Abstract
BackgroundRecent experimental studies using herbal extracts have shown the possibility of peripheral nerve regeneration. This study aimed to investigate the effects of herbal extracts on peripheral nerve regeneration in a rat sciatic nerve injury model.MethodsA total of 53 rats were randomly assigned to a control group or one of four experimental groups. In all rats, the sciatic nerve was completely severed and microscopic epineural end-to-end neurorrhaphy was performed. Normal saline (2 mL) was topically applied to the site of nerve repair in the control group, whereas four different herbal extracts – 2 mL each of Astragalus mongholicus Bunge, Coptis japonica (Thunb.) Makino, Aconitum carmichaelii Debeaux, or Paeonia lactiflora Pall. – were topically applied to the site of nerve repair in each experimental group. Nerve conduction studies were performed at an average of 11.9 weeks after the operation, and conduction velocity and proximal and distal amplitudes were measured. Biopsies were performed at an average of 13.2 weeks after the initial neurorrhaphy. The quality of nerve anastomosis and perineural adhesion to the surrounding soft tissues was macroscopically evaluated. The neuroma size at the site of the neurorrhaphy was microscopically measured, whereas the size of the scar tissue was evaluated relative to the diameter of the repaired nerve.ResultsThe nerve conduction study results showed the highest nerve conduction velocity in the experimental group that used the Coptis japonica (Thunb.) Makino extract and the highest proximal and distal amplitudes in the experimental group that used the Aconitum carmichaelii Debeaux extract. Macroscopic evaluations after the second operation showed that grade 2 perineural adhesion was found in 70.8% of rats. The mean neuroma size in the Coptis japonica (Thunb.) Makino, Aconitum carmichaelii Debeaux, and Paeonia lactiflora Pall. groups showed statistically significant decreases relative to the control group. The mean scar tissue formation index in the Paeonia lactiflora Pall. group showed a statistically significant decrease relative to the control group.ConclusionsThe peripheral nerve regeneration effect of the herbal extracts was confirmed through decreased neuroma and scar tissue formation.
Highlights
Recent experimental studies using herbal extracts have shown the possibility of peripheral nerve regeneration
Three rats died after neurorrhaphy, and the remaining 50 rats underwent the nerve conduction study
Nerve conduction velocity was an average of 88.45 m/s in the control group
Summary
Recent experimental studies using herbal extracts have shown the possibility of peripheral nerve regeneration. Peripheral nerve injury is often seen clinically, and when nerve injury is caused by a sharp knife, glass laceration, or fracture of the diaphysis, the nerve may get completely cut. Neurotmesis, the most severe type of peripheral nerve injury according to Seddon’s classification, is the complete cutting of the nerve due to laceration or severe trauma [3]. It refers to the condition in which the continuity of the nerve trunk is lost, and the endoneurium, perineurium, and epineurium (the supporting tissues around the axon) are ruptured. Spontaneous regeneration of the nerve does not occur, and the prognosis is poor if connectivity is not recovered via surgical methods such as neurorrhaphy or nerve graft which uses a microsurgical technique
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