中国神经再生研究(英文版) ›› 2020, Vol. 15 ›› Issue (2): 189-198.doi: 10.4103/1673-5374.265540

• 综述:周围神经损伤修复保护与再生 •    下一篇

周围神经损伤引起脊髓的变化和通过抵消/增强改变策略以促进神经再生

  

  • 出版日期:2020-02-15 发布日期:2020-05-23

Peripheral nerve injury induced changes in the spinal cord and strategies to counteract/enhance the changes to promote nerve regeneration

Yan Liu1, 2, Huan Wang2   

  1. 1 Department of Hand Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
    2 Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
  • Online:2020-02-15 Published:2020-05-23
  • Contact: Huan Wang, MD, PhD,wang.huan@mayo.edu.
  • Supported by:
    YL was supported by Chinese Scholar Council; HW was supported by Mayo Clinic Center for Regenerative Medicine and Fund for the Center for Regenerative Medicine Program Director, Neuroregenerative Medicine.

摘要: orcid: 0000-0002-5540-0648 (Huan Wang)

Abstract: Peripheral nerve injury leads to morphological, molecular and gene expression changes in the spinal cord and dorsal root ganglia, some of which have positive impact on the survival of neurons and nerve regeneration, while the effect of others is the opposite. It is crucial to take prompt measures to capitalize on the positive effects of these reactions and counteract the negative impact after peripheral nerve injury at the level of spinal cord, especially for peripheral nerve injuries that are severe, located close to the cell body, involve long distance for axons to regrow and happen in immature individuals. Early nerve repair, exogenous supply of neurotrophic factors and Schwann cells can sustain the regeneration inductive environment and enhance the positive changes in neurons. Administration of neurotrophic factors, acetyl-L-carnitine, N-acetyl-cysteine, and N-methyl-D-aspartate receptor antagonist MK-801 can help counteract axotomy-induced neuronal loss and promote regeneration, which are all time-dependent. Sustaining and reactivation of Schwann cells after denervation provides another effective strategy. FK506 can be used to accelerate axonal regeneration of neurons, especially after chronic axotomy. Exploring the axotomy-induced changes after peripheral nerve injury and applying protective and promotional measures in the spinal cord which help to retain a positive functional status for neuron cell bodies will inevitably benefit regeneration of the peripheral nerve and improve functional outcomes.

Key words: axotomy, dorsal root ganglion, neural regeneration, neurotrophic factors, outcomes, peripheral nerve injury, repair, spinal cord