IR820近红外实时成像支配女性内生殖器的盆腔自主神经及其机制和神经毒性研究

深部浸润型子宫内膜异位症、宫颈癌等妇科手术中极易损伤支配内生殖器等的盆腔自主神经，可造成严重的膀胱、直肠和性功能障碍，其关键原因是术中神经辨识太难，但目前没有很好的办法。根据最新研究进展及我们的预实验，本课题提出科学假设：利用吲哚菁绿的结构衍生物IR820作为近红外荧光造影剂，能术中实时、高效地成像盆腔自主神经，可能机制是IR820转运受体在不同组织表达差异而造成其在神经内有滞留效应。为此，本项目拟开展IR820近红外成像盆腔自主神经技术解决方案的探索、优化及验证研究；从IR820在盆腔自主神经内的滞留效应及与周围组织转运受体表达差异等探究其成像机制；并从神经传导功能、神经组织微观形态、细胞活性、施万细胞分泌功能和慢性神经毒性等方面评估其生物安全性。本课题有望建立一种机制明确、安全有效的妇科手术中识别盆腔自主神经的技术，为减少妇科手术自主神经损伤并发症的发生提供新方法。

Pelvic autonomic nerves innervating female internal genitalia were usually damaged during gynecological surgeries, such as deep infiltrating endometriosis, cervical cancer, which may cause serious bladder, rectum and sexual dysfunction. The key strategy to reduce complications was identifying and preserving of pelvic autonomic nerves during surgeries, but it's difficult for clinicians. According to the latest research reports and our pre-experiment results, we put forward the hypothesis that IR820, a derivative of indocyanine green, can be used as a near-infrared fluorescent contrast agent for real-time and efficient imaging of pelvic autonomic nerves, and the mechanism may be that the expression of IR820 transporters in nerve tissue are different from that in other tissues, resulting in the retention effect of IR820 in pelvic autonomic nerves. Therefore, this project aims to explore, optimize and validate the technical solution of IR820 real-time fluorescence imaging of pelvic autonomic nerves, reveal the mechanism of neuroimaging by studying the retention effect of IR820 in pelvic autonomic nerves and the different expression of transporter receptor between nerves and the surrounding tissues, and assess the neurotoxicity of IR820 by studying the effects of IR820 on nerve conduction, microscopic morphology, primary cell activity, Schwann cell secretion function and chronic neurotoxicity. Based on these studies, we will develop a new technique of identifying pelvic autonomic nerves with clear mechanism, safety and effectiveness, then provide an innovative strategy to reduce the complications of pelvic autonomic nerves injury in gynecological surgeries.