Department of Plastic and Reconstructive Surgery, Yuzuncu Yil University, Medical Faculty, Van, Turkey.
J Surg Res. 2011 Apr;166(2):330-6. doi: 10.1016/j.jss.2009.06.002. Epub 2009 Jul 10.
Peripheral nerve damage that requires surgical repair does not result in complete recovery because of collagen scar formation, ischemia, free oxygen radical damage, and other factors. To date, the best treatment method has not yet been determined. In this study, we designed an experimental peripheral nerve injury model, and researched the possible effects of melatonin hormone, based on evidence of its strong antioxidant and cell-protective effects via mimicking the effects of calcium channel blockers.
We randomized 24 healthy female albino rats into three groups: the pinealectomy group, melatonin group, and control group. In the pinealectomy group, craniotomy, pinealectomy, sciatic nerve transection, and coaptation were performed, and 0.9% NaCl was injected intraperitoneally. In the melatonin group, craniotomy (without pinealectomy), sciatic nerve dissection, and coaptation were performed, and melatonin was injected intraperitoneally, instead of NaCl. In the control group, craniotomy (without pinealectomy), sciatic nerve dissection and coaptation, and intraperitoneal NaCl injection were performed. In each group, nerve recovery was evaluated histologically, functionally, and electrophysiologically. Functional and electrophysiologic evaluations were conducted before surgery and at 4 and 12 wk.
At 4 wk, no significant difference was observed between the groups. However, at 12 wk, significant electrophysiologic and functional improvement was observed only in the melatonin group.
Melatonin seems to have a beneficial effect on nerve recovery. However, this effect is not effective at physiologic doses. Future comparative studies with melatonin versus other nerve-regenerating agents are necessary to determine the clinical utility of melatonin hormone.
由于胶原瘢痕形成、缺血、游离氧自由基损伤等因素,需要手术修复的周围神经损伤不会完全恢复。迄今为止,尚未确定最佳的治疗方法。在这项研究中,我们设计了一个实验性周围神经损伤模型,并研究了褪黑素激素的可能作用,其依据是它通过模拟钙通道阻滞剂的作用具有很强的抗氧化和细胞保护作用的证据。
我们将 24 只健康雌性白化大鼠随机分为三组:松果体切除术组、褪黑素组和对照组。在松果体切除术组中,进行开颅术、松果体切除术、坐骨神经横断和吻合,并腹腔内注射 0.9%生理盐水。在褪黑素组中,进行开颅术(不切除松果体)、坐骨神经解剖和吻合,并腹腔内注射褪黑素,而不是生理盐水。在对照组中,进行开颅术(不切除松果体)、坐骨神经解剖和吻合,并腹腔内注射生理盐水。在每组中,均进行组织学、功能和电生理学评估以评估神经恢复情况。在手术前和 4 周和 12 周时进行功能和电生理评估。
在 4 周时,各组之间没有观察到显著差异。然而,在 12 周时,仅在褪黑素组观察到显著的电生理和功能改善。
褪黑素似乎对神经恢复有有益的影响。然而,这种作用在生理剂量下并不有效。未来需要进行褪黑素与其他神经再生剂的比较研究,以确定褪黑素激素的临床应用价值。