低功率雷射應用不同治療策略對於神經導管接合大鼠截斷大間距坐骨神經再生的影響

本研究主要應用近來新開發而成的可降解性神經導管，此神經導管是利用綠梔子素（Genipin）交聯明膠（Gelatin）並添加三鈣磷酸鹽（Tricalcium phosphate, TCP）陶瓷粉末所製備而成的強化神經導管（簡稱為GGT神經導管）。在本研究中，將GGT神經導管植入於坐骨神經截斷受損15 mm的大鼠體內中，然後輔以由鎵鋁砷磷（GaAlAsP）二極體低功率之黏貼式雷射治療儀（Aculas®-AM-100A）治療（波長為660 nm及功率為50 mW），從體外（in vivo）方式於損傷神經的兩邊斷端進行照射治療。實驗動物隨機分為三個組別，第一組為未接收雷射光治療控制組（GGT／Sham）；第二組為接受每天1分鐘（3 J）的雷射光治療組（GGT／LT1），連續照射治療10天；第三組為接受每天4分鐘（12 J）雷射光治療組（GGT／LT4），連續照射治療5天。首先可觀察GGT神經導管的外觀上呈現暗藍色，且經由SEM觀察神經導管的外壁為粗糙狀，而內壁則呈現光滑型態；將神經導管植入實驗大鼠體內12週後，與未經雷射治療組（GGT／Sham）相比之下，雷射治療組（GGT／LT1與GGT／LT4）可顯著地降低腓腸肌肉的萎縮（P＜ 0.001）。由組織形態學評估顯示，雷射治療組的神經再生修復比未經雷射治療組更為迅速，將GGT神經導管接合坐骨神經截斷受損15 mm的大鼠體內中，然後輔以黏貼式低功率雷射治療可以加速截斷受損神經的再生與修復。再者顯示高劑量短療期（GGT／LT4組）比低劑量長療期（GGT／LT1組）的雷射治療組則顯示具有更佳的神經再生修復效果。

關鍵字

周邊神經損傷；神經導管；低功率雷射；治療模式；坐骨神經

並列摘要

This study proposed a novel combination of neural regeneration techniques for the repair of damaged peripheral nerves. A biodegradable nerve conduit containing genipin-cross-linked gelatin was annexed using beta-tricalcium phosphate (TCP) ceramic particles (Genipin-Gelatin-TCP, GGT) to bridge the transection of a 15 mm sciatic nerve in rats. Two trigger points were irradiated transcutaneouslyon the surgical site using 660 nm of gallium-aluminum arsenide phosphide (GaAlAsP) laser diodes and the laser therapy starts on day 1 after the operation. The animals were divided into three groups: (1) the sham-irradiated control group (GGT/Sham); (2) the laser therapy group (GGT/LT1) with an exposure time 1 min/day for 10 consecutive days; (3) the laser therapy group (GGT/LT4) with an exposure time 4 min/day for 5 consecutive days. The conduit was dark bluish in appearance and round with a rough and compact outer surface observed by SEM. Twelve weeks following implantation, the results demonstrated that laser stimulation significantly reduced muscular atrophy (P＜ 0.001). Histomorphometric assessments revealed that laser stimulation accelerated nerve regeneration over a larger area of neural tissue, resulting in axons of greater diameter and myelin sheaths of greater thickness than that observed in rats treated with nerve conduits alone. Thus, this study demonstrated that the proposed therapeutic modalities of low-level laser can accelerate the repair of transected peripheral nerves bridged using a GGT nerve conduit. In addition, high-dose/short-period laser therapygroup(GGT/ LT4group) showed the betternerveregenerationeffect than the low-dose/long-period treatment group(GGT/ LT1group).

並列關鍵字

Peripheral nerve injury ； nerve conduit ； low-level laser ； therapeutic modality ； sciatic nerve

國際替代計量

低功率雷射應用不同治療策略對於神經導管接合大鼠截斷大間距坐骨神經再生的影響

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