From the Departments of Plastic, Reconstructive, and Aesthetic Surgery and Histology and Embryology, Faculty of Medicine, Gazi University.
Plast Reconstr Surg. 2022 Feb 1;149(2):395-403. doi: 10.1097/PRS.0000000000008796.
Erythropoietin has neuroregenerative effects. Fibrin glue may be used for nerve repair and controlled release of substances. In this study, the authors investigated the effects of erythropoietin-containing fibrin glue on nerve repair, based on the hypothesis that erythropoietin-containing fibrin glue would positively affect nerve regeneration.
Thirty-six Long-Evans rats were used. The animals were divided into six groups. Their left sciatic nerves were isolated, transected, and repaired with saline-containing fibrin glue in group 1, with erythropoietin-containing fibrin glue in group 2, with saline-containing fibrin glue and two sutures in group 3, with erythropoietin-containing fibrin glue and two sutures in group 4, with two sutures in group 5, and with four sutures in group 6. Sciatic Functional Index calculation, pin-prick test, and toe-spread test were performed on days 21, 42, and 63. All animals were killed on day 63. The nerve sections were analyzed histologically.
The Sciatic Functional Index, pin-prick test, and toe-spread test results were the best in group 4 and the worst in group 5. Group 4 showed superior Schwann cell proliferation (p < 0.05). Groups with epineural suture use (groups 3, 4, 5, and 6) had higher endoneurial collagen synthesis scores than the groups without suture use (groups 1 and 2) (p < 0.05). The myelin protein zero immunostaining results were significantly higher in the erythropoietin-treated groups (groups 2 and 4) (p < 0.05).
The combined use of erythropoietin-containing fibrin glue and two epineural sutures (group 4) showed a statistically significant improvement in many parameters.
Fibrin glue is already used in nerve repair. Adding erythropoietin to fibrin glue could be a safe and easy option to improve nerve regeneration.
促红细胞生成素具有神经再生作用。纤维蛋白胶可用于神经修复和物质的控制释放。本研究基于促红细胞生成素胶体能积极促进神经再生的假设，探讨了含促红细胞生成素的纤维蛋白胶在神经修复中的作用。
使用 36 只长耳大白鼠。将动物分为 6 组。第 1 组用含生理盐水的纤维蛋白胶、第 2 组用含促红细胞生成素的纤维蛋白胶、第 3 组用含生理盐水的纤维蛋白胶和 2 根缝线、第 4 组用含促红细胞生成素的纤维蛋白胶和 2 根缝线、第 5 组只用 2 根缝线、第 6 组用 4 根缝线隔离、横断和修复左侧坐骨神经。在第 21、42 和 63 天进行坐骨神经功能指数计算、针刺痛觉试验和足趾张开试验。所有动物均于第 63 天处死。分析神经节段的组织学变化。
第 4 组的坐骨神经功能指数、针刺痛觉试验和足趾张开试验结果最佳，第 5 组最差。第 4 组雪旺氏细胞增殖较好（p < 0.05）。有神经外膜缝线使用的组（第 3、4、5 和 6 组）的神经内膜胶原合成评分高于无缝线使用的组（第 1 和 2 组）（p < 0.05）。促红细胞生成素处理组（第 2 和 4 组）的髓鞘蛋白零免疫染色结果明显较高（p < 0.05）。
联合使用含促红细胞生成素的纤维蛋白胶和 2 根神经外膜缝线（第 4 组）可显著改善多项参数。
纤维蛋白胶已用于神经修复。在纤维蛋白胶中添加促红细胞生成素可能是一种安全、简便的选择，以改善神经再生。
