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1.
Acta Orthop Traumatol Turc ; 58(1): 10-19, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38525505

RESUMO

OBJECTIVE: This study aimed to introduce a reliable and useful model of selective sensorial or motor denervations of the sciatic nerve in rats with clinical and laboratory outcomes. METHODS: The surgical technique was determined via detailed cadaveric dissections of rat sciatic nerve roots and cross-sectional histoanatomy. Forty animals were divided into the sham, sensorial denervation (SD), motor denervation (MD), and combined denervation (CD) groups and evaluated clinically via the pinch test and observation. Electrophysiological tests, retrograde neuronal labeling, and histologic and radiographic studies were performed. The weights of the muscles innervated by the sciatic nerve were measured. RESULTS: The nerve root topography at the L4 level was consistent. Hemilaminectomy satisfactorily exposed all the roots contributing to the sciatic nerve and selectively denervated its sensorial and motor zones. Sensorial denervation caused foot deformities and wound problems, which were more severe in SD than in MD and CD. Nerve histomorphometry, electrophysiological tests, retrograde neuronal labeling studies, and measurements of the muscle weights also verified the denervations. CONCLUSION: This study has shown the feasibility of selective (sensory or motor) sciatic nerve denervation through a single-level hemilaminectomy. The surgical technique is reliable and has a confounding effect on gait. Sensorial denervation had more severe foot problems than motor and combined denervation in rats.


Assuntos
Denervação Muscular , Músculos , Humanos , Ratos , Animais , Estudos Transversais , Músculos/inervação , Nervo Isquiático/cirurgia , Denervação
2.
ACS Biomater Sci Eng ; 10(4): 2001-2021, 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38487853

RESUMO

Despite the advances in tissue engineering approaches, reconstruction of long segmental peripheral nerve defects remains unsatisfactory. Although autologous grafts with proper fascicular complementation have shown meaningful functional recovery according to the Medical Research Council Classification (MRCC), the lack of donor nerve for such larger defect sizes (>30 mm) has been a serious clinical issue. Further clinical use of hollow nerve conduits is limited to bridging smaller segmental defects of denuded nerve ends (<30 mm). Recently, bioinspired multichannel nerve guidance conduits (NGCs) gained attention as autograft substitutes as they mimic the fascicular connective tissue microarchitecture in promoting aligned axonal outgrowth with desirable innervation for complete sensory and motor function restoration. This review outlines the hierarchical organization of nerve bundles and their significance in the sensory and motor functions of peripheral nerves. This review also emphasizes the major challenges in addressing the longer nerve defects with the role of fascicular arrangement in the multichannel nerve guidance conduits and the need for fascicular matching to accomplish complete functional restoration, especially in treating long segmental nerve defects. Further, currently available fabrication strategies in developing multichannel nerve conduits and their inconsistency in existing preclinical outcomes captured in this review would seed a new process in designing an ideal larger nerve conduit for peripheral nerve repair.


Assuntos
Traumatismos dos Nervos Periféricos , Humanos , Traumatismos dos Nervos Periféricos/cirurgia , Nervo Isquiático/lesões , Nervo Isquiático/fisiologia , Nervo Isquiático/cirurgia , Tecidos Suporte , Engenharia Tecidual
3.
Biomater Adv ; 159: 213803, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38447384

RESUMO

Autologous nerve grafts have been considered the gold standard for peripheral nerve grafts. However, due to drawbacks such as functional loss in the donor area and a shortage of donor sources, nerve conduits are increasingly being considered as an alternative approach. Polymer materials have been widely studied as nerve repair materials due to their excellent processing performance. However, their limited biocompatibility has restricted further clinical applications. The epineurium is a natural extra-neural wrapping structure. After undergoing decellularization, the epineurium not only reduces immune rejection but also retains certain bioactive components. In this study, decellularized epineurium (DEP) derived from the sciatic nerve of mammals was prepared, and a bilayer nerve conduit was created by electrospinning a poly (l-lactide-co-ε-caprolactone) (PLCL) membrane layer onto the outer surface of the DEP. Components of the DEP were examined; the physical properties and biosafety of the bilayer nerve conduit were evaluated; and the functionality of the nerve conduit was evaluated in rats. The results demonstrate that the developed bilayer nerve conduit exhibits excellent biocompatibility and mechanical properties. Furthermore, this bilayer nerve conduit shows significantly superior therapeutic effects for sciatic nerve defects in rats compared to the pure PLCL nerve conduit. In conclusion, this research provides a novel strategy for the design of nerve regeneration materials and holds promising potential for further clinical translation.


Assuntos
Tecido Nervoso , Nervo Isquiático , Ratos , Animais , Nervo Isquiático/cirurgia , Nervo Isquiático/fisiologia , Próteses e Implantes , Polímeros/farmacologia , Mamíferos
4.
Sci Prog ; 107(1): 368504241231656, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38490165

RESUMO

OBJECTIVE: Acute limb ischemia (ALI) is a rapid decrease in lower limb blood flow due to acute occlusion of peripheral arteries or bypass grafts. This study aimed to establish an ALI model using microsized gelatin beads and to investigate the pathophysiological conditions. METHODS: Male Sprague-Dawley rats were anesthetized, and a low or high dose of microsized gelatin beads was administered into the left femoral artery on days 0 and 7. A control, that is, normal saline (NS) group in which NS was administered in the left femoral artery, a femoral artery cut (FAC) group in which the left femoral artery was cut, and a sciatic nerve cut (SNC) group in which the left sciatic nerve was cut were prepared. After 21 days, the temperature changes and the muscle weights in the lower limbs were measured. To assess nerve damage, the L1-6 sympathetic ganglia were immunostained with activating transcription factor 3 (ATF3) antibody. RESULTS: In the Low-dose, High-dose, and FAC groups, a decrease in temperature was predominantly observed in the left limb. In the High-dose and SNC groups, the weight of the soleus muscle and extensor digitorum longus in the left limb decreased; however, no weight changes were observed in the Low-dose and FAC groups. Conversely, the weight of the gastrocnemius muscle significantly decreased in the Low-dose, High-dose, FAC, and SNC groups. In the High-dose and SNC groups, the number of ATF3-positive cells in the sympathetic ganglia significantly increased, and in the Low-dose, a small number of ATF3-positive cells were observed. However, ATF3-positive cells were rarely observed in the FAC and NS groups. CONCLUSION: We established an ALI rat model using microsized gelatin beads. The results of this study suggest that autonomic neuropathy in ALI is related to both muscle damage and peripheral neuropathy.


Assuntos
Gelatina , Isquemia , Ratos , Animais , Masculino , Ratos Sprague-Dawley , Músculo Esquelético , Nervo Isquiático/cirurgia
5.
JBJS Case Connect ; 14(1)2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38394316

RESUMO

CASE: A 31-year-old patient presented with an encapsulated sciatic nerve secondary to extensive hip heterotopic ossification (HO), which prevented visualization of a safe osteotomy site to avoid nerve damage. The 3D-printed model demonstrated an easily identifiable osseous reference point along the inferior aspect of the heterotopic mass, allowing for a vertical osteotomy to be safely performed. CONCLUSION: HO is associated with loss of normal anatomic topography. The current case report illustrates the use of a 3D-printed model to identify pertinent anatomic landmarks required for safe decompression of an encapsulated sciatic nerve within the anatomic region of the hip.


Assuntos
Ossificação Heterotópica , Nervo Isquiático , Humanos , Adulto , Nervo Isquiático/cirurgia , Ossificação Heterotópica/diagnóstico por imagem , Ossificação Heterotópica/cirurgia , Ossificação Heterotópica/complicações , Osteotomia/efeitos adversos , Descompressão/efeitos adversos , Impressão Tridimensional
7.
J Biomed Mater Res B Appl Biomater ; 112(1): e35369, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38247253

RESUMO

Peripheral nerve injuries (PNIs) include complete and partial transection, crushing, and chronic compression injuries. Hollow absorbable conduits are used to treat complete transection with short defects, while wrapping the injured part with an absorbent material promotes nerve recovery by inhibiting inflammatory cell infiltration and scar tissue formation in crush injuries. For treatment of partially transected nerve injuries (PTNIs), such as injection-related iatrogenic PNI, whether wrapping the entire nerve, including the injury site, or bridging the transected fascicle with an artificial nerve conduit (ANC) is beneficial remains to be verified. The purpose of this study was to investigate whether wrapping the injured nerve and placing collagen fibers as scaffolds at the nerve defect site contribute to neural recovery in PTNI. A unilateral 5-mm partial nerve defect was created at the mid-thigh level in a rat sciatic nerve injury model. Fifty-four Sprague-Dawley (SD) rats (150-250 g) were divided into three groups (n = 9 each): group 1, collagen fibers were placed in the nerve defect and the sciatic nerve was wrapped with collagen conduit; group 2, the sciatic nerve was wrapped by collagen conduit without collagen fibers; and group 3, nerve defect was reconstructed with collagen-filled conduit. Nerve regeneration was evaluated by analyses of gait, electrophysiology, wet muscle weight, and axon numbers with immunohistochemistry at 12 and 24 weeks. Dorsiflexion angles among all groups improved significantly from 12 to 24 weeks postoperatively. At 24 weeks postoperatively, compound muscle action potential amplitudes (CMAPs) of tibialis anterior were 5.26 ± 4.64, 1.31 ± 1.17, and 0.14 ± 0.24 mV (p < .05), CMAPs of gastrocnemius were 21.3 ± 5.98, 15.4 ± 5.46, and 13.11 ± 3.91 mV in groups 1, 2, and 3, respectively; and the value of group 1 was significantly higher than that of group 3 (p < .05). Axon numbers were 2194 ± 629; 1106 ± 645; and 805 ± 907 in groups 1, 2, and 3, respectively (p < .05). For PTNI reconstruction, artificial nerve wrap (ANW) was superior to ANC. Providing collagen scaffold at the nerve defect site enhanced nerve recovery during reconstruction with ANW.


Assuntos
Traumatismos dos Nervos Periféricos , Ratos , Animais , Traumatismos dos Nervos Periféricos/terapia , Ratos Sprague-Dawley , Nervo Isquiático/cirurgia , Regeneração Nervosa , Colágeno
8.
Ann Plast Surg ; 92(3): 313-319, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38170975

RESUMO

PURPOSE: The ideal number of sutures for epineural nerve repair is still unclear. Increased number of sutures increases secondary damage and inflammation to the nerve tissue, which negatively affects nerve regeneration. When the number of sutures decreases, the strength of the nerve repair site decreases and nerve endings are fringed, which also negatively affects nerve regeneration. Therefore, each additional suture is not only beneficial but also detrimental. The aim of this study was to find out the ideal number of sutures for nerve repair. METHODS: Seventy rats were randomly divided into 5 groups. One of the groups was used as a control group, and right sciatic nerves of the rats in other 4 groups were repaired by using 2, 3, 4, or 6 epineural sutures, respectively, after nerve transection. Biomechanical assessment was performed on the nerves collected from these rats at 5 days of follow-up. Functional and histological analyses were evaluated after 12 weeks of follow-up. RESULTS: It was found that an increase in the number of sutures enhances resistance to tensile force in general. However, there was no significant biomechanical difference between the 6-sutured group in which the most sutures were used and the 4-sutured group. In functional examinations, overall successful results were obtained in the group with 4 sutures. In histological examinations, there was no statistical difference between the control group, 2-sutured groups, and 4-sutured groups in terms of connective tissue index. However, it was observed that the group with 6 sutures had a higher connective tissue index than the control group and groups with 2 and 4 sutures. In terms of regeneration index, it was found that repair with 4 sutures was superior to repair with 2 and 6 sutures. No difference was found between any of the suture groups according to the diameter change index. CONCLUSIONS: These results indicate that repair with 4 sutures is the best method of epineural repair that provides both strength and regeneration. These findings will contribute to both the repair of clinically similar nerves and the standardization of rat nerve studies.


Assuntos
Procedimentos de Cirurgia Plástica , Nervo Isquiático , Ratos , Animais , Nervo Isquiático/cirurgia , Suturas , Procedimentos Neurocirúrgicos/métodos , Regeneração Nervosa
9.
Microsurgery ; 44(1): e31034, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36914614

RESUMO

BACKGROUND: Concomitant resection of the sciatic nerve along with a malignant tumor is no longer a contraindication for limb-sparing surgery, as most of these patients remain ambulatory. However, sciatic nerve reconstruction after sarcoma resection is not commonly performed. Restoration of nerve function can improve patient quality of life. We describe our experience with four patients who underwent sciatic nerve reconstruction using an ipsilateral common peroneal nerve graft at the time of sarcoma resection. METHODS: Because of the low chance of peroneal nerve recovery, the ipsilateral peroneal trunk was used as a graft to reconstruct the tibial trunk of the sciatic nerve. Two patients were men and two were women. Mean age was 45.3 years (range, 15-62). Mean sciatic nerve defect length was 9.4 cm (range, 8.5-12.0). Proximal thigh defects (three patients) were reconstructed with a double cable; the one patient with a distal thigh defect underwent single cable reconstruction. Mean operation time was 492 min (range, 428-682). RESULTS: Mean length of the harvested peroneal trunks was 21 cm (range, 11-26). Mean graft length was 11.9 cm (range, 11-13). Postoperative course was uneventful in all four patients. One patient died of sarcoma lung metastasis and could not be evaluated. Three patients were followed for more than 2 years. Two patients achieved British Medical Research Council grade 4 plantar flexion; the remaining patient achieved grade 5 plantar flexion and grade 4 toe flexion. Semmes-Weinstein monofilament sensory testing showed loss of protective sensation on the plantar surface in all three. Musculoskeletal Tumor Society scores at last follow-up were 60.0%, 70.0%, and 43.3%, respectively. CONCLUSIONS: Immediate sciatic nerve reconstruction using an ipsilateral common peroneal nerve graft avoids reconstruction delay and scar tissue formation, which is advantageous for nerve recovery. This technique may be considered when sciatic nerve resection is anticipated during sarcoma resection.


Assuntos
Nervo Fibular , Sarcoma , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Nervo Fibular/cirurgia , Qualidade de Vida , Nervo Isquiático/cirurgia , Coxa da Perna , Sarcoma/cirurgia , Resultado do Tratamento
10.
Clin Neurol Neurosurg ; 236: 108051, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37995621

RESUMO

PURPOSE: To repair peripheral nerve defects and seek alternatives for autografts, nerve conduits with various growth factors and cells have been invented. Few pieces of literature report the effect of nerve conduits plus platelet-rich fibrin (PRF). This study aimed to investigate the effectiveness of nerve conduits filled with PRF. METHODS: The model of a 10 mm sciatic nerve gap in a rat was used to evaluate peripheral nerve regeneration. The thirty rats were randomly divided into one of the following three groups (n = 10 per group). Autogenous nerve grafts (autograft group), conduits filled with phosphate-buffered saline (PBS) (PBS group), or conduits filled with PRF group (PRF group). We assessed motor and sensory functions for the three groups at 4, 8, and 12 weeks postoperatively. In addition, axon numbers were measured 12 weeks after repair of the peripheral nerve gaps. RESULTS: Significant differences in motor function were observed between the autograft group and the other two groups at 12 weeks postoperatively. In the test to evaluate the recovery of sensory function, there were significant differences between the PBS group and the other two groups at all time points. The most axon number was found in the autograft group. The axon number of the PRF group was significantly more extensive than that of the PBS group. CONCLUSIONS: The nerve conduit filled with PRF promoted the axon regeneration of the sciatic nerve and improved sensory function.


Assuntos
Implantes Absorvíveis , Fibrina Rica em Plaquetas , Ratos , Humanos , Animais , Axônios , Regeneração Nervosa/fisiologia , Nervo Isquiático/cirurgia
11.
J Reconstr Microsurg ; 40(3): 232-238, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37696294

RESUMO

BACKGROUND: Photochemical tissue bonding (PTB) is a technique for peripheral nerve repair in which a collagenous membrane is bonded around approximated nerve ends. Studies using PTB with cryopreserved human amnion have shown promising results in a rat sciatic nerve transection model including a more rapid and complete return of function, larger axon size, and thicker myelination than suture repair. Commercial collagen membranes, such as dehydrated amnion allograft, are readily available, offer ease of storage, and have no risk of disease transmission or tissue rejection. However, the biomechanical properties of these membranes using PTB are currently unknown in comparison to PTB of cryopreserved human amnion and suture neurorrhaphy. METHODS: Rat sciatic nerves (n = 10 per group) were transected and repaired using either suture neurorrhaphy or PTB with one of the following membranes: cryopreserved human amnion, monolayer human amnion allograft (crosslinked and noncrosslinked), trilayer human amnion/chorion allograft (crosslinked and noncrosslinked), or swine submucosa. Repaired nerves were subjected to mechanical testing. RESULTS: During ultimate stress testing, the repair groups that withstood the greatest strain increases were suture neurorrhaphy (69 ± 14%), PTB with crosslinked trilayer amnion (52 ± 10%), and PTB with cryopreserved human amnion (46 ± 20%), although the differences between these groups were not statistically significant. Neurorrhaphy repairs had a maximum load (0.98 ± 0.30 N) significantly greater than all other repair groups except for noncrosslinked trilayer amnion (0.51 ± 0.27 N). During fatigue testing, all samples repaired with suture, or PTBs with either crosslinked or noncrosslinked trilayer amnion were able to withstand strain increases of at least 50%. CONCLUSION: PTB repairs with commercial noncrosslinked amnion allograft membranes can withstand physiological strain and have comparable performance to repairs with human amnion, which has demonstrated efficacy in vivo. These results indicate the need for further testing of these membranes using in vivo animal model repairs.


Assuntos
Âmnio , Nervo Isquiático , Humanos , Ratos , Animais , Suínos , Âmnio/cirurgia , Âmnio/transplante , Nervo Isquiático/cirurgia , Nervo Isquiático/fisiologia , Axônios/fisiologia , Transplante Homólogo , Aloenxertos , Técnicas de Sutura
12.
ANZ J Surg ; 94(4): 749-751, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38105585

RESUMO

Peripheral nerve injuries are common and debilitating. The goals of nerve repair are to accurately approximate the fascicular tissue, whilst ensuring continuous overlying epineurium and eliminating external sprouting of neural tissue. We describe a modification of standard micro-suturing which allows superior epineural eversion and fascicular coaptation.


Assuntos
Traumatismos dos Nervos Periféricos , Procedimentos de Cirurgia Plástica , Humanos , Técnicas de Sutura , Nervos Periféricos/cirurgia , Traumatismos dos Nervos Periféricos/cirurgia , Procedimentos Neurocirúrgicos , Nervo Isquiático/cirurgia
13.
Acta Neurochir (Wien) ; 165(12): 3993-4002, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37907766

RESUMO

PURPOSE: Polyethylene glycol is known to improve recovery following its use in repair of acute peripheral nerve injury. The duration till which PEG works remains a subject of intense research. We studied the effect of PEG with augmentation of 20Htz of electrical stimulation (ES) following neurorrhaphy at 48 h in a rodent sciatic nerve neurotmesis model. METHOD: Twenty-four Sprague Dawley rats were divided into 4 groups. In group I, the sciatic nerve was transected and repaired immediately. In group II, PEG fusion was done additionally after acute repair. In group III, repair and PEG fusion were done at 48 h. In group IV, ES of 20Htz at 2 mA for 1 h was added to the steps followed for group III. Weekly assessment of sciatic functional index (SFI), pinprick, and cold allodynia tests were done at 3 weeks and euthanized. Sciatic nerve axonal count and muscle weight were done. RESULTS: Groups II, III, and IV showed significantly better recovery of SFI (II: 70.10 ± 1.24/III: 84.00 ± 2.59/IV: 74.40 ± 1.71 vs I: 90.00 ± 1.38) (p < 0.001) and axonal counts (II: 4040 ± 270/III: 2121 ± 450/IV:2380 ± 158 vs I: 1024 ± 094) (p < 0.001) at 3 weeks. The experimental groups showed earlier recovery of sensation in comparison to the controls as demonstrated by pinprick and cold allodynia tests and improved muscle weights. Addition of electrical stimulation helped in better score with SFI (III: 84.00 ± 2.59 vs IV: 74.40 ± 1.71) (p < 0.001) and muscle weight (plantar flexors) (III: 0.49 ± 0.02 vs IV: 0.55 ± 0.01) (p < 0.001) in delayed repair and PEG fusions. CONCLUSION: This study shows that PEG fusion of peripheral nerve repair in augmentation with ES results in better outcomes, and this benefit can be demonstrated up to a window period of 48 h after injury.


Assuntos
Traumatismos dos Nervos Periféricos , Traumatismos do Sistema Nervoso , Ratos , Animais , Ratos Sprague-Dawley , Polietilenoglicóis/uso terapêutico , Hiperalgesia , Modelos Animais de Doenças , Nervo Isquiático/cirurgia , Estimulação Elétrica , Regeneração Nervosa/fisiologia , Recuperação de Função Fisiológica
14.
J Plast Reconstr Aesthet Surg ; 87: 329-338, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37925923

RESUMO

BACKGROUND: Motor function recovery following acellular nerve allograft (ANA) repair remains inferior to autologous nerve reconstruction. We investigated the functional recovery of ANAs after combined mesenchymal stem cell (MSC) delivery and surgical angiogenesis in a rat sciatic nerve defect model. METHODS: In 100 Lewis rats, unilateral sciatic nerve defects were reconstructed with (I) autografts, (II) ANAs, (III) ANAs wrapped with a superficial inferior epigastric artery fascial (SIEF) flap, combined with either (IV) undifferentiated MSCs or (V) Schwann cell-like differentiated MSCs. The tibialis anterior muscle area was evaluated during the survival period using ultrasonography. Functional recovery, histomorphometry, and immunofluorescence were assessed at 12 and 16 weeks. RESULTS: At 12 weeks, the addition of surgical angiogenesis and MSCs improved ankle contractures. The SIEF flap also significantly improved compound muscle action potential (CMAP) outcomes compared with ANAs. Autografts outperformed all groups in muscle force and weight. At 16 weeks, ankle contractures of ANAs remained inferior to autografts and SIEF, whereas the CMAP amplitude was comparable between groups. The muscle force of autografts remained superior to all other groups, and the muscle weight of ANAs remained inferior to autografts. No differences were found in histomorphometry outcomes between SIEF groups and ANAs. Vascularity, determined by CD34 staining, was significantly higher in SIEF groups compared with ANAs. CONCLUSIONS: The combination of surgical angiogenesis and MSCs did not result in a synergistic improvement in functional outcomes. In a short nerve gap model, the adipofascial flap may provide sufficient MSCs to ANAs without additional ex vivo MSC seeding.


Assuntos
Contratura , Células-Tronco Mesenquimais , Ratos , Animais , Aloenxertos , Ratos Endogâmicos Lew , Nervo Isquiático/cirurgia , Nervo Isquiático/irrigação sanguínea , Células-Tronco Mesenquimais/fisiologia , Regeneração Nervosa/fisiologia
15.
Biomacromolecules ; 24(11): 5451-5466, 2023 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-37917398

RESUMO

The morphological structure reconstruction and functional recovery of long-distance peripheral nerve injury (PNI) are global medical challenges. Biodegradable nerve scaffolds that provide mechanical support for the growth and extension of neurites are a desired way to repair long-distance PNI. However, the synchrony of scaffold degradation and nerve regeneration is still challenging. Here, a novel bioinspired multichannel nerve guide conduit (MNGC) with topographical cues based on silk fibroin and ε-polylysine modification was constructed. This conduit (SF(A) + PLL MNGC) exhibited sufficient mechanical strength, excellent degradability, and favorable promotion of cell growth. Peripheral nerve repairing was evaluated by an in vivo 10 mm rat sciatic model. In vivo evidence demonstrated that SF(A) + PLL MNGC was completely biodegraded in the body within 4 weeks after providing sufficient physical support and guide for neurite extension, and a 10 mm sciatic nerve defect was effectively repaired without scar formation, indicating a high synchronous effect of scaffold biodegradation and nerve regeneration. More importantly, the regenerated nerve of the SF(A) + PLL MNGC group showed comparable morphological reconstruction and functional recovery to that of autologous nerve transplantation. This work proved that the designed SF(A) + PLL MNGC has potential for application in long-distance PNI repair in the clinic.


Assuntos
Fibroínas , Traumatismos dos Nervos Periféricos , Ratos , Animais , Tecidos Suporte/química , Traumatismos dos Nervos Periféricos/cirurgia , Nervo Isquiático/cirurgia , Nervo Isquiático/lesões , Fibroínas/química , Regeneração Nervosa
16.
Biomater Adv ; 154: 213623, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37837905

RESUMO

The development of nerve wraps for use in the repair of peripheral nerves has shown promise over recent years. A pharmacological effect to improve regeneration may be achieved by loading such materials with therapeutic agents, for example ibuprofen, a non-steroidal anti-inflammatory drug with neuroregenerative properties. In this study, four commercially available polymers (polylactic acid (PLA), polycaprolactone (PCL) and two co-polymers containing different ratios of PLA to PCL) were used to fabricate ibuprofen-loaded nerve wraps using blend electrospinning. In vitro surgical handling experiments identified a formulation containing a PLA/PCL 70/30 molar ratio co-polymer as the most suitable for in vivo implantation. In a rat model, ibuprofen released from electrospun materials significantly improved the rate of axonal growth and sensory recovery over a 21-day recovery period following a sciatic nerve crush. Furthermore, RT-qPCR analysis of nerve segments revealed that the anti-inflammatory and neurotrophic effects of ibuprofen may still be observed 21 days after implantation. This suggests that the formulation developed in this work could have potential to improve nerve regeneration in vivo.


Assuntos
Ibuprofeno , Traumatismos dos Nervos Periféricos , Ratos , Animais , Ibuprofeno/farmacologia , Ibuprofeno/uso terapêutico , Traumatismos dos Nervos Periféricos/tratamento farmacológico , Traumatismos dos Nervos Periféricos/cirurgia , Poliésteres , Anti-Inflamatórios/farmacologia , Nervo Isquiático/cirurgia
17.
Sovrem Tekhnologii Med ; 15(1): 30-36, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37388749

RESUMO

The aim of the investigation is to study structural alterations of autologous omental adipose tissue in a silicon conduit and to evaluate its possible use for regeneration of the sciatic nerve in diastasis. Materials and Methods: Mature outbred male Wistar rats have been used in the study. The animals were divided into 7 experimental groups with complete transection of the sciatic nerve on the right side at the mid-third level of the thigh. The ends of the transected nerve were pulled apart, inserted into a silicon conduit, and secured to the epineurium. The conduit of group 1 (control) was filled with a saline solution; in group 2, it was filled with an autologous omental adipose tissue with saline solution. Intravital labeling of the omental adipose tissue with the lipophilic PKH 26 dye (in group 3) was used for the first time to find out whether the omental cells were involved in formation of the regenerating nerve. Diastasis in groups 1-3 was 5 mm, the postoperative period was 14 weeks. The dynamics of the omental adipose tissue changes in groups 4-7 was assessed by placing the omental tissues into the conduit covering 2 mm of diastasis. The postoperative period was 4, 14, 21, and 42 weeks. Results: In group 2 (omental adipose tissue + saline), the clinical condition of the damaged limb after 14 weeks may be evaluated as satisfactory and approximating to the intact parameters as compared to group 1 where the conduit was filled with a saline solution only. The sum of large and medium-sized nerve fibers in group 2 was 2.7 times greater than that in group 2. The milled omental adipose tissue inside the conduit changed its volume and structure in nerve diastasis and was constantly utilized up to complete elimination over time. The omental cells integrated into the newly formed nerve in the graft area. Conclusion: As a graft, the adipose tissue of the autologous omentum produces a stimulating effect on the post-traumatic regeneration of the sciatic nerve.


Assuntos
Cirurgia Plástica , Masculino , Ratos , Animais , Ratos Wistar , Solução Salina , Silício , Nervo Isquiático/cirurgia , Tecido Adiposo
18.
Exp Neurol ; 367: 114470, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37327964

RESUMO

Clinical evidence indicates that major depression is a common comorbidity of chronic pain, including neuropathic pain; however, the cellular basis for chronic pain-mediated major depression remains unclear. Mitochondrial dysfunction induces neuroinflammation and has been implicated in various neurological diseases, including depression. Nevertheless, the relationship between mitochondrial dysfunction and anxiodepressive-like behaviors in the neuropathic pain state remains unclear. The current study examined whether hippocampal mitochondrial dysfunction and downstream neuroinflammation are involved in anxiodepressive-like behaviors in mice with neuropathic pain, which was induced by partial sciatic nerve ligation (PSNL). At 8 weeks after surgery, there was decreased levels of mitochondrial damage-associated molecular patterns, such as cytochrome c and mitochondrial transcription factor A, and increased level of cytosolic mitochondrial DNA in the contralateral hippocampus, suggesting the development of mitochondrial dysfunction. Type I interferon (IFN) mRNA expression in the hippocampus was also increased at 8 weeks after PSNL surgery. The restoration of mitochondrial function by curcumin blocked the increased cytosolic mitochondrial DNA and type I IFN expression in PSNL mice and improved anxiodepressive-like behaviors. Blockade of type I IFN signaling by anti-IFN alpha/beta receptor 1 antibody also improved anxiodepressive-like behaviors in PSNL mice. Together, these findings suggest that neuropathic pain induces hippocampal mitochondrial dysfunction followed by neuroinflammation, which may contribute to anxiodepressive-behaviors in the neuropathic pain state. Improving mitochondrial dysfunction and inhibiting type I IFN signaling in the hippocampus might be a novel approach to reducing comorbidities associated with neuropathic pain, such as depression and anxiety.


Assuntos
Ansiedade , Depressão , Interferon Tipo I , Mitocôndrias , Neuralgia , Animais , Masculino , Camundongos , Ansiedade/complicações , Ansiedade/tratamento farmacológico , Ansiedade/metabolismo , Dor Crônica/complicações , Dor Crônica/metabolismo , Dor Crônica/patologia , Dor Crônica/psicologia , Curcumina/farmacologia , Curcumina/uso terapêutico , Citosol/efeitos dos fármacos , Citosol/metabolismo , Depressão/complicações , Depressão/tratamento farmacológico , Depressão/metabolismo , DNA Mitocondrial/metabolismo , Lobo Frontal/metabolismo , Lobo Frontal/patologia , Hipocampo/efeitos dos fármacos , Hipocampo/imunologia , Hipocampo/metabolismo , Hipocampo/patologia , Interferon Tipo I/antagonistas & inibidores , Interferon Tipo I/genética , Interferon Tipo I/metabolismo , Microglia/efeitos dos fármacos , Microglia/imunologia , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Mitocôndrias/patologia , Neuralgia/complicações , Neuralgia/metabolismo , Neuralgia/patologia , Neuralgia/psicologia , Doenças Neuroinflamatórias/complicações , Nervo Isquiático/cirurgia
19.
ACS Biomater Sci Eng ; 9(6): 3512-3521, 2023 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-37126860

RESUMO

This study aimed to investigate the effect of electrical stimulation on poly(d,l-lactide-co-ε-caprolactone) nerve guidance conduits (NGCs) in promoting the recovery of facial function and nerve regeneration after facial nerve (FN) injury in a rat model. In the experimental group, both the NGC and transcutaneous electrical nerve stimulation (ES) were used simultaneously; in the control group, only NGC was used. ES groups were divided into two groups, and direct current (DC) and charge-balanced pulse stimulation (Pulse) were applied. The ES groups showed significantly improved whisker movement than the NGC-only group. The number of myelinated neurons was higher in ES groups, and the myelin sheath was also thicker and more uniform. In addition, the expression of neurostructural proteins was also higher in ES groups than in the NGC-only group. This study revealed that FN regeneration and functional recovery occurred more efficiently when ES was applied in combination with NGCs.


Assuntos
Nervo Facial , Regeneração Tecidual Guiada , Ratos , Animais , Ratos Sprague-Dawley , Nervo Isquiático/lesões , Nervo Isquiático/cirurgia , Regeneração Nervosa/fisiologia , Estimulação Elétrica
20.
Pol Merkur Lekarski ; 51(2): 112-119, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37254757

RESUMO

OBJECTIVE: Aim: To determine the effect of laser irradiation of different spectrum on the expression of neuronal proteins (GFAP, S100, NSE and NF-L) in the sciatic nerve during its regeneration after crossing and surgical suturing. PATIENTS AND METHODS: Materials and methods: The experiment was performed on 60 laboratory rats of the Wistar line (200-250 g) with crossing of the left sciatic nerve and sutur¬ing with an epineural suture end to end 30 minutes after neurotomy. 90 days later, an immunohistochemical study was performed using specific antibodies (Thermo Fisher Scientific; USA). RESULTS: Results: A study of the marker of non-myelin Schwann GFAP cells showed their pronounced activation with germination in nerve thickness and the formation of weaves of processes around regenerated nerve fibers. The number of S-100-positive myelin Schwann cells decreased, the heterogeneity of their color and the loss of processes were determined. It showed a general decrease in the intensity of NSE- and NF-L-positive staining of nerve fibers regenerated after neurotomy, which was less pronounced when irradiated with a laser with a wavelength of 450-480 nm and 520 nm. CONCLUSION: Conclusions: In general, the use of laser radiation had a positive effect on the repair of nerve fibers after neurotomy. According to the immunohistochemical study of neuromarkers, the effect of laser irradiation of the blue spectrum was the most effective.


Assuntos
Células de Schwann , Nervo Isquiático , Ratos , Animais , Ratos Wistar , Nervo Isquiático/fisiologia , Nervo Isquiático/cirurgia , Regeneração Nervosa/fisiologia , Regeneração Nervosa/efeitos da radiação , Lasers
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