دورية أكاديمية
أعرض في EDS

A novel therapy to promote axonal fusion in human digital nerves.

التفاصيل البيبلوغرافية
العنوان: A novel therapy to promote axonal fusion in human digital nerves.
المؤلفون: Bamba R; From the Department of Plastic Surgery (R.B., R.N., D.C.R., R.B.B., K.W.S., R.B.S., W.P.T.), Vanderbilt University, Nashville, TN; Department of General Surgery (R.B.), Georgetown University, Washington, DC; Department of Orthopaedics (T.W., C.B., S.N.), Thammasat University, Pathumthani, Thailand; Georgetown University School of Medicine (D.C.R.), Washington, DC; Department of General Surgery (K.W.S.), University of Arkansas, Little Rock, AR; Vanderbilt University Institute of Imaging Science (N.D.K., M.D.D., R.D.D.), Nashville, TN; Department of Radiology and Radiological Sciences (R.D.D.), Vanderbilt University, Nashville, TN; and Department of Biomedical Engineering (R.D.D.), Vanderbilt University, Nashville, Tennessee., Waitayawinyu T, Nookala R, Riley DC, Boyer RB, Sexton KW, Boonyasirikool C, Niempoog S, Kelm ND, Does MD, Dortch RD, Shack RB, Thayer WP
المصدر: The journal of trauma and acute care surgery [J Trauma Acute Care Surg] 2016 Nov; Vol. 81 (5 Suppl 2 Proceedings of the 2015 Military Health System Research Symposium), pp. S177-S183.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott, Williams & Wilkins Country of Publication: United States NLM ID: 101570622 Publication Model: Print Cited Medium: Internet ISSN: 2163-0763 (Electronic) Linking ISSN: 21630755 NLM ISO Abbreviation: J Trauma Acute Care Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hagerstown, MD : Lippincott, Williams & Wilkins
مواضيع طبية MeSH: Lacerations/*surgery , Nerve Regeneration/*drug effects , Peripheral Nerve Injuries/*drug therapy , Peripheral Nerves/*physiology , Polyethylene Glycols/*therapeutic use, Adolescent ; Historically Controlled Study ; Humans ; Lacerations/complications ; Male ; Peripheral Nerve Injuries/etiology ; Peripheral Nerve Injuries/physiopathology ; Recovery of Function/physiology
مستخلص: Background: Peripheral nerve injury can have a devastating impact on our military and veteran population. Current strategies for peripheral nerve repair include techniques such as nerve tubes, nerve grafts, tissue matrices, and nerve growth guides to enhance the number of regenerating axons. Even with such advanced techniques, it takes months to regain function. In animal models, polyethylene glycol (PEG) therapy has shown to improve both physiologic and behavioral outcomes after nerve transection by fusion of a portion of the proximal axons to the distal axon stumps. The objective of this study was to show the efficacy of PEG fusion in humans and to retrospectively compare PEG fusion to standard nerve repair.
Methods: Patients with traumatic lacerations involving digital nerves were treated with PEG after standard microsurgical neurorrhaphy. Sensory assessment after injury was performed at 1 week, 2 weeks, 1 month, and 2 months using static two-point discrimination and Semmes-Weinstein monofilament testing. The Medical Research Council Classification (MRCC) for Sensory Recovery Scale was used to evaluate the level of injury. The PEG fusion group was compared to patient-matched controls whose data were retrospectively collected.
Results: Four PEG fusions were performed on four nerve transections in two patients. Polyethylene glycol therapy improves functional outcomes and speed of nerve recovery in clinical setting assessed by average MRCC score in week 1 (2.8 vs 1.0, p = 0.03). At 4 weeks, MRCC remained superior in the PEG fusion group (3.8 vs 1.3, p = 0.01). At 8 weeks, there was improvement in both groups with the PEG fusion cohort remaining statistically better (4.0 vs 1.7, p = 0.01).
Conclusion: Polyethylene glycol fusion is a novel therapy for peripheral nerve repair with proven effectiveness in animal models. Clinical studies are still in early stages but have had encouraging results. Polyethylene glycol fusion is a potential revolutionary therapy in peripheral nerve repair but needs further investigation.
Level of Evidence: Therapeutic study, level IV.
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معلومات مُعتمدة: R01 NS097821 United States NS NINDS NIH HHS; T32 EB014841 United States EB NIBIB NIH HHS
المشرفين على المادة: 3WJQ0SDW1A (Polyethylene Glycols)
تواريخ الأحداث: Date Created: 20161022 Date Completed: 20170517 Latest Revision: 20220311
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC7229641
DOI: 10.1097/TA.0000000000001203
PMID: 27768666
قاعدة البيانات: MEDLINE
الوصف
تدمد:2163-0763
DOI:10.1097/TA.0000000000001203