Ultrasound-guided platelet-rich plasma injection for repair of sciatic nerve crush injury / 中国组织工程研究

ABSTRACT

BACKGROUND: Platelet-rich plasma (PRP) contains growth factors that affect tendon, ligament, muscle and bone healing. On this basis, researchers gradually realize that such molecules released after PRP activation can regulate the early inflammation of peripheral nerve injury, activate Schwann cells, promote the polarization of macrophages, and actively prevent the hyperplasia of collagen fibers, thus becoming the key drivers of nerve function recovery. OBJECTIVE: To evaluate the value of ultrasound-guided PRP injection in the repair of sciatic nerve crush injury. METHODS: Twenty-eight healthy New Zealand white rabbits (provided by the Beijing Longan Experimental Animal Breeding Center) were randomly divided into normal group, control group, single PRP group and multiple PRPs group. In the normal group, the right sciatic nerve was exposed and then sutured directly. In the control group, a compression injury model of the right sciatic nerve was established. In the single PRP group, autologous PRP was injected around the injured nerve under ultrasound guidance at 24 hours after modeling. In the multiple PRPs group, autologous PRP was injected around the injured nerve under ultrasound guidance at 24 hours after modeling, and then the PRP injection was performed once at the 3rd and 5th weeks after modeling. Histological and morphological observation of regenerated nerves, wet weight recovery and histological manifestations of the denervated muscle were evaluated at 12 weeks after modeling. The study protocol was approved by the Administrative Committee of Experimental Animals in PLA General Hospital with the approval No. 2015-x10-02. RESULTS AND CONCLUSION: The integral optical density values of NF-200 and S100 staining, myelinated nerve fiber density, myelinated nerve fiber diameter and myelin sheath thickness were significantly increased in the single PRP and multiple PRPs groups compared with the control group (all P < 0.05), and the multiple PRPs group showed better outcomes than the single PRP group (all P < 0.05), but was still inferior to the normal group (all P < 0.05). Compared with the control group, wet weight and cross-sectional area of muscle fibers significantly increased in the single PRP group and multiple PRPs group (P < 0.05), and the multiple RPRs group showed better outcomes than the single PRP group, but was still inferior to the normal group (P < 0.05). To conclude, ultrasound-guided multi-frequency injection of autologous PRP has a good effect on the repair of sciatic nerve crush injury.