Krishnan Anand, Verge Valerie M K, Zochodne Douglas W
Department of Anatomy, Physiology, and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada; Cameco MS Neuroscience Research Centre (CMSNRC), Saskatoon, SK, Canada.
Neuroscience and Mental Health Institute and Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Handb Clin Neurol. 2024;201:1-17. doi: 10.1016/B978-0-323-90108-6.00014-4.
Peripheral nerves are functional networks in the body. Disruption of these networks induces varied functional consequences depending on the types of nerves and organs affected. Despite the advances in microsurgical repair and understanding of nerve regeneration biology, restoring full functions after severe traumatic nerve injuries is still far from achieved. While a blunted growth response from axons and errors in axon guidance due to physical barriers may surface as the major hurdles in repairing nerves, critical additional cellular and molecular aspects challenge the orderly healing of injured nerves. Understanding the systematic reprogramming of injured nerves at the cellular and molecular levels, referred to here as "hallmarks of nerve injury regeneration," will offer better ideas. This chapter discusses the hallmarks of nerve injury and regeneration and critical points of failures in the natural healing process. Potential pharmacological and nonpharmacological intervention points for repairing nerves are also discussed.
周围神经是人体中的功能网络。这些网络的破坏会根据受影响的神经和器官类型而引发各种功能后果。尽管显微外科修复技术有所进步,且对神经再生生物学的理解也不断深入,但严重创伤性神经损伤后仍远未实现完全功能恢复。虽然轴突生长反应减弱以及物理屏障导致的轴突导向错误可能成为修复神经的主要障碍,但关键的细胞和分子层面的其他因素也对受损神经的有序愈合构成挑战。从细胞和分子水平理解受损神经的系统性重编程,即这里所说的“神经损伤再生的特征”,将提供更好的思路。本章讨论神经损伤和再生的特征以及自然愈合过程中失败的关键点。还讨论了修复神经的潜在药物和非药物干预点。