Adyaksa Gana, Suroto Heri
Department of Orthopedics & Traumatology, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Ann Med Surg (Lond). 2021 Feb 17;63:102156. doi: 10.1016/j.amsu.2021.02.002. eCollection 2021 Mar.
The success of the micro-surgery procedure for the treatment of postganglionic brachial plexus injury was influenced by several factors, including the surgical timing and also the viability of the proximal stump. This study evaluates the evidence of apoptosis in the brachial plexus proximal stump and its correlation with the surgical timing.
Proximal stump biopsy of postganglionic brachial plexus injury patients were obtained during nerve procedure surgery. The samples were grouped based on the surgical timing, before six months post-trauma (early group) and after six months post-trauma (late group). The apoptosis of motorneurons was evaluated by immunohistochemistry expression of Caspase-3, TNF-α, Caspase-8, and Caspase-9.
Immunohistochemistry findings showed higher expression of Caspase-3 in the late group compared to the early group, as well as the expression of Caspase-8 and Caspase-9 (p < 0,05), and with a positive correlation between Caspase-8 and Caspase-9 to Caspase-3. Meanwhile, TNF-α expression was higher in the early group than the late group (p < 0,05) and with no correlation between TNF-α to Caspase-3.
Apoptosis of proximal stump motorneuron plexus brachialis on more than six months post-trauma is higher than on less than six months post-trauma.
显微外科手术治疗节后臂丛神经损伤的成功受到多种因素影响，包括手术时机以及近端残端的活力。本研究评估臂丛神经近端残端凋亡的证据及其与手术时机的相关性。
在神经手术过程中获取节后臂丛神经损伤患者的近端残端活检样本。根据手术时机将样本分组，创伤后六个月内（早期组）和创伤后六个月后（晚期组）。通过Caspase-3、TNF-α、Caspase-8和Caspase-9的免疫组化表达评估运动神经元的凋亡情况。
免疫组化结果显示，晚期组Caspase-3的表达高于早期组，Caspase-8和Caspase-9的表达也高于早期组（p<0.05），且Caspase-8和Caspase-9与Caspase-3呈正相关。同时，早期组TNF-α的表达高于晚期组（p<0.05），且TNF-α与Caspase-3无相关性。
创伤后超过六个月的臂丛神经近端残端运动神经元凋亡高于创伤后不到六个月的情况。
