Inhibition of neural and muscle degeneration after epineural neurorrhaphy.

Investigations were undertaken on the regeneration of transected rat sciatic nerves. The ability of the protease inhibitor leupeptin to inhibit wallerian degeneration and muscle atrophy was evaluated. After transection of a sciatic nerve and immediate neurorrhaphy, animals were treated with leupeptin for a period of 1 week to 6 months. Our results indicate a significant increase in the numbers of myelinated and unmyelinated neurofibers in the distal segment of treated nerves. Peroxidase tracer, injected intramuscularly, was transported by retrograde axonal flow and was observed to label increased numbers of treated axons both distal and proximal to the repair site. This finding suggests that treated neurofibers are functionally viable. Evaluation of muscle showed that secondary muscular atrophy is also significantly inhibited by leupeptin.