PLGA-PEG-PLGA hydrogel with NEP1-40 promotes the functional recovery of brachial plexus root avulsion in adult rats

Wenlai Guo; Bingbing Pei; Zehui Li; Xiao Lan Ou; Tianwen Sun; Zhe Zhu

doi:10.7717/peerj.12269

PLGA-PEG-PLGA hydrogel with NEP1-40 promotes the functional recovery of brachial plexus root avulsion in adult rats

PeerJ. 2021 Nov 1:9:e12269. doi: 10.7717/peerj.12269. eCollection 2021.

Authors

Wenlai Guo¹, Bingbing Pei², Zehui Li¹, Xiao Lan Ou¹, Tianwen Sun¹, Zhe Zhu¹

Affiliations

¹ Department of Hand Surgery, The Second Hospital of Jilin University, Chang chun, Jilin, China.
² Department of Orthopedics, Chinese People's Liberation Army Joint Logistics, Support Unit 964 Hospital, Chang chun, Jilin, China.

Abstract

Adult brachial plexus root avulsion can cause serious damage to nerve tissue and impair axonal regeneration, making the recovery of nerve function difficult. Nogo-A extracellular peptide residues 1-40 (NEP1-40) promote axonal regeneration by inhibiting the Nogo-66 receptor (NgR1), and poly (D, L-lactide-co-glycolide)-poly (ethylene glycol)-poly (D, L-lactide-co-glycolide) (PLGA-PEG-PLGA) hydrogel can be used to fill in tissue defects and concurrently function to sustain the release of NEP1-40. In this study, we established an adult rat model of brachial plexus nerve root avulsion injury and conducted nerve root replantation. PLGA-PEG-PLGA hydrogel combined with NEP1-40 was used to promote nerve regeneration and functional recovery in this rat model. Our results demonstrated that functional recovery was enhanced, and the survival rate of spinal anterior horn motoneurons was higher in rats that received a combination of PLGA-PEG-PLGA hydrogel and NEP1-40 than in those receiving other treatments. The combined therapy also significantly increased the number of fluorescent retrogradely labeled neurons, muscle fiber diameter, and motor endplate area of the biceps brachii. In conclusion, this study demonstrates that the effects of PLGA-PEG-PLGA hydrogel combined with NEP1-40 are superior to those of other therapies used to treat brachial plexus nerve root avulsion injury. Therefore, future studies should investigate the potential of PLGA-PEG-PLGA hydrogel as a primary treatment for brachial plexus root avulsion.

Keywords: Brachial plexus avulsion; NEP1-40; Nerve regeneration; PLGA-PEG-PLGA.

Grants and funding

This study was supported by the Jilin Provincial Educational 135 Science and Technology Project (JJKH20190047KJ). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.