Acute inflammatory demyelination in reperfusion nerve injury

Nukada, Hitoshi; McMorran, P. Denise; Shimizu, Jun

doi:10.1002/1531-8249(200001)47:1<71::aid-ana12>3.0.co;2-p

Cited by 46 publications

(24 citation statements)

References 28 publications

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“…Reperfusion in the peripheral nervous system elicits an acute inflammatory response and the generation of free radicals ( Nagamatsu et al, 1996 ; Anderson et al, 1997 ; He et al, 1999 ; Mitsui et al, 1999 ; Nukada et al, 2000 ). Increased endothelial ICAM‐1 expression, neutrophil emigration, and the expression of TNF‐α and IL‐1β mRNA are early events during reperfusion, followed by endoneurial infiltration and accumulation of monocyte/macrophages in rat sciatic nerves ( Mitsui et al, 1999 ; Nukada et al, 2000 ). Diabetes intensifies these reperfusion‐induced inflammatory responses ( Granger, 1999 ).…”

Section: Discussionmentioning

confidence: 99%

“…Transient (2.5‐hour) near‐complete ischemia in the right hindlimb was achieved in 20‐week diabetic rats (n = 15) and age‐matched controls (n = 15). The method of surgical procedures has been described previously, and the duration of ischemia and reperfusion was determined by our previous studies ( Nukada, 1986; 1992 ; Nukada and McMorran, 1994 ; Nukada et al, 2000 ). Rats were anesthetized with xylazine (0.4 mg/100 g BW i.p.)…”

Section: Methodsmentioning

confidence: 99%

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Aggravated reperfusion injury in STZ‐diabetic nerve

Nukada

Lynch

McMorran

2002

J Peripheral Nervous Sys

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The streptozocin (STZ)-diabetic nerve manifests increased morphological susceptibility to a superimposed acute ischemic injury, and reperfusion injury exaggerates ischemic nerve pathology. To determine whether STZ-diabetic nerves are susceptible to reperfusion, we evaluated the pathological consequences after 2.5 hours of ischemia followed by 3 and 24 hours of reperfusion in a 20-week STZ-diabetic rat sciatic nerve. After 3 hours of reperfusion, endoneurial edema developed in diabetic nerves, whereas non-diabetic controls showed mild or no edema. Morphometric analysis of endoneurial edema, quantified by the total transverse fascicular area and the point-count score of endoneurial structureless space, confirmed significantly more reperfusion-induced edema at thigh and knee levels in diabetic nerves than in controls. Reperfusion caused a significant increase in the number of endoneurial mast cells at the thigh level in diabetic nerves. After 24 hours of reperfusion, there were striking morphological anomalies of myelinated nerve fibers in diabetic nerves, without any observable changes in control nerves. In conclusion, we have demonstrated that STZ-diabetes exacerbates the morphological change to reperfusion. Diabetes therefore renders the microvasculature more vulnerable to the deleterious effects of ischemia/reperfusion.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Aggravated reperfusion injury in STZ‐diabetic nerve

Nukada

Lynch

McMorran

2002

J Peripheral Nervous Sys

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“…During IIH, ischaemia has been reported to cause endothelial swelling of endoneurial microvessels, as well as axonal degeneration in hind limb nerves of rats . If ischaemia is involved in the pathogenesis, nerve regions of poorest vascular perfusion would be most vulnerable, as shown in rats .…”

Section: Introductionmentioning

confidence: 99%

Effect of Insulin‐Induced Hypoglycaemia on the Peripheral Nervous System: Focus on Adaptive Mechanisms, Pathogenesis and Histopathological Changes

Jensen

Mølck

Bøgh

et al. 2014

J Neuroendocrinology

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).Insulin-induced hypoglycaemia (IIH) is a common acute side effect in type 1 and type 2 diabetic patients, especially during intensive insulin therapy. The peripheral nervous system (PNS) depends on glucose as its primary energy source during normoglycaemia and, consequently, it may be particularly susceptible to IIH damage. Possible mechanisms for adaption of the PNS to IIH include increased glucose uptake, utilisation of alternative energy substrates and the use of Schwann cell glycogen as a local glucose reserve. However, these potential adaptive mechanisms become insufficient when the hypoglycaemic state exceeds a certain level of severity and duration, resulting in a sensory-motor neuropathy with associated skeletal muscle atrophy. Large myelinated motor fibres appear to be particularly vulnerable. Thus, although the PNS is not an obligate glucose consumer, as is the brain, it appears to be more prone to IIH than the central nervous system when hypoglycaemia is not severe (blood glucose level ≤ 2 mM), possibly reflecting a preferential protection of the brain during periods of inadequate glucose availability. With a primary focus on evidence from experimental animal studies investigating nondiabetic IIH, the present review discusses the effect of IIH on the PNS with a focus on adaptive mechanisms, pathogenesis and histological changes.

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“…9 The mechanism behind the expression of muscle fat infiltration is somewhat unclear, given a number of explanatory models, such as disuse, segmental nerve irritation or injury, and damage to segmental structures such as the facet joint, disc, or the muscle itself provoking an inflammatory reaction. 20,28 Preliminary evidence also exists to suggest that central mechanisms could drive muscle changes secondary to reductions in alpha-motoneuron drive. 8 The etiology of chronic WAD and especially the cause and effect are still unclear.…”

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confidence: 99%

An Investigation of Fat Infiltration of the Multifidus Muscle in Patients With Severe Neck Symptoms Associated With Chronic Whiplash-Associated Disorder

Karlsson¹,

Leinhard²,

Åslund³

et al. 2016

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Cross-sectional study. Background Findings of fat infiltration in cervical spine multifidus, as a sign of degenerative morphometric changes due to whiplash injury, need to be verified. Objectives To develop a method using water/fat magnetic resonance imaging (MRI) to investigate fat infiltration and cross-sectional area of multifidus muscle in individuals with whiplash-associated disorders (WADs) compared to healthy controls. Methods Fat infiltration and cross-sectional area in the multifidus muscles spanning the C4 to C7 segmental levels were investigated by manual segmentation using water/fat-separated MRI in 31 participants with WAD and 31 controls, matched for age and sex. Results Based on average values for data spanning C4 to C7, participants with severe disability related to WAD had 38% greater muscular fat infiltration compared to healthy controls (P = .03) and 45% greater fat infiltration compared to those with mild to moderate disability related to WAD (P = .02). There were no significant differences between those with mild to moderate disability and healthy controls. No significant differences between groups were found for multifidus cross-sectional area. Significant differences were observed for both cross-sectional area and fat infiltration between segmental levels. Conclusion Participants with severe disability after a whiplash injury had higher fat infiltration in the multifidus compared to controls and to those with mild/moderate disability secondary to WAD. Earlier reported findings using T1-weighted MRI were reproduced using refined imaging technology. The results of the study also indicate a risk when segmenting single cross-sectional slices, as both cross-sectional area and fat infiltration differ between cervical levels. J Orthop Sports Phys Ther 2016;46(10):886-893. Epub 2 Sep 2016. doi:10.2519/jospt.2016.6553.

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Acute inflammatory demyelination in reperfusion nerve injury

Cited by 46 publications

References 28 publications

Aggravated reperfusion injury in STZ‐diabetic nerve

Aggravated reperfusion injury in STZ‐diabetic nerve

Effect of Insulin‐Induced Hypoglycaemia on the Peripheral Nervous System: Focus on Adaptive Mechanisms, Pathogenesis and Histopathological Changes

An Investigation of Fat Infiltration of the Multifidus Muscle in Patients With Severe Neck Symptoms Associated With Chronic Whiplash-Associated Disorder

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