Department of Plastic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Microsurgery. 2010 May;30(4):307-13. doi: 10.1002/micr.20727.
The aim of this study was to investigate the correlation between contractile function recovery and changes of acetylcholine receptors (AChR) in a transferred muscle flap following reinnervation. Orthotopic transfer of the gracilis muscle flap with repair of its nerve was performed bilaterally in 48 rats. The rats were randomly divided into six experimental groups based on the time intervals for assessments (1, 4, 5, 10, 20, and 30 weeks). Sixteen gracilis muscle samples from eight rats without surgery were used as the controls. In each group, muscle contractile force and weight were measured (n = 16). The AChR numbers (n = 8) and subunits (epsilon and gamma) mRNA (n = 8) were examined using [(125)I]-alpha-bungarotoxin and fluorescent quantitative-PCR. The results showed the AChR numbers in the muscle flap increased from 4 to 20 weeks after reinnervation and correlated with recovery of the tetanic contraction force. However, correlation between the increase of AChR number with the specific tension (peak contractile force normalized to wet muscle weight) was only found from 4 to 10 weeks postoperatively. The expression of gamma-subunit mRNA increased at the early period after flap transfer and then decreased rapidly, whereas the epsilon-subunit mRNA recovered gradually since fourth week postoperatively. A small amount of gamma-subunit mRNA could still be detected at 30 weeks after surgery. In conclusion, following reinnervation of the transferred muscle flap, the contractile functional recovery is partially correlated to increase of the AChRepsilon. Our findings may provide evidence for further study of improving muscle function in functional reconstruction by targeting the AChR.
本研究旨在探讨神经再支配后转移肌瓣收缩功能恢复与乙酰胆碱受体(AChR)变化的相关性。48 只大鼠双侧行比目鱼肌原位转移,修复神经。根据评估时间间隔(1、4、5、10、20 和 30 周),将大鼠随机分为 6 个实验组(n=16)。8 只大鼠的 16 个比目鱼肌标本未手术作为对照。每组均测量肌肉收缩力和重量(n=16)。采用[(125)I]-α-银环蛇毒素和荧光定量 PCR 检测 AChR 数量(n=8)和亚基(epsilon 和 gamma)mRNA(n=8)。结果显示,神经再支配后 4 至 20 周,肌瓣 AChR 数量增加,与强直收缩力恢复相关。然而,仅在术后 4 至 10 周,AChR 数量的增加与比张力(峰值收缩力除以湿肌重)的相关性才被发现。转肌瓣后早期 gamma 亚基 mRNA 表达增加,然后迅速下降,而 epsilon 亚基 mRNA 自术后第 4 周逐渐恢复。术后 30 周仍可检测到少量 gamma 亚基 mRNA。结论:转移肌瓣神经再支配后,收缩功能的恢复与 AChRepsilon 的增加部分相关。我们的研究结果可能为进一步研究通过靶向 AChR 改善功能重建中的肌肉功能提供依据。