摘要
周围神经损伤是一种由于压迫、牵引、切割、缺血等原因引起的外周神经细胞损伤或坏死的疾病。周围神经损伤病理学变化包括轴浆运输受损、轴突变性、施万细胞损伤、节段性脱髓鞘和完全瓦勒氏变性。神经损伤后修复成为了现代医学研究中的热点与难点。本文对干细胞移植、神经营养因子、新型材料和生物电刺激在周围神经损伤修复中的作用及机制做了综述,并且对其在临床中的应用进行展望。
Peripheral nerve injury(PNI) is a disease in which peripheral nerve cells are damaged or necrotic due to compression, traction, cutting and ischemia. Pathological changes of peripheral nerve injury include impaired axoplasmic transport, axonal degeneration, schwann cell injury, segmental demyelination and complete Waller’ s degeneration. Autogenous nerve transplantation(ANT) is the gold standard for treatment of large peripheral nerve defects(>1 cm in rats and >3 cm in humans). In addition to autologous transplantation, stem cell transplantation will promote peripheral nerve regeneration, improve myelin sheath formation and nerve survival. Neurotrophic factors include nerve growth factor(NGF), glial cell line-derived neurotrophic factor(GDNF), brain-derived neurotrophic factor(BDNF) can promote neuronal differentiation, axon growth and synaptic connection. New biomaterials including chitosan scaffold(CS), silk fibroin(SF), 3-hydroxyoctanoic acid co-3-hydroxydecanoic acid/polycaprolactone(P(3HO-3 HD)/PCL75/25) or acellular cauda equina allograft(ACEA) can support and guide the growth of axon. Combined with 3 D printing technology, personalized neural conduits can be designed and manufactured. Electroacupuncture stimulation of Huan-jump point(GB 30) and Zusanli point(ST 36) can prevent apoptosis of neurons and promote the growth of axon. The combination of several materials and formation of tissue engineered nerve graft(TENG), will have better effects on repairing of nerve injury. Thus, the role and mechanisms of these methods in the repair of peripheral nerve injury were reviewed, and their clinical application was prospected.
作者
肖雨
翁秋燕
邵磊
薛阳
吴璨
郭蕾
牛艳芳
鲍晓明
徐淑君
XIAO Yu;WENG Qiu-Yan;SHAO Lei;XUE Yang;WU Can;GUO Lei;NIU Yan-Fang;Bao Xiao-Ming;XU Shu-Jun(Department of Neurology,the Affiliated Hospital of Medical School,Ningbo University,Ningbo 315020,China;School of Medicine,Ningbo University,Zhejiang Provincial Key Laboratory of Pathophysiology,Ningbo 315211,China;Hwa Mei Hospital,University of Chinese Academy of Sciences,Ningbo 315010,China;Ningbo Institute of Life and Health Industry,University of Chinese Academy of Sciences,Ningbo 315010,China)
出处
《生物化学与生物物理进展》
SCIE
CAS
CSCD
北大核心
2022年第7期1243-1250,共8页
Progress In Biochemistry and Biophysics
基金
国家自然科学基金(81771166)
宁波市科技局计划项目(202002N3165)
宁波市公益类科技计划项目(2021S178)
宁波市自然科学基金(2021J250)
宁波大学王宽诚幸福基金资助。
关键词
周围神经损伤
神经营养因子
新型材料
电刺激
干细胞
peripheral nerve injury
neurotrophin
new materials
electrical stimulation
stem cell
