Periferik sinir kesisinde farklı dozlarda sistemik uygulanan CDP-kolin'in aksonal rejenerasyon ve epinöral skar dokusu üzerine etkilerinin erken primer sütür modelinde araştırılması
Loading...
Files
Date
2012
Authors
Kaplan, Tolga
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Periferik sinir kesisi sonrası iyileşmede nadiren fonksiyonel geri kazanım nadiren tam olarak görülmektedir. Daha önce kliniğimizde yapılan çalışmalarda periferik sinir hasarında CDP-kolin'in perinöral skar dokusu, aksonal rejenerasyon ve fonksiyonel geri kazanım üzerine etkinliğini kanıtlanmıştı. Bu çalışmamızda ise sitikolin'in periferik sinir hasarındaki etkinliğinin dozla ilişkisini inceledik.Çalışmada ağırlıkları 200-270 (±23) gr arasında değişen 60 adet Wistar Albino tipi dişi yetişkin sıçan kullanıldı. Tüm sıçanlarda sağ siyatik sinire mikromakas ile kesi yapılarak 8/0 prolen ile hemen primer anastomoz yapıldı. Takiben sıçanlar 4 tedavi grubuna ayrıldı: kontrol (K; n=15) grubuna intraperitoneal yolla 2 cc serum fizyolojik (SF) enjekte edilirken, C-300 (n=15), C-600 (n=15) ve C-900 (n=15) gruplarındaki sıçanlara 2 cc SF içinde sulandırılmış sırasıyla 300 mol/kg, 600 mol/kg ve 900 mol/kg CDP-kolin uygulandı.12.haftada tüm sıçanlar yüksek doz Tiopental sodyum uygulamasıyla sakrifiye edildi. Sıçanlar sakrifiye edilmeden önce 4, 8, 12 haftada siyatik fonksiyon indeksi (SFİ) çalışmaları ve 12. haftada elektrofizyolojik (EMG) kayıtları alındı. Takiben sıçanlar sakrifiye edilerek, sinir yapışıklığı, SFİ, EMG sonuçları ve histomorfolojik inceleme yapıldı. Sinir yapışıklığı, SFİ ve EMG inceleme değerlendirmelerinde K ve C-300 grubuna göre C-600 ve C-900 grubunun sonuçlarının istatistiksel olarak anlamlı derecede iyi çıktığı gözlendi (p<0.05).Yapılan histomorfolojik değerlendirmede gruplar arasındaki akson sayıları ve aksonal dansite bakıldığında C-900 grubunda istatistiksel olarak anlamlı derecede artma olmasa da (p>0.05); fonksiyonel olarak myelinli akson sayılarının arttığı ve morfolojilerinin daha düzgün olduğu gözlendi.Bu anlamda periferik sinir kesisi ve primer anastomoz modelinde CDP-kolinin aksonal rejenerasyon ve skarsız iyileşme üzerine etkinliğinin doza bağımlı olduğu söylenebilir.
A full functional recovery is rarely seen after peripheral nerve injuries. We reported citicolines effect on perineural scar tissue, axonal regeneration and functional recovery after peripheral nerve injury in our previous studies. In this study, we investigated the relation of citicoline dose on its effectiveness in peripheral nerve injury.Sixty adult female Wistar Albino rats weighing 200 to 270 (±23) g were used in the study. Right sciatic nerves of all rats were incised using micro-scissors and primary anastomosis was performed immediately with 8/0 prolene. Rats were then divided into four groups: control (K) (n=15) group received 2 cc saline (SF) intraperitoneally, while rats in C-300 (n=15), C-600 (n=15) and C-900 (n=15) groups received 300 mol/kg, 600 mol/kg and 900 mol/kg CDP-choline diluted in 2 cc saline, respectively.At the 12th week, all the rats were sacrificed by administration of high dose Thiopental sodium. Before rats were sacrificed, the sciatic functional index (SFI) at the 4th, 8th and 12th weeks and electrophysiological recordings at the 12th week were recorded. Then, rats were sacrificed and nerve adhesions, SFI, electrophysiological results and histomorphological examinations were performed. According to neural adhesion, SFI and electrophysiological evaluations, it was observed that the results of C-600 and C-900 groups were significantly better than the results of K and C-300 groups (p<0.05).It was determined that the number of functionally myelinated axons were increased and they were more uniform in morphology in C-900 group, even though there was no statistically significant increase in number observed when the number of axons and axonal density between the groups were examined by histomorphological evaluation.In this sense, it can be said that there is dose dependent efficiency of CDP-choline on axonal regeneration and recovery without scar formation in the model of peripheral nerve incision and primary anastomosis.
A full functional recovery is rarely seen after peripheral nerve injuries. We reported citicolines effect on perineural scar tissue, axonal regeneration and functional recovery after peripheral nerve injury in our previous studies. In this study, we investigated the relation of citicoline dose on its effectiveness in peripheral nerve injury.Sixty adult female Wistar Albino rats weighing 200 to 270 (±23) g were used in the study. Right sciatic nerves of all rats were incised using micro-scissors and primary anastomosis was performed immediately with 8/0 prolene. Rats were then divided into four groups: control (K) (n=15) group received 2 cc saline (SF) intraperitoneally, while rats in C-300 (n=15), C-600 (n=15) and C-900 (n=15) groups received 300 mol/kg, 600 mol/kg and 900 mol/kg CDP-choline diluted in 2 cc saline, respectively.At the 12th week, all the rats were sacrificed by administration of high dose Thiopental sodium. Before rats were sacrificed, the sciatic functional index (SFI) at the 4th, 8th and 12th weeks and electrophysiological recordings at the 12th week were recorded. Then, rats were sacrificed and nerve adhesions, SFI, electrophysiological results and histomorphological examinations were performed. According to neural adhesion, SFI and electrophysiological evaluations, it was observed that the results of C-600 and C-900 groups were significantly better than the results of K and C-300 groups (p<0.05).It was determined that the number of functionally myelinated axons were increased and they were more uniform in morphology in C-900 group, even though there was no statistically significant increase in number observed when the number of axons and axonal density between the groups were examined by histomorphological evaluation.In this sense, it can be said that there is dose dependent efficiency of CDP-choline on axonal regeneration and recovery without scar formation in the model of peripheral nerve incision and primary anastomosis.
Description
Keywords
Periferik sinir, Sitikolin, Rejenerasyon, Peripheral nerve, Citicoline, Regeneration
Citation
Kaplan, T. (2012). Periferik sinir kesisinde farklı dozlarda sistemik uygulanan CDP-kolin'in aksonal rejenerasyon ve epinöral skar dokusu üzerine etkilerinin erken primer sütür modelinde araştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.