Trombositten zengin plazmanın sıçan modelinde sinir rejenerasyonuna etkileri

Yıl 2014, Cilt: 48 Sayı: 4, 449 - 454, 03.09.2014

Levent Kucuk Huseyin Gunay Oytun Erbas Ulku Kucuk Funda Atamaz Erhan Coskunol

https://doi.org/10.3944/AOTT.2014.13.0029

Öz

Amaç: Çalışmamızda trombositten zengin plazmanın periferik siyatik sinir yaralanması modelinde sinir rejenerasyonunu arttırıcı etkisi olup olmadığını belirlemeye çalıştık.

Çalışma planı: On iki sıçana ait 24 siyatik sinirde sinir kesisi modeli yapıldıktan sonra tüm sinirler aynı cerrah tarafından epinöral sütürlerle onarıldı. Daha sonra sıçanların yarısında (trombositten zengin plazma grubu) onarım bölgesine trombositten zengin plazma, diğer yarısında da (kontrol grubu) aynı bölgeye serum fizyolojik uygulandı. Operasyondan 12 hafta sonra yapılan motor ve elektromiyografik değerlendirmeler sonrası histopatolojik örnekler için denekler sakrifiye edildi.

Bulgular: Motor iyileşme trombositten zengin plazma grubunda kontrol grubuna göre anlamlı derecede daha iyi idi. Elektromiyografik ve histomorfometrik bulgular açısından gruplar arasındaki farkın anlamlı olduğu görüldü (p<0.05).

Çıkarımlar: Yaptığımız deneysel çalışma trombositten zengin plazmanın sinir rejenerasyonu üzerine pozitif etkilerinin olduğunu göstermiştir.

Anahtar Kelimeler

Büyüme faktörü; periferik sinir yaralanması; trombositten zengin plazma; sinir rejenerasyonu; siyatik sinir.

Effects of platelet-rich plasma on nerve regeneration in a rat model

Öz

Objective: The aim of this study was to determine whether platelet-rich plasma has a regenerative effect on a sciatic nerve injury model in rats.

Methods: A sciatic nerve cut model was created in 24 nerves of 12 rats. All nerves were repaired with epineural sutures by the same surgeon. Rats were randomly divided into two groups; platelet-rich plasma was applied to the injury site in the platelet-rich plasma group and saline only to the same area in the control group. Motor and electromyographic assessments were performed at the end of 12th postoperative week and all rats were euthanized for histological specimens.

Results: Motor recovery was significantly better in the platelet-rich plasma group than the control group. The differences in electromyographic and histomorphometric findings between the groups were significant (p<0.05).

Conclusion: Our experimental study demonstrated positive effects of platelet-rich plasma on nerve regeneration.

Anahtar Kelimeler

Growth factor, nerve regeneration, peripheral nerve injury, platelet-rich plasma, sciatic nerve

Kaynakça

• Yu W, Wang J, Yin J. Platelet-rich plasma: a promising product for treatment of peripheral nerve regeneration after nerve injury. Int J Neurosci 2011;121:176-80.
• Guntinas-Lichius O, Wewetzer K, Tomov TL, Azzolin N, Kazemi S, Streppel M, et al. Transplantation of olfactory mucosa minimizes axonal branching and promotes the recovery of vibrissae motor performance after facial nerve repair in rats. J Neurosci 2002;22:7121-31.
• Farrag TY, Lehar M, Verhaegen P, Carson KA, Byrne PJ. Effect of platelet rich plasma and fibrin sealant on facial nerve regeneration in a rat model. Laryngoscope 2007;117:157-65.
• Emel E, Ergün SS, Kotan D, Gürsoy EB, Parman Y, Zengin A, et al. Effects of insulin-like growth factor-I and platelet-rich plasma on sciatic nerve crush injury in a rat model. J Neurosurg 2011;114:522-8.
• Lundborg G. A 25-year perspective of peripheral nerve surgery: evolving neuroscientific concepts and clinical significance. J Hand Surg Am 2000;25:391-414.
• Huang W, Begum R, Barber T, Ibba V, Tee NC, Hussain M, et al. Regenerative potential of silk conduits in repair of peripheral nerve injury in adult rats. Biomaterials 2012;33:59-71.
• Cervelli V, Lucarini L, Spallone D, Brinci L, de Angelis B. Use of platelet rich plasma and hyaluronic acid on exposed tendons of the foot and ankle. J Wound Care 2010;19:188-90.
• Cho HH, Jang S, Lee SC, Jeong HS, Park JS, Han JY, et al. Effect of neural-induced mesenchymal stem cells and platelet-rich plasma on facial nerve regeneration in an acute nerve injury model. Laryngoscope 2010;120:907
• Eppley BL, Woodell JE, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg 2004;114:1502-8.
• Gordon T, Sulaiman O, Boyd JG. Experimental strategies to promote functional recovery after peripheral nerve injuries. J Peripher Nerv Syst 2003;8:236-50.
• Grothe C, Nikkhah G. The role of basic fibroblast growth factor in peripheral nerve regeneration. Anat Embryol (Berl) 2001;204:171-7.
• Rivlin AS, Tator CH. Objective clinical assessment of motor function after experimental spinal cord injury in the rat. J Neurosurg 1977;47:577-81.
• Federici T, Liu JK, Teng Q, Yang J, Boulis NM. A means for targeting therapeutics to peripheral nervous system neurons with axonal damage. Neurosurgery 2007;60:911-8.
• Fenrich K, Gordon T. Canadian Association of Neuroscience review: axonal regeneration in the peripheral and central nervous systems--current issues and advances. Can J Neurol Sci 2004;31:142-56.
• Apel PJ, Ma J, Callahan M, Northam CN, Alton TB, Sonntag WE, et al. Effect of locally delivered IGF-1 on nerve regeneration during aging: an experimental study in rats. Muscle Nerve 2010;41:335-41.
• Koriyama Y, Homma K, Sugitani K, Higuchi Y, Matsukawa T, Murayama D, et al. Upregulation of IGF-I in the goldfish retinal ganglion cells during the early stage of optic nerve regeneration. Neurochem Int 2007;50:749-56.
• Ohta M, Suzuki Y, Chou H, Ishikawa N, Suzuki S, Tanihara M, et al. Novel heparin/alginate gel combined with basic fibroblast growth factor promotes nerve regeneration in rat sciatic nerve. J Biomed Mater Res A 2004;71:661-8.
• Yao CC, Yao P, Wu H, Zha ZG. Absorbable collagen sponge combined with recombinant human basic fibroblast growth factor promotes nerve regeneration in rat sciatic nerve. J Mater Sci Mater Med 2007;18:1969-72.
• Haas SL, Fitzner B, Jaster R, Wiercinska E, Gaitantzi H, Jesnowski R, et al. Transforming growth factor-beta induces nerve growth factor expression in pancreatic stellate cells by activation of the ALK-5 pathway. Growth Factors 2009;27:289-99.
• Rosenstein JM, Krum JM. New roles for VEGF in nervous tissue--beyond blood vessels. Exp Neurol 2004;187:246
• Ding XG, Li SW, Zheng XM, Hu LQ, Hu WL, Luo Y. The effect of platelet-rich plasma on cavernous nerve regeneration in a rat model. Asian J Androl 2009;11:215-21. Sariguney Y, Yavuzer R, Elmas C, Yenicesu I, Bolay H, Atabay K. Effect of platelet-rich plasma on peripheral nerve regeneration. J Reconstr Microsurg 2008;24:159
• Welch JA, Kraus KH, Wells MR, Blunt DG, Weremowitz J. Effect of combined administration of insulin-like growth factor and platelet-derived growth factor on the regeneration of transected and anastomosed sciatic nerve in rats. Am J Vet Res 1997;58:1033-7.
• Piskin A, Kaplan S, Aktaş A, Ayyildiz M, Raimondo S, Aliç T, et al. Platelet gel does not improve peripheral nerve regeneration: an electrophysiological, stereological, and electron microscopic study. Microsurgery 2009;29:144-53.