골격근섬유로 채워진 Gore-Tex® 도관을 이용한 신경재생에 있어서 Valproic Acid의 효과

Valproic Acid Effect in Nerve Regeneration Using Gore-Tex® Tube Filled with Skeletal Muscle

  • 강낙헌 (충남대학교 의과대학 성형외과학교실) ;
  • 오현배 (충남대학교 의과대학 성형외과학교실) ;
  • 이기호 (충남대학교 의과대학 성형외과학교실) ;
  • 김종구 (을지대학교 의과대학 성형외과학교실)
  • Kang, Nak Heon (Department of Plastic & Reconstructive Surgery, College of Medicine, Chungnam National University) ;
  • Oh, Hyeon Bae (Department of Plastic & Reconstructive Surgery, College of Medicine, Chungnam National University) ;
  • Lee, Ki Ho (Department of Plastic & Reconstructive Surgery, College of Medicine, Chungnam National University) ;
  • Kim, Jong Gu (Department of Plastic & Reconstructive Surgery, Eulji Medical College)
  • 투고 : 2005.11.25
  • 발행 : 2006.03.10

초록

As the large defect of peripheral nerve occurs, the autologous nerve graft is the most ideal method but it has many limitations due to donor site morbidities. Various materials have been developed for the nerve defect as the conduits, but none of these materials is satisfactory. Among them, $Gore-Tex^{(R)}$ tube seems to be one of the most ideal nerve conduit materials at peripheral nerve defect. Many researches have focused on finding the neurotrophic factors. It is recently demonstrated that Valproic acid(VPA) has an effect of axonal regeneration as a neurotrophic factor without enzymatic degradation and toxicity problems. The purpose of this study is to evaluate the effect of VPA on the nerve regeneration at the peripheral nerve defect. A 10 mm gap of rat sciatic nerve was made and $Gore-Tex^{(R)}$ tube filled with biceps femoris muscle was placed at the nerve defect site. We let the rat take VPA as drinking water in experimental group and did not give VPA to the control group. We estimated the results as electrophysiologic and histological aspects for 16 weeks after the surgery. The nerve conduction velocity, total myelinated axon count, myelin sheath thickness and mean nerve fiber diameter significantly increased in VPA-treated experimental group when compared to the control (p < 0.05). From the above results, we conclude that VPA promotes the nerve regeneration at the peripheral nerve defect site. It is suggested that $Gore-Tex^{(R)}$ tube filled with skeletal muscle and VPA administration may be a good substitute for autologous nerve graft.

키워드

참고문헌

  1. Hudson TW, Evans GR, Schmidt CE: Engineering strategies for peripheral nerve repair. Clin Plast Surg 26: 617, 1999
  2. Stanec S, Stanec Z: Reconstruction of upper-extremity peripheral-nerve injuries with ePTFE conduits. J Reconstr Microsurg 14: 227, 1998 https://doi.org/10.1055/s-2007-1000173
  3. Brunelli GA, Battiston B, Vigasio A, Brunelli G, Marocolo D: Bridging nerve defects with combined skeletal muscle and vein conduits. Microsurgery 14: 247, 1993 https://doi.org/10.1002/micr.1920140407
  4. Cheng YS, Hsieh CL, Tsai CC, Chen TH, Chen WC, Hu CL, Yao CH: Peripheral nerve regeneration using silicone rubber chambers filled with collagen, laminin and fibronectin. Biomaterials 21: 1541, 2000 https://doi.org/10.1016/S0142-9612(00)00028-4
  5. Ide C: Peripheral nerve regeneration. Neurosci Res 25: 101, 1996 https://doi.org/10.1016/0168-0102(96)01042-5
  6. Haglid KG, Yang Q, Hamberger A, Bergman S, Widerberg A, Danielsen N: S-100$\beta$ stimulates neurite outgrowth in the rat sciatic nerve grafted with acellular muscle transplants. Brain Res 753: 196, 1997 https://doi.org/10.1016/S0006-8993(96)01463-1
  7. Voinesco F, Glauser L, Kraftsik R, Barakat-Walter I: Local administration of thyroid hormones in silicone chamber increases regeneration of rat transected sciatic nerve. Exp Neurol 150: 69, 1998 https://doi.org/10.1006/exnr.1997.6732
  8. Cui SS, Yang CP, Bowen RC, Bai 0, Li XM, Jiang W, Zhang X: Valproic acid enhances axonal regeneration and recovery of motor function after sciatic nerve axotomy in adult rats. Brain Res 975: 229, 2003 https://doi.org/10.1016/S0006-8993(03)02699-4
  9. Kim JT, Kim IG, Uhm KI, Lew JM, Lee HS: An experimental study on the mechanism of nerve regeneration using effects of different distal stumps of silastic tube in resected sciatic nerve model of rats. J Korean Soc Plast Reconstr Surg 18: 195, 1991
  10. Cheng ET, Utley DS, Ho PR, Tarn DM, Coan GM, Verity AN, Sierra DH, Terris DJ: Functional recovery of transected nerves treated with systemic BDNF and CNTF. Microsurgery 18: 35, 1998 https://doi.org/10.1002/(SICI)1098-2752(1998)18:1<35::AID-MICR9>3.0.CO;2-T
  11. Lutz BS, Wei FC, Ma SF, Chuang DCC: Effects of insulin-like growth factor-1 in motor nerve regeneration after nerve transection and repair vs. nerve crushing injury in the rat. Acta Neurochir 141: 1101, 1999 https://doi.org/10.1007/s007010050490
  12. Grothe C, Nikkhah G: The role of basic fibroblast growth factor in peripheral nerve regeneration. Anat Embryol 204: 171, 2001 https://doi.org/10.1007/s004290100205
  13. Fansa H, Keilhoff G, Wolf G, Schneider W: Tissue engineering of peripheral nerves: A comparison of venous and acellular muscle grafts with cultured Schwann cells. Plast Reconstr Surg 107: 485, 2001 https://doi.org/10.1097/00006534-200102000-00026