Surgery for brachial plexus injuries

Birch, R

doi:10.1302/0301-620x.75b3.8496196

Cited by 33 publications

(18 citation statements)

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“…Clinical uses for NGF have been proposed in Parkinson's and Alzheimer's diseases, 77 and the use of other neurotrophic factors has also been advocated, e.g., CNTF to treat amyotrophic lateral sclerosis. 78 Clinical research has shown that the level of nerve growth factor is changed in injured nerve stumps biopsied during operations for repair of the brachial plexus, 79 which suggests that exogenous NGF might be used to accelerate the nerve regeneration. A problem in assessing the literature is that methods of delivering neurotrophic factors vary considerably, from systemic administration to local delivery by, e.g., osmotic minipump, fibrin glue mixed with factors, and incorporation of factor into fibronectin mats.…”

Section: Some Considerations For the Peripheral Nerve Injury And Regementioning

confidence: 99%

Schwann cells, neurotrophic factors, and peripheral nerve regeneration

1998

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The peripheral nervous system retains a considerable capacity for regeneration. However, functional recovery rarely returns to the preinjury level no matter how accurate the nerve repair is, and the more proximal the injury the worse the recovery. Among a variety of approaches being used to enhance peripheral nerve regeneration are the manipulation of Schwann cells and the use of neurotrophic factors. Such factors include, first, nerve growth factor (NGF) and the other recently identified members of the neurotrophin family, namely, brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), neurotrophin-4/5 (NT-4/5); second, the neurokines ciliary neurotrophic factor (CNTF) and leukemia inhibitory factor (LIF); and third, the transforming growth factors (TGFs)-beta and their distant relative, glial cell line-derived neurotrophic factor (GDNF). In this review article we focus on the roles in peripheral nerve regeneration of Schwann cells and of the neurotrophin family, CNTF and GDNF, and the relationship between these. Finally, we discuss what remains to be understood about the possible clinical use of neurotrophic factors.

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Section: Some Considerations For the Peripheral Nerve Injury And Regementioning

confidence: 99%

Schwann cells, neurotrophic factors, and peripheral nerve regeneration

1998

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“…Therefore, complete recovery remains an important clinical challenge for the improvement of functional recovery following peripheral nerve injury. In a discussion of future trends in the management of brachial plexus injuries, Birch hypothesized that the administration of nerve growth factor may represent a useful treatment strategy (4).…”

Section: Introductionmentioning

confidence: 99%

Etifoxine promotes glial-derived neurotrophic factor-induced neurite outgrowth in PC12 cells

Zhou

et al. 2013

Molecular Medicine Reports

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Abstract. Nerve regeneration and functional recovery are major issues following nerve tissue damage. Etifoxine is currently under investigation as a therapeutic strategy for promoting neuroprotection, accelerating axonal regeneration and modulating inflammation. In the present study, a well-defined PC12 cell model was used to explore the underlying mechanism of etifoxine-stimulated neurite outgrowth. Etifoxine was found to promote glial-derived growth factor (GDNF)-induced neurite outgrowth in PC12 cells. Average axon length increased from 50.29±9.73 to 22.46±5.62 µm with the use of etifoxine. However, blockage of GDNF downstream signaling was found to lead to the loss of this phenomenon. The average axon length of the etifoxine group reduces to a normal level after the blockage of the GDNF family receptor α1 (GFRα1) and receptor tyrosine kinase (RETS) receptors (27.46 ± 3.59 vs. 22.46 ± 5.62 µm and 25.31±3.68 µm vs. 22.46±5.62 µm, respectively, p>0.05). In addition, etifoxine markedly increased GDNF mRNA and protein expression (1.55-and 1.36-fold, respectively). However, blockage was not found to downregulate GDNF expression. The results of the current study demonstrated that etifoxine stimulated neurite outgrowth via GDNF, indicating that GDNF represents a key molecule in etifoxine-stimulated neurite outgrowth in PC12 cells. IntroductionTraumatic injury to peripheral nerves results in considerable loss of sensory and motor function, decreasing quality of life in patients (1). Peripheral nerve injuries substantially impact quality of life through loss of function and increased risk of secondary disabilities from falls, fractures and other injuries. Several research groups have attempted to improve the regeneration of traumatized nerves by developing favorable microsurgical techniques. However, clinicians soon noted that despite advancement in these techniques, complete recovery is rarely achieved (2,3). Therefore, complete recovery remains an important clinical challenge for the improvement of functional recovery following peripheral nerve injury. In a discussion of future trends in the management of brachial plexus injuries, Birch hypothesized that the administration of nerve growth factor may represent a useful treatment strategy (4).Neurotrophic factors are important in a number of biological processes, including survival, proliferation, differentiation and apoptosis of neurons in the nervous system (5-7). However, direct use of trophic factors in clinical practice is extremely challenging as they are difficult to administer and have severe side effects (8). However, molecules that easily diffuse into nerve tissues, including ligands of the progesterone and thyroid hormone receptors, and immunophilins, have beneficial effects on peripheral nerves in various experimental lesion and disease models (9-12). We hypothesize that clinically established drugs may be suitable to elevate trophic factor levels to improve the outcome of peripheral nerve injuries.Previous studies have demonstrated that the drug, etifoxi...

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“…1 Some cases, however, are unexplained, and some authors have proposed a prenatal cause in this group. 2 The aims of this survey were to estimate the incidence of CBP, currently unknown, 3 in the United Kingdom and Republic of Ireland, study its causes, and record the extent of the lesion and the outcome at 6 months of age. Although there have been recent suggestions that young infants with CBP may benefit from microsurgery, the effectiveness of this highly specialised procedure remains uncertain.…”

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confidence: 99%