探討發光二極體光治療對於神經導管接合大鼠截斷大缺陷坐骨神經之神經再生影響評估

Effects of Neural Regeneration in a Nerve Conduit Across a Large Gap of The Transected Sciatic Nerve in Rats With a Light-Emitting Diode Phototherapy

沙亞拿(YA-NA SHA)

指導教授 ： 劉百栓

中臺科技大學/健康科學院/醫學影像暨放射科學系暨研究所/碩士(2017年)

摘要

本研究應用所開發具有可生物降解性的一種創新型神經導管（簡稱為GCC），此神經導管是由具生物相容性的天然高分子材料-幾丁聚醣(Chitosan)作為神經導管基材，並添加增強導管機械強度的奈米碳管(Carbon nanotube)，最後將神經導管浸泡於天然的生物交聯劑綠梔子素(Genipin)進行交聯，以減緩神經導管的降解速率。本研究目的為採用GCC神經導管植入大鼠坐骨神經斷裂大缺陷損傷模式，並結合波長640 nm發光二極體之體外光治療照射神經損傷部位，來評估是否具有加速神經組織再生修復之效果？
GCC神經導管觀察其外觀平滑、顏色為深藍色，為完整的中空同心圓狀，能正確地引導神經組織的再生。實驗動物隨機分為三個組別：第一組為將坐骨神經截斷後縫合GCC神經導管，但未接收發光二極體光治療控制組(GCC/Sham)；第二組為將坐骨神經截斷後縫合GCC神經導管，並且每天接收10分鐘發光二極體光治療組(GCC/LED)；第三組為將動物的坐骨神經截斷後，立即將神經的近端與遠端縫合之自體移植對照組（Autograft）。每組各六隻，總共18隻大鼠。
首先，神經導管植入大鼠體內12週後，在坐骨神經功能指數(sciatic functional index, SFI)分析方面，GCC/LED組與Autograft組於每個植入時期的SFI值皆優於GCC/Sham組。且神經導管於大鼠體內並未產生嚴重組織病理現象，且仍保有導管強度結構性及生物相容性。在腓腸肌萎縮量化結果亦顯示GCC/LED組與Autograft組相較GCC/Sham組，更明顯地可以減少肌肉萎縮(P<0.05)。最後在組織形態學評估顯示，GCC/LED組和Autograft 組相較於 GCC/Sham 組有較快速的神經再生修復效果。
本研究結果顯示，以 GCC 神經導管接合周邊神經損傷，並輔以發光二極體之體外光治療照射，可以改善大鼠的運動功能、減少肌肉萎縮，及加 速神經的再生與修復。

關鍵字

神經導管 ； 坐骨神經 ； 周邊神經修復 ； 發光二極體光治療

並列摘要

This paper proposes a novel biodegradable nerve conduit made using genipin-cross-linked chitosan and carbon nanotubes (GCC). The aim of this study was to evaluate the influence of phototherapy using a 640-nm-wavelength light-emitting diode on the neurorehabilitation of transected sciatic nerves after bridging the GCC nerve guide conduit in rats.
The proposed GCC nerve guide conduit has a cylindrical shape, dark blue color; the interior of the nerve bridge was hollow to aid in guiding the growth of the damaged nerve fiber. The rats were divided into three groups: a sham-irradiated group (GCC/Sham group); an experimental group, undergoing light-emitting diode (LED) phototherapy (GCC/LED group); and a control group, undergoing autologous nerve grafts (Autograft group). Each group consisted of six rats, or a total of 18 rats were included in the examination.
Initially, twelve weeks after implantation, the mean sciatic functional index (SFI) of the GCC/LED group was higher than the mean SFI of the GCC/Sham group in each period after surgery. Before the rats were sacrificed, there were no observable pathological phenomena, and the conduit had adequate structural strength and biocompatibility. Muscle atrophy in the GCC/LED and Autograft groups was significantly reduced (P< 0.05) compared with that the GCC/Sham group. The histomorphological assessments revealed that the GCC/LED group had undergone more rapid nerve regeneration than the GCC/Sham group.
This study investigated the effectiveness of different modes of LED phototherapy in the repair of damaged sciatic nerves. The improvements in the motor function, muscular reinnervation, and histomorphometric assessments demonstrate that LED phototherapy accelerates the repair of a transected peripheral nerve in rats after bridging with GCC conduit.

並列關鍵字

Nerve conduit. ； Sciatic nerve ； Peripheral nerve repair ； Light-emitting diode (LED) phototherapy

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