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Sheu ML, Shen CC, Tsou HK, Yang MY, Su HL, Sheehan J, Chang MH, Chen HS, Pan HC. Dual Regeneration of Muscle and Nerve by Intramuscular Infusion of Mitochondria in a Nerve Crush Injury Model. Neurosurgery 2021; 89:E49-E59. [PMID: 33862620 DOI: 10.1093/neuros/nyab105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 01/30/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Peripheral nerve injuries result in muscle denervation and apoptosis of the involved muscle, which subsequently reduces mitochondrial content and causes muscle atrophy. The local injection of mitochondria has been suggested as a useful tool for restoring the function of injured nerves or the brain. OBJECTIVE To determine outcomes following the administration of isolated mitochondria into denervated muscle after nerve injury that have not been investigated. METHODS Muscle denervation was conducted in a sciatic nerve crushed by a vessel clamp and the denervated gastrocnemius muscle was subjected to 195 μg hamster green fluorescent protein (GFP)-mitochondria intramuscular infusion for 10 min. RESULTS The mitochondria were homogeneously distributed throughout the denervated muscle after intramuscular infusion. The increases in caspase 3, 8-oxo-dG, Bad, Bax, and ratio of Bax/Bcl-2 levels in the denervated muscle were attenuated by mitochondrial infusion, and the downregulation of Bcl-2 expression was prevented by mitochondrial infusion. In addition, the decrease in the expression of desmin and the acetylcholine receptor was counteracted by mitochondrial infusion; this effect paralleled the amount of distributed mitochondria. The restoration of the morphology of injured muscles and nerves was augmented by the local infusion of mitochondria. Mitochondrial infusion also led to improvements in sciatic functional indexes, compound muscle action potential amplitudes, and conduction latencies as well as the parameters of CatWalk (Noldus) gait analysis. CONCLUSION The local infusion of mitochondria can successfully prevent denervated muscle atrophy and augment nerve regeneration by reducing oxidative stress in denervated muscle.
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Affiliation(s)
- Meei-Ling Sheu
- Institute of Biomedical Sciences, National Chung-Hsing University, Taichung, Taiwan
| | - Chiung-Chyi Shen
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Physical Therapy, Hung Kuang University, Taichung, Taiwan
| | - Hsi-Kai Tsou
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Meng Yin Yang
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hong-Lin Su
- Department of Life Sciences, Agriculture Biotechnology Center, National Chung-Hsing University, Taichung, Taiwan
| | - Jason Sheehan
- Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA
| | - Ming-Hong Chang
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hong-Shiu Chen
- Department of Neurosurgery, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Hung-Chuan Pan
- Institute of Biomedical Sciences, National Chung-Hsing University, Taichung, Taiwan.,Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.,College of Medicine and Life Science, Chung Hwa University of Medical Technology, Tainan, Taiwan
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McAvoy M, Doloff JC, Khan OF, Rosen J, Langer R, Anderson DG. Vascularized Muscle Flap to Reduce Wound Breakdown During Flexible Electrode-Mediated Functional Electrical Stimulation After Peripheral Nerve Injury. Front Neurol 2020; 11:644. [PMID: 32793094 PMCID: PMC7385241 DOI: 10.3389/fneur.2020.00644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/29/2020] [Indexed: 11/15/2022] Open
Abstract
The success of devices delivering functional electrical stimulation (FES) has been hindered by complications related to implants including skin breakdown and subsequent wound dehiscence. Our hypothesis was that a vascularized muscle flap along the dorsal surface of an epimysial electrode would prevent skin breakdown during FES therapy to treat atrophy of the gastrocnemius muscle during peripheral nerve injury. Resection of a tibial nerve segment with subsequent electrode implantation on the dorsal surfaces of the gastrocnemius muscle was performed on ten Lewis rats. In five rats, the biceps femoris (BF) muscle was dissected and placed along the dorsal surface of the electrode (Flap group). The other five animals did not undergo flap placement (No Flap group). All animals were treated with daily FES therapy for 2 weeks and degree of immune response and skin breakdown were evaluated. The postoperative course of one animal in the No Flap group was complicated by complete wound dehiscence requiring euthanasia of the animal on postoperative day 4. The remaining 4 No Flap animals showed evidence of ulceration at the implant by postoperative day 7. The 5 animals in the Flap group did not have ulcerative lesions. Excised tissue at postoperative day 14 examined by histology and in vivo Imaging System (IVIS) showed decreased implant-induced inflammation in the Flap group. Expression of specific markers for local foreign body response were also decreased in the Flap group.
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Affiliation(s)
- Malia McAvoy
- Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Massachusetts Institute of Technology, Boston, MA, United States
| | - Joshua C Doloff
- Department of Biomedical Engineering, Translational Tissue Engineering Center, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Materials Science and Engineering, Institute of NanoBioTechnology, Johns Hopkins University, Baltimore, MD, United States
| | - Omar F Khan
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Joseph Rosen
- Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, Lebanon, NH, United States
| | - Robert Langer
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States.,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Biomedical and Materials Science Engineering, Translational Tissue Engineering Center, Wilmer Eye Institute and the Institute for NanoBioTechnology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Daniel G Anderson
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States.,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Biomedical and Materials Science Engineering, Translational Tissue Engineering Center, Wilmer Eye Institute and the Institute for NanoBioTechnology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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