,用于桥接周围神经缺损的静脉段可实现功能性神经修复。据报道,FK-506和碱性成纤维细胞生长因子(b-FGF)均可促进周围神经再生。本研究在大鼠自体静脉移植导管模型中比较了FK-506和b-FGF对周围神经再生的影响。
将30只大鼠的右侧坐骨神经主干切断,并用自体静脉进行桥接。在吻合口近端放置小型渗透泵。将10只大鼠分为一组,分别通过渗透泵接受生理盐水、b-FGF(2000单位)或FK-506(0.5毫克/千克/天),持续2周。通过感觉功能、行走轨迹分析、电生理研究和光学显微镜评估来评价坐骨神经再生情况。
术后第90天,接受生理盐水的大鼠与接受FK-506或b-FGF的大鼠在神经再生方面存在统计学显著差异(p<.005)。这是通过感觉功能测试、坐骨神经功能指数和电生理研究确定的。组织学分析确定的神经轴突数量显示,与接受生理盐水的大鼠相比,两个实验组(FK-506和b-FGF)再生的神经纤维明显更多。注射FK-506的大鼠与注射b-FGF的大鼠再生的神经轴突数量没有统计学显著差异。
与对照组相比,FK-506和b-FGF在大鼠中促进相似的神经再生。