Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
Neural Regen Res. 2014 Aug 15;9(16):1525-31. doi: 10.4103/1673-5374.139479.
Botulinum toxin type A is a potent muscle relaxant that blocks the transmission and release of acetylcholine at the neuromuscular junction. Intramuscular injection of botulinum toxin type A has served as an effective and safe therapy for strabismus and focal dystonia. However, muscular weakness is temporary and after 3-4 months, muscle strength usually recovers because functional recovery is mediated by nerve sprouting and reconstruction of the neuromuscular junction. Acrylamide may produce neurotoxic substances that cause retrograde necrotizing neuropathy and inhibit nerve sprouting caused by botulinum toxin type A. This study investigated whether acrylamide inhibits nerve sprouting after intramuscular injection of botulinum toxin type A. A tibial nerve sprouting model was established through local injection of botulinum toxin type A into the right gastrocnemius muscle of Sprague-Dawley rats. Following intramuscular injection, rats were given intraperitoneal injection of 3% acrylamide every 3 days for 21 days. Nerve sprouting appeared 2 weeks after intramuscular injection of botulinum toxin type A and single-fiber electromyography revealed abnormal conduction at the neuromuscular junction 1 week after intramuscular injection of botulinum toxin type A. Following intraperitoneal injection of acrylamide, the peak muscle fiber density decreased. Electromyography jitter value were restored to normal levels 6 weeks after injection. This indicates that the maximal decrease in fiber density and the time at which functional conduction of neuromuscular junction was restored were delayed. Additionally, the increase in tibial nerve fibers was reduced. Acrylamide inhibits nerve sprouting caused by botulinum toxin type A and may be used to prolong the clinical dosage of botulinum toxin type A.
A型肉毒毒素是一种强效肌肉松弛剂,可阻断神经肌肉接头处乙酰胆碱的传递和释放。A型肉毒毒素的肌肉内注射已成为斜视和局灶性肌张力障碍的有效且安全的治疗方法。然而,肌肉无力是暂时的,3-4 个月后,由于功能恢复是通过神经发芽和神经肌肉接头的重建介导的,肌肉力量通常会恢复。丙烯酰胺可能产生神经毒性物质,导致逆行坏死性神经病,并抑制 A 型肉毒毒素引起的神经发芽。本研究探讨了丙烯酰胺是否抑制 A 型肉毒毒素肌肉内注射后的神经发芽。通过在 Sprague-Dawley 大鼠右侧腓肠肌局部注射 A 型肉毒毒素建立胫神经发芽模型。肌肉内注射后,每隔 3 天给大鼠腹腔内注射 3%丙烯酰胺,共 21 天。肌肉内注射 A 型肉毒毒素后 2 周出现神经发芽,肌肉内注射 A 型肉毒毒素后 1 周单纤维肌电图显示神经肌肉接头异常传导。腹腔内注射丙烯酰胺后,峰值肌纤维密度降低。肌电图抖动值在注射后 6 周恢复正常水平。这表明纤维密度的最大降低和神经肌肉接头功能传导恢复的时间延迟。此外,胫神经纤维的增加减少。丙烯酰胺抑制 A 型肉毒毒素引起的神经发芽,可能用于延长 A 型肉毒毒素的临床剂量。