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神经横断术后的长期神经内膜变化。

Long-term endoneurial changes after nerve transection.

作者信息

Röyttä M, Salonen V

机构信息

Department of Pathology, University of Turku, Finland.

出版信息

Acta Neuropathol. 1988;76(1):35-45. doi: 10.1007/BF00687678.

Abstract

Long-term endoneurial changes in the distal stump of transected rat sciatic nerve were examined from 8 to 50 weeks after nerve transection. The morphological alterations were followed both in nerves which were allowed to regenerate and in nerves in which regeneration was prevented by suturing. The nerves prevented from regenerating showed markedly atrophied Schwann cell columns after 20 weeks and a disappearance of some Schwann cell columns after 30 weeks. The surrounding endoneurial fibroblast-like cells gradually lost their delicate cytoplasmic extensions and formed rough fascicles around numerous shrunken Schwann cell columns or around areas from which Schwann cells had apparently disappeared. Inside the fascicles, the Schwann cell loss was replaced by collagen fibrils or occasionally, by a dense accumulation of microfibrils. The loss of endoneurial cytoplasmic processes continued up to 50 weeks, leaving behind patches of thin fibrils around numerous shrunken Schwann cell columns or around collagenous areas where Schwann cells were lost. The endoneurial matrix showed presence of thin 25- to 30-nm collagen fibrils close to shrunken Schwann cell columns up to 50 weeks but in areas with advanced degeneration a shift towards regular 50- to 60-nm collagen fibrils occurred. The degenerated areas resembled those described in Renaut bodies and neurofibromas. Despite suturing of transected nerves to prevent sprouting, occasional regenerating sprouts were noted in the Schwann cell columns. These axons were surrounded in a sheath-like fashion by pre-existing endoneurial cell fascicles covered by a basal lamina. In the reinnervating nerves the endoneurial space gradually lost its compartmentized structures consisting of collagen fibrils and endoneurial fibroblast-like cells. After 20 weeks the endoneurial cells were inconspicuous and the extracellular matrix consisted mainly of 50- to 60-nm collagen fibrils. During axonal growth and maturation, Schwann cells containing unmyelinated axons surrounded large, myelinated axons in a collar-like fashion. Close to these collars of Schwann cells, thin 25- to 30-nm collagen fibrils were noted in focal areas, even after 50 weeks. Occasionally, numerous clusters of regenerating axonal sprouts were noted in the perineurium. These were surrounded by multiple layers of cells possessing basal lamina. The present results show that after nerve transection the distal stump of the severed nerve shows dynamic changes in the endoneurial space, especially in nerves where reinnervation is prevented.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

在大鼠坐骨神经横断后8至50周,对其远侧断端的长期神经内膜变化进行了检查。观察了允许再生的神经以及通过缝合阻止再生的神经的形态学改变。阻止再生的神经在20周后显示雪旺细胞柱明显萎缩,30周后一些雪旺细胞柱消失。周围的神经内膜成纤维细胞样细胞逐渐失去其纤细的胞质突起,并在许多萎缩的雪旺细胞柱周围或雪旺细胞明显消失的区域周围形成粗糙的束状结构。在束状结构内部,雪旺细胞的缺失被胶原纤维所取代,偶尔也被微纤维的密集堆积所取代。神经内膜胞质突起的丧失一直持续到50周,在许多萎缩的雪旺细胞柱周围或雪旺细胞缺失的胶原区域周围留下了细纤维斑块。直到50周,在萎缩的雪旺细胞柱附近的神经内膜基质中都可见到25至30纳米的细胶原纤维,但在晚期退变区域则出现向规则的50至60纳米胶原纤维的转变。退变区域类似于在雷诺体和神经纤维瘤中所描述的区域。尽管缝合了横断的神经以阻止发芽,但在雪旺细胞柱中偶尔仍可见到再生的芽。这些轴突被预先存在的、被基膜覆盖的神经内膜细胞束以鞘状方式包围。在再支配的神经中,神经内膜间隙逐渐失去了由胶原纤维和神经内膜成纤维细胞样细胞组成的分隔结构。20周后,神经内膜细胞不明显,细胞外基质主要由50至60纳米的胶原纤维组成。在轴突生长和成熟过程中,含有无髓轴突的雪旺细胞以领状方式围绕着大的有髓轴突。即使在50周后,在这些雪旺细胞领的附近,局部区域仍可见到25至30纳米的细胶原纤维。偶尔,在神经束膜中可见到大量再生轴突芽的簇。它们被多层具有基膜的细胞所包围。目前的结果表明,神经横断后,切断神经的远侧断端在神经内膜间隙中显示出动态变化,尤其是在阻止再支配的神经中。(摘要截选至400字)

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