Keane Grace C, Pan Deng, Roh Joseph, Larson Ellen L, Schellhardt Lauren, Hunter Daniel A, Snyder-Warwick Alison K, Moore Amy M, Mackinnon Susan E, Wood Matthew D
Washington University in St. Louis, MO, USA.
The Ohio State University, Columbus, USA.
Hand (N Y). 2022 May;17(3):540-548. doi: 10.1177/1558944720939200. Epub 2020 Jul 15.
Therapeutic electrical stimulation (ES) applied to repaired nerve is a promising treatment option to improve regeneration. However, few studies address the impact of ES following nerve graft reconstruction. The purpose of this study was to determine if ES applied to a nerve repair using nerve isograft in a rodent model could improve nerve regeneration and functional recovery. Adult rats were randomized to 2 groups: "ES" and "Control." Rats received a tibial nerve transection that was repaired using a tibial nerve isograft (1.0 cm length), where ES was applied immediately after repair in the applicable group. Nerve was harvested 2 weeks postrepair for immunohistochemical analysis of axon growth and macrophage accumulation. Independently, rats were assessed using walking track and grid-walk analysis for up to 21 weeks. At 2 weeks, more robust axon regeneration and greater macrophage accumulation was observed within the isografts for the ES compared to Control groups. Both walking track and grid-walk analysis revealed that return of functional recovery was accelerated by ES. The ES group demonstrated improved functional recovery over time, as well as improved recovery compared to the Control group at 21 weeks. ES improved early axon regeneration into a nerve isograft and was associated with increased macrophage and beneficial M2 macrophage accumulation within the isograft. ES ultimately improved functional recovery compared to isograft repair alone. This study supports the clinical potential of ES to improve the management of nerve injuries requiring a nerve graft repair.
应用于修复神经的治疗性电刺激（ES）是一种很有前景的促进神经再生的治疗选择。然而，很少有研究探讨神经移植重建后ES的影响。本研究的目的是确定在啮齿动物模型中，对使用同种异体神经移植进行的神经修复施加ES是否能改善神经再生和功能恢复。成年大鼠被随机分为两组：“ES组”和“对照组”。大鼠接受胫神经横断，然后用胫神经同种异体移植（长度1.0厘米）进行修复，在适用组中，修复后立即施加ES。修复后2周采集神经，用于轴突生长和巨噬细胞聚集的免疫组织化学分析。另外，对大鼠进行长达21周的行走轨迹和网格行走分析评估。在2周时，与对照组相比，ES组同种异体移植内观察到更强劲的轴突再生和更多的巨噬细胞聚集。行走轨迹和网格行走分析均显示，ES加速了功能恢复的进程。ES组随着时间推移功能恢复得到改善，并且在21周时与对照组相比恢复情况更好。ES促进了早期轴突向同种异体神经移植内的再生，并与同种异体移植内巨噬细胞及有益的M2巨噬细胞聚集增加有关。与单纯同种异体移植修复相比，ES最终改善了功能恢复。本研究支持了ES在改善需要神经移植修复的神经损伤治疗方面的临床潜力。
