Role of exogenous epidermal growth factor in nerve regeneration after terminolateral neurorrhaphy / 中国组织工程研究

ABSTRACT

BACKGROUND: It is proved that nerve regeneration induced by terminolateral neurorrhaphy(TLN) is not as active as that induced by end-to-end suture. Exogenous epidermal growth factor(EGF) increases the opportunity of neuron survival in vitro and promotes nerve regeneration. Whether it can increase nerve regeneration after terminolateral neurorrhaphy deserves further study.OBJECTIVE: To evaluate the effect of exogenous EGF in promoting nerve regeneration after terminolateral neurorrhaphy.DESIGN: A randomized controlled trial.SETTING: Orthopedic Institute of Chinese PLA General Hospital.PARTICIPANTS: The trial was conducted in the Orthopedic Institute of Chinese PLA General Hospital from September 2001 to February 2002. A total of 32 male Wistar rats, weighting 200- 250 g, were randomized to control group and EGF group with 16 rats in each group.METHODS: The right peroneal nerve was transected and an epineural window of 1 mm was created on the neighboring tibial nerve. The distal end of the transected peroneal nerve was sutured to the windowed tibial nerve by means of end-to-side attachment. Each rat in EGF group received injection of 0. 1 mL/d EGF diluted with normal saline at 2 g/L for two weeks while each in control group received injection of normal saline (0. 1 mL/d) at the distal site of the transected peroneal nerve for two weeks. Histological, morphological and electrophysiological examinations were performed 4 and 8 weeks after operation.MAIN OUTCOME MEASURES: The regeneration rate of myelinated nerve, motor nerve conduction velocity and ultrastructural changes of the two groups.rate of myelinated nerve fibers 4 and 8 weeks after operation, it was better in EGF group[ (52.42 ± 1.45)% and(61.41 ± 1.54)% ] than that in control nerve conduction velocity 4 and 8 weeks after operation it was obviously greater in EGF group[ (30. 33 ±0. 88)m/s and(34. 36 ± 1.09)m/s] than that in conObservation of ultrastructure The number of myelinated nerve fibers, and the thickness and maturation degree of myelin sheath were significantly better than those in control group.CONCLUSION: Exogenous EGF can promote nerve regeneration, increase nerve conduction velocity after terminolateral neurorrhaphy.