Lee Joo-Yup, Giusti Guilherme, Friedrich Patricia F, Bishop Allen T, Shin Alexander Y
Department of Orthopedic Surgery, St. Vincent's Hospital, the Catholic University of Korea, Seoul, Korea.
Microvascular Research Laboratory, Mayo Clinic, Rochester, Minnesota.
J Reconstr Microsurg. 2016 Mar;32(3):183-8. doi: 10.1055/s-0035-1563709. Epub 2015 Sep 30.
The aim of this study was to evaluate the effect of vascular endothelial growth factor (VEGF) administration around the autologous nerve graft on nerve recovery in a rat model.
A total of 69 rats were randomly divided into three experimental groups. A 10-mm sciatic nerve defect was made and reconstructed with the reversed nerve segment. Group I received an osmotic pump with saline, group II received an osmotic pump with VEGF, and group III added a silicone tube around the nerve graft to decrease the surrounding blood supply. Nine animals in each group were sacrificed on day 3 to evaluate improvement in new vessel formation. In each group 14 animals were sacrificed at 16 weeks after the initial procedure to evaluate the functional motor nerve regeneration using compound muscle action potential, isometric tetanic force, wet muscle weight, and nerve histomorphometry.
The average vascular density on day 3 was 10.7% in group I, 21.4% in group II, and 0.9% in group III. These differences were significant. However, the average maximum isometric tetanic force at 16 weeks was 54.4% in group I, 57.5% in group II, and 47.6% in group III. No difference was found with or without VEGF administration. Histomorphometric analysis was also not significantly different between the groups.
New vessel formation on autologous nerve graft was enhanced by VEGF administration. However, the neovascularization effect of VEGF administration did not translate into better motor nerve recovery.
本研究旨在评估在大鼠模型中,自体神经移植物周围给予血管内皮生长因子(VEGF)对神经恢复的影响。
总共69只大鼠被随机分为三个实验组。制作10毫米的坐骨神经缺损,并用反转的神经段进行重建。第一组接受装有生理盐水的渗透泵,第二组接受装有VEGF的渗透泵,第三组在神经移植物周围添加硅胶管以减少周围血液供应。每组9只动物在第3天处死,以评估新血管形成的改善情况。每组14只动物在初始手术后16周处死,使用复合肌肉动作电位、等长强直收缩力、湿肌肉重量和神经组织形态计量学来评估功能性运动神经再生。
第3天,第一组的平均血管密度为10.7%,第二组为21.4%,第三组为0.9%。这些差异具有统计学意义。然而,16周时,第一组的平均最大等长强直收缩力为54.4%,第二组为57.5%,第三组为47.6%。给予或不给予VEGF之间未发现差异。组间组织形态计量学分析也无显著差异。
给予VEGF可增强自体神经移植物上的新血管形成。然而,VEGF给药的新生血管形成效果并未转化为更好的运动神经恢复。