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Nickerson DS, Yamasaki DS. Objective Evidence That Nerve Decompression Surgery Reduces Neuropathic DFU Recurrence Risk to Less than 5%. Adv Wound Care (New Rochelle) 2024; 13:363-374. [PMID: 38511527 DOI: 10.1089/wound.2023.0199] [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] [Indexed: 03/22/2024] Open
Abstract
Significance: Despite 20 years of research and new treatment methods, diabetic foot ulcer (DFU) remains a common problem with frequent recurrences and complications. Recent Advances: There are reports that nerve decompression (ND) surgery has been observed to produce significantly fewer DFU recurrences than standard of care (SOC). The explanation of this apparent superiority has not been understood. Critical Issues: Microcirculation is understood to be involved in diabetic peripheral neuropathy (DPN) and DFU. There is an underappreciation of the participation in DPN of entrapment neuropathy (EN) due to nerve swelling and impingement in fibro-osseous tunnels. Reducing c-fiber compression in EN by ND generates recovery of subepidermal capillary flow. ND studies have found improved neuromuscular function and epidermal microcirculation phenomena, including chronic capillary ischemia (CCI) and pressure-induced vasodilatation (PIV). There is no current therapy recommended for impaired microcirculation. Clinical and animal evidence has demonstrated that release of locally compressed peripheral nerves improves the epidermal microcirculation which is under sympathetic control. Future Directions: Using epineurolysis to relieve nerve compressions is a physiology-based therapeutic intervention and provides the scientific foundation clarifying how ND reduces DFU recurrence risk. Incorporating ND with current SOC treatments could improve DFU recurrence risk, hard-to-heal ulcers, neuroischemic wounds, amputation risk, and the resulting costs to society. More studies using ND for DFU, especially evidence-based medicine Level I studies, are needed to confirm these preliminary outcomes.
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Paradoxical Changes of Cutaneous Microcirculation and Sympathetic Fibers of Rat Hind Limbs after Sciatic Nerve Compression. Plast Reconstr Surg 2023; 151:245-254. [PMID: 36696318 DOI: 10.1097/prs.0000000000009842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Recent studies show evidence that surgical nerve decompression could improve cutaneous blood flow (CBF), which might benefit ulcer healing. However, the change of CBF and sympathetic fibers after nerve compression is poorly understood. In the current study, a unilateral sciatic nerve compression model was created in Sprague-Dawley rats. METHODS A laser Doppler imaging system was applied to assess the CBF of the regions below the ankles. Immunohistochemistry and transmission electron microscopy were used to investigate the histopathologic changes of sympathetic fibers in sciatic nerve samples. RESULTS Laser Doppler imaging revealed decreased CBF of both the lesional limb and the contralesional limb, which occurred earlier in the lesional side, indicating an enhanced sympathetic tone on vasomotor function. Intraneural density of sympathetic fibers decreased on both sides and the ultrastructure of unmyelinated fibers of both sides degenerated in a nonsynchronized manner. CONCLUSIONS The study revealed nonsynchronized reduced CBF of bilateral hind limbs with paradoxically degenerated and diminished sympathetic fibers in bilateral sciatic nerves after unilateral sciatic nerve compression. These results may validate the importance of and broaden the indications for surgical nerve decompression in preventing or treating foot ulcers.
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Zwanenburg PR, Backer SFM, Obdeijn MC, Lapid O, Gans SL, Boermeester MA. A Systematic Review and Meta-Analysis of the Pressure-Induced Vasodilation Phenomenon and Its Role in the Pathophysiology of Ulcers. Plast Reconstr Surg 2019; 144:669e-681e. [PMID: 31568315 DOI: 10.1097/prs.0000000000006090] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Physiologic studies show that tissue perfusion increases during moderate amounts of tissue compression. This is attributed to sensory nerves initiating a vasodilatory cascade referred to as pressure-induced vasodilation. METHODS PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies investigating perfusion during pressure exposure longer than 10 minutes. Retrieved studies were assessed using the Office of Health Assessment and Translation Risk of Bias Rating Tool for Human and Animal Studies. Results were pooled with random effects models. The body of evidence was rated using the Office of Health Assessment and Translation approach. RESULTS Twenty-nine articles were included, of which 19 articles were included in meta-analyses. The evidence indicates that moderate amounts of tissue compression have the capacity to increase perfusion in healthy humans by 46 percent (95 percent CI, 30 to 62 percent). Using the Office of Health Assessment and Translation approach, the authors found a high level of confidence in the body of evidence. Pressure-induced vasodilation blockade was associated with increased pressure ulcer formation. Pressure-induced vasodilation was impaired by neuropathy and by the drugs diclofenac and amiloride. CONCLUSIONS This systematic review and meta-analysis indicates that healthy humans have the capacity to increase local perfusion in response to mechanical stress resulting from tissue compression. Because pressure-induced vasodilation is mediated by sensory nerves, pressure-induced vasodilation emphasizes the importance of sensory innervation for durable tissue integrity. Pressure-induced vasodilation impairment seems to provide a complementary explanation for the susceptibility of neuropathic tissues to pressure-induced lesions.
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Affiliation(s)
- Pieter R Zwanenburg
- From the Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam Infection and Immunity, and the Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam
| | - Sophia F M Backer
- From the Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam Infection and Immunity, and the Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam
| | - Miryam C Obdeijn
- From the Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam Infection and Immunity, and the Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam
| | - Oren Lapid
- From the Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam Infection and Immunity, and the Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam
| | - Sarah L Gans
- From the Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam Infection and Immunity, and the Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam
| | - Marja A Boermeester
- From the Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam Infection and Immunity, and the Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam
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4
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Maiuolo J, Gliozzi M, Musolino V, Carresi C, Nucera S, Macrì R, Scicchitano M, Bosco F, Scarano F, Ruga S, Zito MC, Oppedisano F, Mollace R, Paone S, Palma E, Muscoli C, Mollace V. The Role of Endothelial Dysfunction in Peripheral Blood Nerve Barrier: Molecular Mechanisms and Pathophysiological Implications. Int J Mol Sci 2019; 20:ijms20123022. [PMID: 31226852 PMCID: PMC6628074 DOI: 10.3390/ijms20123022] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/14/2019] [Accepted: 06/16/2019] [Indexed: 02/06/2023] Open
Abstract
The exchange of solutes between the blood and the nerve tissue is mediated by specific and high selective barriers in order to ensure the integrity of the different compartments of the nervous system. At peripheral level, this function is maintained by the Blood Nerve Barrier (BNB) that, in the presence, of specific stressor stimuli can be damaged causing the onset of neurodegenerative processes. An essential component of BNB is represented by the endothelial cells surrounding the sub-structures of peripheral nerves and increasing evidence suggests that endothelial dysfunction can be considered a leading cause of the nerve degeneration. The purpose of this review is to highlight the main mechanisms involved in the impairment of endothelial cells in specific diseases associated with peripheral nerve damage, such as diabetic neuropathy, erectile dysfunction and inflammation of the sciatic nerve.
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Affiliation(s)
- Jessica Maiuolo
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Micaela Gliozzi
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Vincenzo Musolino
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Cristina Carresi
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Saverio Nucera
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
| | - Roberta Macrì
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Miriam Scicchitano
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
| | - Francesca Bosco
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Federica Scarano
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
| | - Stefano Ruga
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
| | - Maria Caterina Zito
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
| | - Francesca Oppedisano
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Rocco Mollace
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Sara Paone
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Ernesto Palma
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
| | - Carolina Muscoli
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, Via di Valcannuta 247, 00133 Rome, Italy.
| | - Vincenzo Mollace
- Interregional Research Center for Food Safety and Health (IRC-FSH), Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy.
- Nutramed Societa' Consortile A Responsabilita' Limitata (S.c.a.r.l.), Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy.
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, Via di Valcannuta 247, 00133 Rome, Italy.
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5
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Nguyen-Tu MS, Nivoit P, Oréa V, Lemoine S, Acquaviva C, Pagnon-Minot A, Fromy B, Sethi JK, Sigaudo-Roussel D. Inflammation-linked adaptations in dermal microvascular reactivity accompany the development of obesity and type 2 diabetes. Int J Obes (Lond) 2018; 43:556-566. [PMID: 30006585 PMCID: PMC6223541 DOI: 10.1038/s41366-018-0148-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/26/2018] [Accepted: 06/08/2018] [Indexed: 01/04/2023]
Abstract
Background/Objectives The increased prevalence of obesity has prompted great strides in our understanding of specific adipose depots and their involvement in cardio-metabolic health. However, the impact of obesity on dermal white adipose tissue (dWAT) and dermal microvascular functionality remains unclear. This study aimed to investigate the temporal changes that occur in dWAT and dermal microvascular functionality during the development of diet-induced obesity and type 2 diabetes in mice. Methods Metabolic phenotyping of a murine model of hypercaloric diet (HCD)-induced obesity and type 2 diabetes was performed at three time points that reflected three distinct stages of disease development; 2 weeks of HCD-overweight-metabolically healthy, 4 weeks of HCD-obese-prediabetic and 12 weeks of HCD-obese-type 2 diabetic mice. Expansion of dWAT was characterized histologically, and changes in dermal microvascular reactivity were assessed in response to pressure and the vasodilators SNP and Ach. Results HCD resulted in a progressive expansion of dWAT and increased expression of pro-inflammatory markers (IL1β and COX-2). Impairments in pressure-induced (PIV) and Ach-induced (endothelium-dependent) vasodilation occurred early, in overweight-metabolically healthy mice. Residual vasodilatory responses were NOS-independent but sensitive to COX inhibition. These changes were associated with reductions in NO and adiponectin bioavailability, and rescued by exogenous adiponectin or hyperinsulinemia. Obese-prediabetic mice continued to exhibit impaired Ach-dependent vasodilation but PIV appeared normalized. This normalization coincided with elevated endogenous adiponectin and insulin levels, and was sensitive to NOS, COX and PI3K, inhibition. In obese-type 2 diabetic mice, both Ach-stimulated and pressure-induced vasodilatory responses were increased through enhanced COX-2-dependent prostaglandin response. Conclusions We demonstrate that the development of obesity, metabolic dysfunction and type 2 diabetes, in HCD-fed mice, is accompanied by increased dermal adiposity and associated metaflammation in dWAT. Importantly, these temporal changes are also linked to disease stage-specific dermal microvascular reactivity, which may reflect adaptive mechanisms driven by metaflammation.
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Affiliation(s)
- Marie-Sophie Nguyen-Tu
- LBTI, UMR CNRS 5305, 69367, Lyon Cedex 07, France.,University of Lyon 1, 69367, Lyon Cedex 07, France
| | - Pierre Nivoit
- LBTI, UMR CNRS 5305, 69367, Lyon Cedex 07, France.,University of Lyon 1, 69367, Lyon Cedex 07, France
| | - Valérie Oréa
- LBTI, UMR CNRS 5305, 69367, Lyon Cedex 07, France.,University of Lyon 1, 69367, Lyon Cedex 07, France
| | | | - Cécile Acquaviva
- LBTI, UMR CNRS 5305, 69367, Lyon Cedex 07, France.,Centre de Biologie et Pathologie Est, University Hospital, Hospices Civils de Lyon, 69677, Bron, France
| | | | - Bérengère Fromy
- LBTI, UMR CNRS 5305, 69367, Lyon Cedex 07, France.,University of Lyon 1, 69367, Lyon Cedex 07, France
| | - Jaswinder K Sethi
- Faculty of Medicine, University of Southampton, Institute of Developmental Sciences Building, Southampton General Hospital, Southampton, SO16 6YD, UK. .,National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD, UK. .,Institute for Life Sciences, Life Sciences Building 85, University of Southampton, Highfield, Southampton, SO17 1BJ, UK.
| | - Dominique Sigaudo-Roussel
- LBTI, UMR CNRS 5305, 69367, Lyon Cedex 07, France. .,University of Lyon 1, 69367, Lyon Cedex 07, France.
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6
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Abstract
Current animal models of chronic peripheral nerve compression are mainly silicone tube models. However, the cross section of the rat sciatic nerve is not a perfect circle, and there are differences in the diameter of the sciatic nerve due to individual differences. The use of a silicone tube with a uniform internal diameter may not provide a reliable and consistent model. We have established a chronic sciatic nerve compression model that can induce demyelination of the sciatic nerve and lead to atrophy of skeletal muscle. In 3-week-old pups and adult rats, the sciatic nerve of the right hind limb was exposed, and a piece of surgical latex glove was gently placed under the nerve. N-butyl-cyanoacrylate was then placed over the nerve, and after it had set, another piece of glove latex was placed on top of the target area and allowed to adhere to the first piece to form a sandwich-like complex. Thus, a chronic sciatic nerve compression model was produced. Control pups with latex or N-butyl-cyanoacrylate were also prepared. Functional changes to nerves were assessed using the hot plate test and electromyography. Immunofluorescence and electron microscopy analyses of the nerves were performed to quantify the degree of neuropathological change. Masson staining was conducted to assess the degree of fibrosis in the gastrocnemius and intrinsic paw muscles. The pup group rats subjected to nerve compression displayed thermal hypoesthesia and a gradual decrease in nerve conduction velocity at 2 weeks after surgery. Neuropathological studies demonstrated that the model caused nerve demyelination and axonal irregularities and triggered collagen deposition in the epineurium and perineurium of the affected nerve at 8 weeks after surgery. The degree of fibrosis in the gastrocnemius and intrinsic paw muscles was significantly increased at 20 weeks after surgery. In conclusion, our novel model can reproduce the functional and histological changes of chronic nerve compression injury that occurs in humans and it will be a useful new tool for investigating the mechanisms underlying chronic nerve compression.
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Affiliation(s)
- Zhen-Yu Liu
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Zhen-Bing Chen
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Jiang-Hai Chen
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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7
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Zhang L, Yang W, Tao K, Song Y, Xie H, Wang J, Li X, Shuai X, Gao J, Chang P, Wang G, Wang Z, Wang L. Sustained Local Release of NGF from a Chitosan-Sericin Composite Scaffold for Treating Chronic Nerve Compression. ACS APPLIED MATERIALS & INTERFACES 2017; 9:3432-3444. [PMID: 28032743 DOI: 10.1021/acsami.6b14691] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Chronic nerve compression (CNC), a common form of peripheral nerve injury, always leads to chronic peripheral nerve pain and dysfunction. Current available treatments for CNC are ineffective as they usually aim to alleviate symptoms at the acute phase with limited capability toward restoring injured nerve function. New approaches for effective recovery of CNC injury are highly desired. Here we report for the first time a tissue-engineered approach for the repair of CNC. A genipin cross-linked chitosan-sericin 3D scaffold for delivering nerve growth factor (NGF) was designed and fabricated. This scaffold combines the advantages of both chitosan and sericin, such as high porosity, adjustable mechanical properties and swelling ratios, the ability of supporting Schwann cells growth, and improving nerve regeneration. The degradation products of the composite scaffold upregulate the mRNA levels of the genes important for facilitating nerve function recovery, including glial-derived neurotrophic factor (GDNF), early growth response 2 (EGR2), and neural cell adhesion molecule (NCAM) in Schwann cells, while down-regulating two inflammatory genes' mRNA levels in macrophages, tumor necrosis factor alpha (TNF-α), and interleukin-1 beta (IL-1β). Importantly, our tissue-engineered strategy achieves significant nerve functional recovery in a preclinical CNC animal model by decreasing neuralgia, improving nerve conduction velocity (NCV), accelerating microstructure restoration, and attenuating gastrocnemius muscles dystrophy. Together, this work suggests a promising clinical alternative for treating chronic peripheral nerve compression injury.
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Affiliation(s)
- Lei Zhang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Jiefang Avenue 1277, Wuhan, China 430022
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China 430022
| | - Wen Yang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Jiefang Avenue 1277, Wuhan, China 430022
| | - Kaixiong Tao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China 430022
| | - Yu Song
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Jiefang Avenue 1277, Wuhan, China 430022
| | - Hongjian Xie
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Jiefang Avenue 1277, Wuhan, China 430022
| | - Jian Wang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Jiefang Avenue 1277, Wuhan, China 430022
| | - Xiaolin Li
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Jiefang Avenue 1277, Wuhan, China 430022
| | - Xiaoming Shuai
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China 430022
| | - Jinbo Gao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China 430022
| | - Panpan Chang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Jiefang Avenue 1277, Wuhan, China 430022
| | - Guobin Wang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China 430022
| | - Zheng Wang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Jiefang Avenue 1277, Wuhan, China 430022
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China 430022
| | - Lin Wang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Jiefang Avenue 1277, Wuhan, China 430022
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China 430022
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Li Q, Chen J, Chen Y, Cong X, Chen Z. Chronic sciatic nerve compression induces fibrosis in dorsal root ganglia. Mol Med Rep 2016; 13:2393-400. [PMID: 26820076 PMCID: PMC4768999 DOI: 10.3892/mmr.2016.4810] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 12/15/2015] [Indexed: 01/10/2023] Open
Abstract
In the present study, pathological alterations in neurons of the dorsal root ganglia (DRG) were investigated in a rat model of chronic sciatic nerve compression. The rat model of chronic sciatic nerve compression was established by placing a 1 cm Silastic tube around the right sciatic nerve. Histological examination was performed via Masson's trichrome staining. DRG injury was assessed using Fluoro Ruby (FR) or Fluoro Gold (FG). The expression levels of target genes were examined using reverse transcription-quantitative polymerase chain reaction, western blot and immunohistochemical analyses. At 3 weeks post-compression, collagen fiber accumulation was observed in the ipsilateral area and, at 8 weeks, excessive collagen formation with muscle atrophy was observed. The collagen volume fraction gradually and significantly increased following sciatic nerve compression. In the model rats, the numbers of FR-labeled DRG neurons were significantly higher, relative to the sham-operated group, however, the numbers of FG-labeled neurons were similar. In the ipsilateral DRG neurons of the model group, the levels of transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF) were elevated and, surrounding the neurons, the levels of collagen type I were increased, compared with those in the contralateral DRG. In the ipsilateral DRG, chronic nerve compression was associated with significantly higher levels of phosphorylated (p)-extracellular signal-regulated kinase 1/2, and significantly lower levels of p-c-Jun N-terminal kinase and p-p38, compared with those in the contralateral DRGs. Chronic sciatic nerve compression likely induced DRG pathology by upregulating the expression levels of TGF-β1, CTGF and collagen type I, with involvement of the mitogen-activated protein kinase signaling pathway.
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Affiliation(s)
- Qinwen Li
- Department of Orthopedics, The First People's Hospital of Yichang, Yichang, Hubei 443000, P.R. China
| | - Jianghai Chen
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Yanhua Chen
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Xiaobin Cong
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Zhenbing Chen
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
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9
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Tseng TJ, Hsiao TH, Hsieh ST, Hsieh YL. Determinants of nerve conduction recovery after nerve injuries: Compression duration and nerve fiber types. Muscle Nerve 2015; 52:107-12. [PMID: 25362849 DOI: 10.1002/mus.24501] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2014] [Indexed: 01/20/2023]
Abstract
INTRODUCTION The aims of this study were to determine the influences of: (1) timing of nerve decompression; and (2) nerve fiber types on the patterns of nerve conduction studies (NCS) after nerve injury. METHODS Nerve conduction studies (NCS) were performed on 3 models of nerve injury: (1) crush injury due to transient nerve compression (crush group); (2) chronic constriction injury (CCI), or permanent compression (CCI group); and (3) CCI with removal of ligatures, or delayed nerve decompression (De-CCI group). RESULTS There were distinct patterns of NCS recovery. The crush and De-CCI groups achieved similar motor nerve recovery, better than that of the CCI group. In contrast, recovery of sensory nerves was limited in the CCI and De-CCI groups and was lower than in the crush group. CONCLUSIONS Immediate relief of compression resulted in the best recovery of motor and sensory nerve conduction. In contrast, delayed decompression restored only motor nerve conduction.
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Affiliation(s)
- To-Jung Tseng
- Department of Anatomy, Faculty of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Tin-Hsin Hsiao
- Department of Anatomy, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan
| | - Sung-Tsang Hsieh
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Lin Hsieh
- Department of Anatomy, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan
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VEGF-A Promotes Both Pro-angiogenic and Neurotrophic Capacities for Nerve Recovery After Compressive Neuropathy in Rats. Mol Neurobiol 2014; 51:240-51. [DOI: 10.1007/s12035-014-8754-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 05/15/2014] [Indexed: 12/19/2022]
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11
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Local and remote immune-mediated inflammation after mild peripheral nerve compression in rats. J Neuropathol Exp Neurol 2013; 72:662-80. [PMID: 23771220 DOI: 10.1097/nen.0b013e318298de5b] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
After experimental nerve injuries that extensively disrupt axons, such as chronic constriction injury, immune cells invade the nerve, related dorsal root ganglia (DRGs), and spinal cord, leading to hyperexcitability, raised sensitivity, and pain. Entrapment neuropathies, such as carpal tunnel syndrome, involve minimal axon damage, but patients often report widespread symptoms. To understand the underlying pathology, a tube was placed around the sciatic nerve in 8-week-old rats, leading to progressive mild compression as the animals grew. Immunofluorescence was used to examine myelin and axonal integrity, glia, macrophages, and T lymphocytes in the nerve, L5 DRGs, and spinal cord after 12 weeks. Tubes that did not constrict the nerve when applied caused extensive and ongoing loss of myelin, together with compromise of small-, but not large-, diameter axons. Macrophages and T lymphocytes infiltrated the nerve and DRGs. Activated glia proliferated in DRGs but not in spinal cord. Histologic findings were supported by clinical hyperalgesia to blunt pressure and cold allodynia. Tubes that did not compress the nerve induced only minor local inflammation. Thus, progressive mild nerve compression resulted in chronic local and remote immune-mediated inflammation depending on the degree of compression. Such neuroinflammation may explain the widespread symptoms in patients with entrapment neuropathies.
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