Regeneração de nervos periféricos: terapia celular e fatores neurotróficos

Abstract

Peripheral nerve trauma results in functional loss in the innervated organ, and recovery without surgical intervention is rare. Many surgical techniques can be used for nerve repair. Among these, the tubulization technique can be highlighted: this allows regenerative factors to be introduced into the chamber. Cell therapy and tissue engineering have arisen as an alternative for stimulating and aiding peripheral nerve regeneration. Therefore, the aim of this review was to provide a survey and analysis on the results from experimental and clinical studies that used cell therapy and tissue engineering as tools for optimizing the regeneration process. The articles used came from the LILACS, Medline and SciELO scientific databases. Articles on the use of stem cells, Schwann cells, growth factors, collagen, laminin and platelet-rich plasma for peripheral nerve repair were summarized over the course Rev Bras Ortop. 2011;46(6):643-49 of the review. Based on these studies, it could be concluded that the use of stem cells derived from different sources presents promising results relating to nerve regeneration, because these cells have a capacity for neuronal differentiation, thus demonstrating effective functional results. The use of tubes containing bioactive elements with controlled release also optimizes the nerve repair, thus promoting greater myelination and axonal growth of peripheral nerves. Another promising treatment is the use of platelet-rich plasma, which not only releases growth factors that are important in nerve repair, but also serves as a carrier for exogenous factors, thereby stimulating the proliferation of specific cells for peripheral nerve repair.

Analgesic Effect of Dizocine Combined with Ropivacaine on Recurrent Neuropathic Pain in Peripheral Nerve Compression Rats

“…The evidence suggested that dizocine combined with ropivacaine has a significant analgesic effect in rat model of peripheral nerve compression. Peripheral nerve damage directly affects muscle tissue because they disrupt neuromuscular communication and results in loss of function of the innervating organs and cause muscle fiber cross-section and muscle diameter decrease [15][16][17]. Chronic sciatic nerve compression is characterized by variable degree of degeneration in great myelinated axons and endoneural edema [18,19].…”

Restoration of Neurological Function Following Peripheral Nerve Trauma

“…The influence of PRP in enhancing axon regeneration has been proposed to result from platelet-released neurotrophic and other factors [214][215][216][217]. An additional platelet potential contributor to enhanced axon regeneration is VEGF, which, as discussed earlier, induces enhanced axon regeneration by inducing rapid vascularization of the entire nerve gap [218,219].…”

“…Bridging a rat sciatic nerve gap with a PRP-filled silicon tube [198,211] or surrounding the sciatic nerve anastomosis site with a PRP-saturated membrane [212] enhances axon regeneration. In rabbits, filling vein grafts with PRP induces significant axon regeneration compared to empty vein grafts [198,206,[213][214][215].…”

Identification of critical growth factors for peripheral nerve regeneration

“…15 Emerging studies have shown that many growth factors, especially many neurotrophic factors such as nerve growth factor (Ngf) and brain-derived neurotrophic factor (Bdnf), are very critical for the development and regeneration of the nervous system. [16][17][18][19] However, there is no systemical investigation of the involvement of growth factors in the biological processes of peripheral nerve injury and repair. In our previous study, by using RNA deep sequencing, we fully determined gene expressions in the sciatic nerve stumps at 0 h, 1 d, 4 d, 7 d, and 14 d aer rat sciatic nerve crush injury and proled differentially expressed genes.…”