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James P. Newman, MD; A. Neil Verity, PhD; Salim Hawatmeh; Willard E. Fee, Jr, MD; David J. Terris, MD

Arch Otolaryngol Head Neck Surg. 1996;122(4):399-403.

Abstract
Background
Adjunctive measures to enhance nerve repair have focused on a variety of trophic factors that alter the physiologic response to nerve injury through Schwann cell-axonal interactions.

Objective
To evaluate the effects of two trophic factors, ciliary neurotrophic factor and nerve growth factor, on axonal response to injury.

Design
A prospective, randomized, blinded animal study with a placebo control using lactated Ringer's solution.

Interventions
Rat sciatic nerves were transected and repaired as a model of injury following which experimental factors were delivered in vivo through an implantable osmotic pump.

Outcome Measures
Functional nerve recovery, muscle mass, and gene expression in the three experimental groups were evaluated.

Results
The ciliary neurotrophic factor group (n=6) showed a higher sciatic functional recovery (P=.003) and preservation of affected muscle mass (P=.03) compared with the nerve growth factor (n=8) and control (n=8) groups. Molecular analysis of injured nerves showed no difference in expression of ciliary neurotrophic factor, myelin basic protein, or low-affinity neurotrophin receptor messenger RNA among the three groups.

Conclusion
These data suggest that ciliary neurotrophic factor may serve as an important neurocytokine for axonal regrowth during peripheral nerve regeneration.

(Arch Otolaryngol Head Neck Surg. 1996;122:399-403)

Author Affiliations
From the Division of Otolaryngology–Head and Neck Surgery (Drs Newman, Fee, and Terris and Mr Hawatmeh) and Department of Neurobiology (Dr Verity), Stanford University Medical Center, Stanford, Calif.

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