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Therapeutic augmentation of the growth hormone axis to improve outcomes following peripheral nerve injury

机译:治疗性增加生长激素轴以改善周围神经损伤后的结局

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Introduction: Peripheral nerve injuries often result in debilitating motor and sensory deficits. There are currently no therapeutic agents that are clinically available to enhance the regenerative process. Following surgical repair, axons often must regenerate long distances to reach and reinnervate distal targets. Progressive atrophy of denervated muscle and Schwann cells (SCs) prior to reinnervation contributes to poor outcomes. Growth hormone (GH)-based therapies have the potential to accelerate axonal regeneration while at the same time limiting atrophy of muscle and the distal regenerative pathway prior to reinnervation.Areas covered: In this review, we discuss the potential mechanisms by which GH-based therapies act on the multiple tissue types involved in peripheral nerve regeneration to ultimately enhance outcomes, and review the pertinent mechanistic and translational studies that have been performed. We also address potential secondary benefits of GH-based therapies pertaining to improved bone, tendon and wound healing in the setting of peripheral nerve injury.Expert opinion: GH-based therapies carry great promise for the treatment of peripheral nerve injuries, given the multi-modal mechanism of action not seen with other experimental therapies. A number of FDA-approved drugs that augment the GH axis are currently available, which may facilitate clinical translation.
机译:简介:周围神经损伤通常会导致运动和感觉缺陷。当前没有临床上可用于增强再生过程的治疗剂。进行外科手术修复后,轴突通常必须再生很长的距离才能到达并重新激活远端目标。在神经支配之前,神经支配的肌肉和雪旺氏细胞(SCs)的进行性萎缩会导致不良预后。基于生长激素(GH)的疗法具有加速轴突再生的潜力,同时又可限制神经支配之前的肌肉萎缩和远端再生途径。这些疗法作用于周围神经再生涉及的多种组织类型,以最终提高疗效,并回顾已进行的相关机械和翻译研究。我们还探讨了基于GH的疗法在改善周围神经损伤中的骨骼,肌腱和伤口愈合方面的潜在次要好处。模态作用机制是其他实验疗法所没有的。目前可获得许多增加GH轴的FDA批准药物,这可能有助于临床翻译。

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