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Costimulation blockade in transplantation of nerve allografts: long-term effects

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Costimulation blockade can prevent rejection of nerve allografts in short-term studies. We tested if costimulation blockade also prevented rejection of nerve allografts in long-term experiments, thereby improving functional recovery. A 7-mm sciatic nerve defect in C57/BL6 mice was bridged either by nerve allografts from Balb/C mice or by isogenic nerve grafts (isografts) from C57/BL6 mice. Costimulation blockade in the form of a triple treatment with anti-LFA-1, anti-CD40L, and CTLA4Ig was given at post-operative days 0, 2, 4, and 6 (intraperitoneal). Control mice (placebo; allografts) with nerve grafts were treated with isotype antibodies during the same time period. After 49 days, tetanic muscle force, wet weight of gastrocnemius muscle, histology, and morphometry in the tibial nerve were evaluated. Costimulation blockade diminished rejection of the nerve allografts. Axons bridged the graft. Treatment increased wet weight of the gastrocnemius muscle and resulted in a higher mean myelin area/nerve fiber in the tibial nerve distal to the nerve grafts. Tetanic muscle force and number of axons in tibial nerve showed no differences between groups. We conclude that rejection is suppressed by costimulation blockade. Treatment improves recovery of target muscle and myelination after nerve allografting.
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Keywords: costimulation blockade; functional recovery; nerve allografts; nerve regeneration; sciatic nerve

Document Type: Research Article

Affiliations: 1: Department of Clinical Sciences/Hand Surgery, Malmö University Hospital, Malmö, Sweden 2: Department of Cell and Organism Biology, University of Lund, Lund, Sweden 3: Department of Clinical Sciences/Surgery, Malmö University Hospital, Malmö, Sweden 4: Department of Heart Diseases, Cardiothoracic Surgery, Haukeland University Hospital, University of Bergen, Bergen, Norway

Publication date: September 1, 2008

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