Firat Cemal, Aytekin Ahmet Hamdi, Durak Mehmet Akif, Geyik Yilmaz, Erbatur Serkan, Dogan Metin, Elmas Omer, Dagli Adile Ferda, Celik Hamit
Ann Ital Chir. 2016;87:362-374.
Peripheral nerve defects generally occur due to mechanical, chemical, thermal and pathologic causes and the reconstruction is still a challenging problem. In the present study, we aimed to compare the effects of platelet rich plasma (PRP) that has high levels of growth factors and hyaluronic acid (HA) that is known to have positive effects on nerve regeneration by decreasing scar formation in a rat model where they were injected through allogeneic aorta graft in peripheral nerve defects using histopathologic and functional methods.
The study involved 20 Wistar Albino male rats that weighed 200 to 250 grams and aged about 1 year old. Of the rats, two were used as donor for PRP and aorta graft harvest. Three random groups of 6 rats were composed. In all of the groups, the left sciatic nerves were used and 1 cm of defects were created. The right sciatic nerves were used as control groups. Group 1 was the group repaired with autograft, Group 2 was the group repaired with HA injected through aorta graft and Group 3 was the group repaired with PRP injected through aorta graft. The findings were evaluated in terms of functional (electromyography and walk test analysis) and histopathologic parameters at 12 weeks.
In all of the groups varying degrees of axonal regeneration was observed. Group 1 was the closest group to the control group showing highest rate of nerve regeneration followed by Group 3 where PRP was injected through aorta graft and group 2 where ha was used respectively.
The study demonstrates that PRP enhances peripheral nerve regeneration more than HA when used in a vascular conduit model.
Hyaluronic acid, Peripheral nerve regeneration, PRP.
周围神经缺损通常由机械、化学、热和病理原因引起，其重建仍然是一个具有挑战性的问题。在本研究中，我们旨在通过组织病理学和功能方法，比较富含血小板血浆（PRP）和透明质酸（HA）对大鼠周围神经缺损的影响。PRP含有高水平的生长因子，而HA已知可通过减少瘢痕形成对神经再生产生积极影响，在大鼠模型中，它们通过同种异体主动脉移植物注入周围神经缺损处。
本研究涉及20只体重200至250克、年龄约1岁的雄性Wistar白化大鼠。其中两只用作PRP和主动脉移植物采集的供体。将大鼠随机分为三组，每组6只。在所有组中，均使用左侧坐骨神经并造成1厘米的缺损。右侧坐骨神经用作对照组。第1组用自体移植修复，第2组通过主动脉移植物注射HA修复，第3组通过主动脉移植物注射PRP修复。在12周时根据功能（肌电图和步行试验分析）和组织病理学参数评估结果。
在所有组中均观察到不同程度的轴突再生。第1组最接近对照组，显示出最高的神经再生率，其次是通过主动脉移植物注射PRP的第3组和使用HA的第2组。
该研究表明，在血管导管模型中使用时，PRP比HA更能促进周围神经再生。
透明质酸；周围神经再生；PRP
