• Xiao-Bin Zhou, De-Xin Zou, Wei Gu, Dong Wang, Jian-Shu Feng, Jiang-Yong Wang, and Jun-Lin Zhou.
• Department of Orthopedics, The Third Hospital of Shi Jia-Zhuang, Hebei, People's Republic of China; Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China.
• World Neurosurg. 2018 Jun 1; 114: e11-e21.

BackgroundResearch has shown that ischemic preconditioning reduced the severity of ischemia-reperfusion injury in brain in rats, we have a hypothesis that repeated brief ischemia has positive effects on peripheral nerve damage. This study was conducted to investigate the potential protective effects of repeated brief ischemia on peripheral nerve regeneration using a rat model of experimental sciatic nerve transection injury.MethodsTreatment groups (groups A-D) received repeated, brief ischemia every 1 day/2 days/3 days/7 days. After surgery for 4, 8, 12 weeks, we evaluated sciatic functional index test, gastrocnemius muscle wet mass, axon and nerve fiber diameter, density, G-ratio, immunohistochemistry of S-100, vascular endothelial growth factor (VEGF), and the ultrastructure of the nerves.ResultsSciatic functional index test and muscle wet mass were improved on the repeated brief ischemia groups. Ischemia treatment resulted in a significant increase in axon and nerve fiber density as well as S-100 and VEGF-positive cell, which indicated that repeated brief ischemia promotes Schwann cell proliferation and reconstruction.ConclusionsThis study exhibits the positive effects of repeated brief ischemia in sciatic nerve transection injury, possibly in part because it can improve VEGF and the physiologic state of Schwann cells in the ischemic environment and then accelerate the ability of neurite outgrow.Copyright © 2018 Elsevier Inc. All rights reserved.

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