Keywords
denervation
hypotrophy
trophic ulcer
autophagy
How to Cite
Abstract
Relevance. Peripheral nerve injuries are potentially disabling lesions, which account for about 2-3% of all injuries. In order to study the clinical manifestations of limb denervation in the early and late stages, we conducted an experimental study.
Objective: in the experiment, to study the effect of bone marrow aspirate injection into the target muscles on denervation-reinnervation processes by studying the clinical manifestations of denervation (presence of trophic ulcers, edema, or muscle wasting).
Materials and Methods. The experiment was performed on 36 rabbits, which were divided into four groups: a group of pseudo-operated animals, group 1 (neurotomy and sciatic nerve suture), group 2 (on-time injection of bone marrow aspirate), and group 3 (delayed injection of bone marrow aspirate). Detection of hypotrophy or edema of the tibia was performed by determining the percentage of leg circumference of the operated on and intact limbs. Clinical manifestations of limb denervation were recorded during the examination of experimental animals before their euthanasia.
Results. When comparing the number of complications in group 1 and group 2, more complications of the denervation process was observed in group 1. At the same time, no difference was found between group 1 and group 3, as well as between group 2 and group 3. When comparing the indicators of hypotrophy, the difference between group 1 and group 2, as well as a significant difference (p<0.05) between group 1 and group 3, with a predominance of hypotrophy in group 2 and group 3 were revealed.
Conclusions. The injection of bone marrow aspirate into the target muscles during surgery and in the early stages of reinnervation helped to reduce the clinical manifestations of the denervation process. Delayed administration of bone marrow aspirate to target muscles significantly (p<0.05) helped to reduce edema of denervated target muscles.
References
Wanga ML, Rivlin M, Graham JG, Beredjiklian PK. Peripheral nerve injury, scarring, and recovery. Connective Tissue Research. 2018; 1-7. DOI: 10.1080/03008207.2018.1489381.
Modrak M, Talukder H, Gurgenashvili K, Noble M, Elfar JC. Peripheral nerve injury and myelination: potential therapeutic strategies. J Neurosci Res. 2020; 98(5): 780-795. DOI: 10.1002/jnr.24538.
Sullivan R, Dailey T, Duncan K, Abel N, Borlongan CV. Peripheral Nerve Injury: Stem Cell Therapy and Peripheral Nerve Transfer. International Journal of Molecular Sciences. 2016;(17): 1-12. DOI: 10.3390/ijms17122101.
Mackinnon SE, Dellon AL. Surgery of the Peripheral Nerve Mackinnon SE, editor. New York: Thieme; 1988.
Ruijs ACJ, Jaquet JB, Kalmijn S, Giele H, Hovius SER. Median and ulnar nerve injuries: a meta-analysis of predictors of motor and sensory recovery after modern microsurgical nerve repair. Plast Reconstr Surg. 2005; 116(2): 484-494. DOI: 10.1097/01.prs.0000172896.86594.07.
Kubiak CA, Kung TA, Brown DL, Cederna PS, Kemp SWP. State-of-the-Art Techniques in Treating Peripheral Nerve Injury. Plast Reconstr Surg. 2018; 141(3): 702-710. DOI: 10.1097/PRS.0000000000004121.
Lopes B, Sousa P, Alvites R, Branquinho M, Sousa AC, Mendonça C, et al. Peripheral Nerve Injury Treatments and Advances: One Health Perspective. International Journal of Molecular Sciences. 2022; 23(2): 1-27. DOI: 10.3390/ijms23020918.
Yang X, Liu R, Xu Y, Ma X, Zhou B. The Mechanisms of Peripheral Nerve Preconditioning Injury on Promoting Axonal Regeneration. Neural Plast. 2021; 2021: 1-9. DOI: 10.1155/2021/6648004.
Hatzenbuehler J. Peripheral Nerve Injury. Current Sports Medicine Reports. 2015; 14(5): 356–357. DOI: 10.1249/jsr.0000000000000186.
Menorca RMG, Fussell TS, Elfar JC. Peripheral Nerve Trauma: Mechanisms of Injury and Recovery. Hand Clin. 2013; 29(3): 317–330. DOI: 10.1016/j.hcl.2013.04.002.
Chen P, Piao X, Bonaldo P. Role of macrophages in Wallerian degeneration and axonal regeneration after peripheral nerve injury. Acta Neuropathologica. 2015; 130(5): 605–618. DOI: 10.1007/s00401-015-1482-4.
Kumai Y, Ito T, Matsukawa A, Yumoto E. Effects of denervation on neuromuscular junctions in the thyroarytenoid muscle. Laryngoscope. 2005; 115(10): 1869-1872. DOI: 10.1097/01.mlg.0000177076.33294.89.
Gordon T. Peripheral Nerve Regeneration and Muscle Reinnervation. International Journal of Molecular Sciences. 2020; 21(22): 1-24. DOI: 10.3390/ijms21228652.
Finkelstein DI, Dooley PC, Luff AR. Recovery of muscle after different periods of denervation and treatments. Muscle Nerve. 1993; 16(7): 769-777. DOI: 10.1002/mus.880160712.
Divac N, Aksić M, Rasulić L, Jakovčevski M, Basailović M, Jakovčevski I. Pharmacology of repair after peripheral nerve injury. Int J Clin Pharmacol Ther. 2021; 59(6): 447-462. DOI: 10.5414/CP203893.
Bolandghamat S, Behnam-Rassouli M. Recent Findings on the Effects of Pharmacological Agents on the Nerve Regeneration after Peripheral Nerve Injury. Curr Neuropharmacol. 2020; 18(11): 1154–1163. DOI: 10.2174/1570159X18666200507084024.
Hussain G, Wang J, Rasul A, Anwar H, Qasim M, Zafar S, et al. Current Status of Therapeutic Approaches against Peripheral Nerve Injuries: A Detailed Story from Injury to Recovery. International Journal of Biological Sciences. 2020; 16(1): 116–134. DOI: 10.7150/ijbs.35653.
Gordon T, English AW. Strategies to promote peripheral nerve regeneration: electrical stimulation and/or exercise. European Journal of Neuroscience. 2016; 43(3): 336–350. DOI: 10.1111/ejn.13005.
Yu T, Xu Y, Ahmad MA, Javed R, Hagiwara H, Tian X. Exosomes as a Promising Therapeutic Strategy for Peripheral Nerve Injury. Curr Neuropharmacol. 2021; 19(12): 2141-2151. DOI: 10.2174/1570159X19666210203161559.
Kubiak CA, Grochmal J, Kung TA, Cederna PS, Midha R, Kemp SWP. Stem‐cell Based Therapies to Enhance Peripheral Nerve Regeneration. Muscle & Nerve. 2020; 61(4): 449-459. DOI: 10.1002/mus.26760.
Hogendoorn S, Duijnisveld BJ, van Duinen SG, Stoel BC, van Dijk JG, Fibbe WE, et al. Local injection of autologous bone marrow cells to regenerate muscle in patients with traumatic brachial plexus injury. Bone Joint Res. 2014; 3(2): 38-47. DOI: 10.1302/2046-3758.32.2000229.
Sallomi D, Janzen DL, Munk PL, Connell DG, Tirman PF. Muscle denervation patterns in upper limb nerve injuries: MR imaging findings and anatomic basis. American Journal of Roentgenology. 1998; 171(3): 779–784. DOI: 10.2214/ajr.171.3.9725316.
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