1
|
Xiao B, Feturi F, Su AJA, Van der Merwe Y, Barnett JM, Jabbari K, Khatter NJ, Li B, Katzel EB, Venkataramanan R, Solari MG, Wagner WR, Steketee MB, Simons DJ, Washington KM. Nerve Wrap for Local Delivery of FK506/Tacrolimus Accelerates Nerve Regeneration. Int J Mol Sci 2024; 25:847. [PMID: 38255920 PMCID: PMC10815243 DOI: 10.3390/ijms25020847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Peripheral nerve injuries (PNIs) occur frequently and can lead to devastating and permanent sensory and motor function disabilities. Systemic tacrolimus (FK506) administration has been shown to hasten recovery and improve functional outcomes after PNI repair. Unfortunately, high systemic levels of FK506 can result in adverse side effects. The localized administration of FK506 could provide the neuroregenerative benefits of FK506 while avoiding systemic, off-target side effects. This study investigates the utility of a novel FK506-impregnated polyester urethane urea (PEUU) nerve wrap to treat PNI in a previously validated rat infraorbital nerve (ION) transection and repair model. ION function was assessed by microelectrode recordings of trigeminal ganglion cells responding to controlled vibrissae deflections in ION-transected and -repaired animals, with and without the nerve wrap. Peristimulus time histograms (PSTHs) having 1 ms bins were constructed from spike times of individual single units. Responses to stimulus onsets (ON responses) were calculated during a 20 ms period beginning 1 ms after deflection onset; this epoch captures the initial, transient phase of the whisker-evoked response. Compared to no-wrap controls, rats with PEUU-FK506 wraps functionally recovered earlier, displaying larger response magnitudes. With nerve wrap treatment, FK506 blood levels up to six weeks were measured nearly at the limit of quantification (LOQ ≥ 2.0 ng/mL); whereas the drug concentrations within the ION and muscle were much higher, demonstrating the local delivery of FK506 to treat PNI. An immunohistological assessment of ION showed increased myelin expression for animals assigned to neurorrhaphy with PEUU-FK506 treatment compared to untreated or systemic-FK506-treated animals, suggesting that improved PNI outcomes using PEUU-FK506 is mediated by the modulation of Schwann cell activity.
Collapse
Affiliation(s)
- Bo Xiao
- Department of Plastic Surgery, University of Pittsburgh School of Medicine, Veterans Administration Healthcare System, Pittsburgh, PA 15213, USA; (B.X.); (F.F.)
| | - Firuz Feturi
- Department of Plastic Surgery, University of Pittsburgh School of Medicine, Veterans Administration Healthcare System, Pittsburgh, PA 15213, USA; (B.X.); (F.F.)
| | - An-Jey A. Su
- Department of Plastic Surgery, University of Pittsburgh School of Medicine, Veterans Administration Healthcare System, Pittsburgh, PA 15213, USA; (B.X.); (F.F.)
- Department of Surgery, Division of Plastic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | | | - Joshua M. Barnett
- Department of Plastic Surgery, University of Pittsburgh School of Medicine, Veterans Administration Healthcare System, Pittsburgh, PA 15213, USA; (B.X.); (F.F.)
| | - Kayvon Jabbari
- Department of Surgery, Division of Plastic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Neil J. Khatter
- Department of Surgery, Division of Plastic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Bing Li
- Department of Surgery, Division of Plastic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Evan B. Katzel
- Department of Plastic Surgery, University of Pittsburgh School of Medicine, Veterans Administration Healthcare System, Pittsburgh, PA 15213, USA; (B.X.); (F.F.)
| | | | - Mario G. Solari
- Department of Plastic Surgery, University of Pittsburgh School of Medicine, Veterans Administration Healthcare System, Pittsburgh, PA 15213, USA; (B.X.); (F.F.)
| | - William R. Wagner
- McGowan Institute for Regenerative Medicine, Pittsburgh, PA 15219, USA; (W.R.W.); (D.J.S.)
| | - Michael B. Steketee
- Department of Ophthalmology, University of California, San Diego, CA 90095, USA
- McGowan Institute for Regenerative Medicine, Pittsburgh, PA 15219, USA; (W.R.W.); (D.J.S.)
| | - Daniel J. Simons
- McGowan Institute for Regenerative Medicine, Pittsburgh, PA 15219, USA; (W.R.W.); (D.J.S.)
| | - Kia M. Washington
- Department of Plastic Surgery, University of Pittsburgh School of Medicine, Veterans Administration Healthcare System, Pittsburgh, PA 15213, USA; (B.X.); (F.F.)
- Department of Surgery, Division of Plastic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- McGowan Institute for Regenerative Medicine, Pittsburgh, PA 15219, USA; (W.R.W.); (D.J.S.)
| |
Collapse
|
2
|
Roballo KCS, Gigley JP, Smith TA, Bittner GD, Bushman JS. Functional and immunological peculiarities of peripheral nerve allografts. Neural Regen Res 2021; 17:721-727. [PMID: 34472457 PMCID: PMC8530136 DOI: 10.4103/1673-5374.322445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
This review addresses the accumulating evidence that live (not decellularized) allogeneic peripheral nerves are functionally and immunologically peculiar in comparison with many other transplanted allogeneic tissues. This is relevant because live peripheral nerve allografts are very effective at promoting recovery after segmental peripheral nerve injury via axonal regeneration and axon fusion. Understanding the immunological peculiarities of peripheral nerve allografts may also be of interest to the field of transplantation in general. Three topics are addressed: The first discusses peripheral nerve injury and the potential utility of peripheral nerve allografts for bridging segmental peripheral nerve defects via axon fusion and axon regeneration. The second reviews evidence that peripheral nerve allografts elicit a more gradual and less severe host immune response allowing for prolonged survival and function of allogeneic peripheral nerve cells and structures. Lastly, potential mechanisms that may account for the immunological differences of peripheral nerve allografts are discussed.
Collapse
Affiliation(s)
| | - Jason P Gigley
- Department of Molecular Biology, University of Wyoming, Laramie, WY, USA
| | - Tyler A Smith
- Department of Molecular Biosciences, University of Texas at Austin, Austin, TX, USA
| | - George D Bittner
- Department of Neuroscience, University of Texas at Austin, Austin, TX, USA
| | | |
Collapse
|
3
|
Paskal AM, Paskal W, Pietruski P, Kusmierczyk Z, Jankowska-Steifer E, Andrychowski J, Wlodarski PK. Neuroregenerative effects of polyethylene glycol and FK-506 in a rat model of sciatic nerve injury. J Plast Reconstr Aesthet Surg 2019; 73:222-230. [PMID: 31759923 DOI: 10.1016/j.bjps.2019.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 09/29/2019] [Accepted: 10/05/2019] [Indexed: 01/25/2023]
Abstract
The recently introduced polyethylene glycol (PEG) treatment restores axonal continuity after nerve injury, leading to rapid recovery of nerve function. The impact of PEG therapy on neuroregeneration has not yet been compared with any intervention with an established proneuroregenerative potential. FK-506 is an immunosuppressive agent with documented proneuroregenerative potential in nerve injury models. The aim of this study was to compare the effects of PEG therapy and preinjury FK-506 administration in rats with sciatic nerve transection injury. Four groups of male Sprague Dawley rats (seven per group) underwent sciatic nerve transection with primary repair. Group A received placebo injections, group B placebo injections and PEG treatment, group C FK-506 injections, and group D both FK-506 injections and PEG treatment. Clinical outcomes were assessed by the skin prick test and Sciatic Functional Index (SFI). Regenerated nerves underwent histomorphometric analysis. The histomorphometric analysis demonstrated that compared with the controls, nerve specimens from all treated groups showed signs of enhanced neuroregeneration (higher mean axonal area) (p < 0.001). The histomorphometric parameters for group D (PEG + FK-506), mean axonal area (p < 0.001) and axonal count (p > 0.05), were significantly better than those in the other study groups. The Form factor was closest to its optimal values in group B (p < 0.0001). At the end of the study, mean skin prick test scores in all treated groups were significantly higher than those in controls (p > 0.05). During the first postoperative week, PEG-treated rats (groups B and D) presented with higher values of the SFI than animals from groups A and C, but the difference was not statistically significant. Combined therapy with PEG and FK-506 seems to produce better neuroregeneration outcomes than a simple suture-based repair complemented with either PEG or FK-506 treatment.
Collapse
Affiliation(s)
- Adriana M Paskal
- Department of Methodology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland
| | - Wiktor Paskal
- Department of Methodology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland.
| | - Piotr Pietruski
- Timeless Plastic Surgery Clinic, gen. Romana Abrahama 18/322, 03-982 Warsaw, Poland
| | - Zofia Kusmierczyk
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland
| | - Ewa Jankowska-Steifer
- Department of Histology and Embryology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland.
| | - Jaroslaw Andrychowski
- Department of Neurology and Neurosurgery, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland.
| | - Pawel K Wlodarski
- Department of Methodology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland.
| |
Collapse
|