睫状神经营养因子抗体对眼外肌注射肉毒毒素后神经末梢萌芽的影响  

Effect of polyclonal antibodies against ciliary neurotrophic factor on botulinum toxin-induced axonai sprouting

作　　者：闫丽娟[1,2] 吴晓[1] 

机构地区：[1]首都医科大学附属北京同仁医院眼科中心,研究生100730 [2]北京市海淀医院眼科

出　　处：《眼科》2008年第5期323-326,共4页Ophthalmology in China

摘　　要：目的观察多克隆睫状神经营养因子(CNTF)抗体对肉毒毒素(BTX)注射眼外肌后引起的神经末梢萌芽的抑制作用及对肌肉的影响。设计实验性研究。研究对象20只新西兰大白兔。方法随机取10只兔,左上直肌作为空白对照(1组),右上直肌直视下注射A型肉毒毒素(BTXA)2.5U(3组),14天后全麻下取出双上直肌标本;另外10只兔左上直肌注射生理盐水对照(2组),右上直肌注射BTXA 2.5U后第4天,将50μl CNTF抗体一次性注射到右眼上直肌(4组),14天后取出双上直肌标本。标本行电镜观察、乙酰胆碱酯酶染色及Bielschowsky神经末梢银染法显示神经末稍萌芽,使用Leica显微镜成像系统计数及测量。主要指标眼外肌有萌芽终板数、平均萌芽总长度及电镜超微结构变化。结果眼外肌有萌芽终板数和平均萌芽总长度,1组分别为5.75%和10.53μm;2组为6.11%和11.16μm;3组为84.04%和170.71μm;4组为54.77%和68.12μm;差异均有统计学意义(P均=0.000)。电镜超微结构观察显示:3组肌肉明显萎缩,肌纤维和神经结构无明显改变;而再注射CNTF抗体4组,可见部分肌丝断裂融解,变性的肌细胞坏死崩解成细胞碎片,引起部分肌肉不可逆性破坏,而神经髓鞘及运动终板结构无明显改变。结论多克隆CNTF抗体可以抑制BTX诱发的神经萌芽,引起局部肌肉不可逆性破坏,从而可能延长肌麻痹恢复的时间,提示多克隆CNTF抗体可能延长BTX的肌麻痹作用。Objective To study how polyelonal antibodies against ciliary neurotrophic factor （CNTF） reduce botulinum toxin-induced axonal sprouting and affect paralytic muscle. Design Experimental study. Participants 20 New Zealand rabbits. Methods In 10 rabbits randomly selected, left superior rectus were as control （Group 1）,right superror rectus were injected with botulinum toxin A （BTXA） 2.5U （Group 3）. At 14th day, bilateral superior recti were taken out under general anaesthesia. In the other 10 rabbits, left superior recti were injected equivalent physical saline （NS） as control （Group 2）; right superior recti were injected with BTXA 2.5U, after 4 days, injected with 50 ul polyclonal antibodies against CNTF at same site （Group 4）. And at 14th day, bilateral superior recti were taken out for electron microscopy, dyed with acetylcholinesterase, argentums （Ag） to show nerve axonal sprout, and accounted and measured with Leica microsystems. Main Outcome Measures The mean number of sprouts and the mean total length of sprouts, and the ultrastructure change of muscle by electron microscopy. Results In Group 1, the mean number of sprouts and the mean total length of sprouts were 5.75% and 10.53 um respectively; Group 2 were 6.11% and 11.16 um; Group 3 were 84.04% and 170.71 um; and Group 4 were 54.77% and 68.12 p,m. The differences were statistically significant （all P=-0.000）. Electron microscopy showed that after administration BTXA alone （Group 3）, muscle atrophied obviously, nerve myelin sheath increased, while the structure of nerve and muscle remain invariable. The Group 4 showed that local myofilament disrupted and dissolved, degenerative myocytes necrotized and disintegrated into fragments, which led to partial unreversible destroy. Conclusion Polyelonal anti-CNTF can reduce BTXA-induced axonal sprouting, lead to partial unreversible destroy of muscle, which may prolong the time of paralytic muscle resuming. It suggests that polyclonal anti-CNTF could prolong the duration of mu

关 键 词：睫状神经营养因子抗体 A型肉毒毒素 眼外肌 

分 类 号：R777[医药卫生—眼科]