Repair of motor nerve gaps with sensory nerve inhibits regeneration in rats
Repair of motor nerve gaps with sensory nerve inhibits regeneration in rats
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DOI：
10.1097/01.mlg.0000229469.31749.91
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发表时间：
2006-09-01
期刊：
影响因子：
2.6
通讯作者：
Mackinnon, Susan E.
中科院分区：
文献类型：
--
作者：
Brenner, Michael J.;Hess, Jason R.;Mackinnon, Susan E.
目的：感觉神经移植常被用来重建受损的运动神经，但这种运动/感觉错配的后果还没有得到很好的研究。感觉神经具有比运动神经更多样的纤维分布，可能具有明显不同的雪旺细胞。雪旺细胞特性和通路结构的假定差异可能会对感觉通路下运动神经元的再生产生负面影响。我们假设感觉移植物损害了运动靶点的再支配，从而导致了不理想的结果。本研究探讨了运动移植物和感觉移植物对神经再生和功能恢复的影响。研究设计：作者进行了一项前瞻性、随机、对照的动物研究。方法：将56只Lewis大鼠随机分为7组，每组8只。用单股、双股、三股或四股神经组成的运动神经或感觉神经移植物重建5毫米长的胫神经缺损区。以自体胫神经移植为阳性对照。术后3周取材进行组织学检查和定量组织形态计量学分析。湿肌块提供了功能恢复的指标。结果：运动神经移植物的神经再生明显大于感觉神经移植物，与移植物横截面积或电缆数目无关。运动神经移植物显示神经密度、神经百分比和总纤维数量增加(P<；0.05)。运动组与感觉组相比，正常化的湿肌块有改善恢复的趋势。结论：在啮齿动物模型中，用运动神经和感觉神经移植重建胫神经缺损区可促进神经再生，而不依赖于缆线的数目。通过运动神经移植优先再生神经也可能促进功能恢复，对临床神经重建具有潜在的意义。
Objective: Sensory nerve grafts are often used to reconstruct injured motor nerves, but the consequences of such motor/sensory mismatches are not well studied. Sensory nerves have more diverse fiber distributions than motor nerves and may possess phenotypically distinct Schwann cells. Putative differences in Schwann cell characteristics and pathway architecture may negatively affect the regeneration of motor neurons down sensory pathways. We hypothesized that sensory grafts impair motor target reinnervation, thereby contributing to suboptimal outcomes. This study investigated the effect of motor versus sensory grafts on nerve regeneration and functional recovery. Study Design: The authors conducted a prospective, randomized, controlled animal study. Methods: Fifty-six Lewis rats were randomized to seven groups of eight animals each. Five-millimeter tibial nerve defects were reconstructed with motor or sensory nerve grafts comprised of single, double, triple, or quadruple cables. Tibial nerve autografts served as positive controls. Three weeks after reconstruction, nerves were harvested for histologic examination and quantitative histomorphometric analysis. Wet muscle masses provided an index of functional recovery. Results: Nerve regeneration was significantly greater across motor versus sensory nerve grafts independent of graft cross-sectional area or cable number. Motor grafts demonstrated increased nerve density, percent nerve, and total fiber number (P < .05). Normalized wet muscle masses trended toward improved recovery in motor versus sensory groups. Conclusions: Reconstruction of tibial nerve defects with nerve grafts of motor versus sensory origin enhanced nerve regeneration independent of cable number in a rodent model. Preferential nerve regeneration through motor nerve grafts may also promote functional recovery with potential implications for clinical nerve reconstruction.