TY - JOUR
T1 - A review of research endeavors to optimize peripheral nerve reconstruction
AU - Myckatyn, Terence M.
AU - Mackinnon, Susan E.
PY - 2004/3/1
Y1 - 2004/3/1
N2 - This manuscript reviews studies relating to peripheral nerve allografts, neuroregenerative agents and end-to-side neurorrhaphy. With respect to peripheral nerve allografts, animal studies with the agents cyclosporin A, FK506 and rapamycin are reviewed and related to recent clinical experience. FK506 distinguishes itself as an agent capable of reversing acute rejection of a peripheral nerve allograft and an agent with some neuroregenerative properties. In addition to systemic immunosuppression, experience with agents purported to initiate a state of donor specific tolerance are discussed. Specifically, experimental studies with administration of ultraviolet B treated donor splenocytes, antibodies to cellular adhesion molecules and antibodies to components of the costimulatory pathway of immunosuppression are reviewed. The neuroregenerative properties of FK506 and related compounds are examined in animal models. Finally, the experimental finding that reinnervation following end-to-side neurorrhaphy is mostly sensory and related to the degree of axonal damage at the level of an epineurotomy or perineurotomy is discussed.
AB - This manuscript reviews studies relating to peripheral nerve allografts, neuroregenerative agents and end-to-side neurorrhaphy. With respect to peripheral nerve allografts, animal studies with the agents cyclosporin A, FK506 and rapamycin are reviewed and related to recent clinical experience. FK506 distinguishes itself as an agent capable of reversing acute rejection of a peripheral nerve allograft and an agent with some neuroregenerative properties. In addition to systemic immunosuppression, experience with agents purported to initiate a state of donor specific tolerance are discussed. Specifically, experimental studies with administration of ultraviolet B treated donor splenocytes, antibodies to cellular adhesion molecules and antibodies to components of the costimulatory pathway of immunosuppression are reviewed. The neuroregenerative properties of FK506 and related compounds are examined in animal models. Finally, the experimental finding that reinnervation following end-to-side neurorrhaphy is mostly sensory and related to the degree of axonal damage at the level of an epineurotomy or perineurotomy is discussed.
KW - Anti-CD4OL
KW - Cyclosporin A
KW - End-to-side neurorrhaphy
KW - FK506
KW - Peripheral nerve allograft
KW - Rapamycin
KW - Tolerance
UR - http://www.scopus.com/inward/record.url?scp=1842555124&partnerID=8YFLogxK
U2 - 10.1179/016164104225013743
DO - 10.1179/016164104225013743
M3 - Review article
C2 - 15072631
AN - SCOPUS:1842555124
SN - 0161-6412
VL - 26
SP - 124
EP - 138
JO - Neurological Research
JF - Neurological Research
IS - 2
ER -