Geyik Alper, Koc Basar, Micili Serap Cilaker, Kiray Müge, Vayvada Haluk, Guler Selin
Department of Plastic, Reconstructive, and Aesthetic Surgery, Dokuz Eylul University, Izmir, Turkey.
Department of Physiology, Dokuz Eylul University, Izmir, Turkey.
Neurol Res. 2022 Mar;44(3):252-261. doi: 10.1080/01616412.2021.1975226. Epub 2021 Sep 28.
Peripheral nerve traumas are common injuries in young adult population. The myriad of techniques and medications have been defined to obtain better recovery but none of them was proved to have superior effect. This study aims to determine the anti-fibrotic effect of the decorin on sciatic nerve injury in order to enhance functional outcome.
24 12-week-old male Sprague-Dawley rats (350-400 gr) were divided into four groups. The sciatic nerve was dissected and exposed; a full-thickness laceration was created 1.5 cm proximal to the bifurcation point and 1.5 cm distal to where it originated from the lumbosacral plexus. Motor and sensory tests were conducted before and after the operations for evaluating the nerve healing.
There was a statistically significant difference between DCN bolus and PBS bolus group. (p<0.0001, p<0.05) in neuromotor tests. Increase of the latency was significantly lower in DCN bolus and infusion group when compared with the PBS bolus group. (p<0,001). All operated gastrocnemius muscles were atrophic compared with the contralateral side. The differences between the averages in the sciatic functional index, the improvement of the DCN infusion group was 8.6 units better than the PBS group and 4.4 units better than the DCN bolus group. When the amount of stimulation was 10 mV at the proximal segment in electromyography, there was no significant difference between the DCN bolus and sham groups. (p> 0.05, p = 0.6623).
Decorin protein reduces the fibrosis and enhances the motor and sensory recovery both clinically and histologically. Despite the high cost, short half-life and production issues, this protein could be administered after the microsurgical repair but more studies are required to overcome the limitations.
周围神经损伤在年轻成年人群中是常见的损伤。已经定义了无数的技术和药物以获得更好的恢复,但没有一种被证明具有卓越的效果。本研究旨在确定核心蛋白聚糖对坐骨神经损伤的抗纤维化作用,以提高功能结果。
将24只12周龄雄性Sprague-Dawley大鼠(350-400克)分为四组。解剖并暴露坐骨神经;在分叉点近端1.5厘米处和从腰骶丛发出处远端1.5厘米处造成全层撕裂伤。在手术前后进行运动和感觉测试以评估神经愈合情况。
在神经运动测试中,核心蛋白聚糖推注组和磷酸盐缓冲盐水推注组之间存在统计学上的显著差异(p<0.0001,p<0.05)。与磷酸盐缓冲盐水推注组相比,核心蛋白聚糖推注组和输注组的潜伏期增加明显更低(p<0.001)。与对侧相比,所有手术侧的腓肠肌均萎缩。在坐骨神经功能指数平均值之间的差异方面,核心蛋白聚糖输注组的改善比磷酸盐缓冲盐水组好8.6个单位,比核心蛋白聚糖推注组好4.4个单位。在肌电图检查中,当近端节段刺激量为10毫伏时,核心蛋白聚糖推注组和假手术组之间无显著差异(p>0.05,p = 0.6623)。
核心蛋白聚糖蛋白在临床和组织学上均可减少纤维化并增强运动和感觉恢复。尽管成本高、半衰期短且存在生产问题,但这种蛋白可在显微外科修复后给药,但需要更多研究来克服这些局限性。