Strategies to promote peripheral nerve regeneration: electrical stimulation and/or exercise.
Strategies to promote peripheral nerve regeneration: electrical stimulation and/or exercise.
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DOI：
10.1111/ejn.13005
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发表时间：
2016-02
期刊：
影响因子：
--
通讯作者：
English AW
中科院分区：
文献类型：
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作者：
Gordon T;English AW
促进轴突再生通常被认为是改善周围神经损伤后功能恢复的治疗靶点。在这篇综述中，电刺激（ES），日常锻炼，以及它们的组合在促进周围神经损伤后的动物模型和人类患者的神经再生的疗效的证据进行了探讨。本文综述了ES和运动加速轴突生长的原理、有效性和分子基础。在比较ES和运动在增强轴突再生方面的作用时，增加的神经活性、神经营养素和雄激素被认为是共同的要求。同样，性别特异性的要求被发现为运动，以增强轴突再生的外围和维持突触输入到受伤的运动神经元。ES促进人类和大鼠延迟神经修复后的神经再生。锻炼的有效性不太清楚。虽然ES，而不是运动，导致再生运动轴突的一个显着的错误方向，以重新神经支配不同的肌肉目标，神经肌肉特异性的损失遇到的只有一个非常小的影响，所产生的功能恢复。ES和运动都是有希望的周围神经损伤的实验性治疗方法，似乎已经准备好转化为临床应用。
Enhancing the regeneration of axons is often considered a therapeutic target for improving functional recovery after peripheral nerve injury. In this review, the evidence for the efficacy of electrical stimulation (ES), daily exercise, and their combination in promoting nerve regeneration after peripheral nerve injuries in both animal models and in human patients, is explored. The rationale, effectiveness, and molecular basis of ES and exercise in accelerating axon outgrowth are reviewed. In comparing the effects of ES and exercise in enhancing axon regeneration, increased neural activity, neurotrophins, and androgens are considered common requirements. Similar, gender-specific requirements are found for exercise to enhance axon regeneration in the periphery and for sustaining synaptic inputs onto injured motoneurons. ES promotes nerve regeneration after delayed nerve repair in humans and rats. The effectiveness of exercise is less clear. Although ES, but not exercise, results in a significant misdirection of regenerating motor axons to reinnervate different muscle targets, the loss of neuromuscular specificity encountered has only a very small impact on resulting functional recovery. Both ES and exercise are promising experimental treatments for peripheral nerve injury that seem ready to be translated to clinical use.