Survival and regeneration of cutaneous and muscular afferent neurons after peripheral nerve injury in adult rats

Peripheral nerve injury induces the retrograde degeneration of dorsal root ganglion (DRG) cells, which affects predominantly the small-diameter cutaneous afferent neurons. This study compares the time-course of retrograde cell death in cutaneous and muscular DRG cells after peripheral nerve transection as well as neuronal survival and axonal regeneration after primary repair or nerve grafting. For comparison, spinal motoneurons were also included in the study. Sural and medial gastrocnemius DRG neurons were retrogradely labeled with the fluorescent tracers Fast Blue (FB) or Fluoro-Gold (FG) from the homonymous transected nerves. Survival of labeled sural and gastrocnemius DRG cells was assessed at 3 days and 1–24 weeks after axotomy. To evaluate axonal regeneration, the sciatic nerve was transected proximally at 1 week after FB-labeling of the sural and medial gastrocnemius nerves and immediately reconstructed using primary repair or autologous nerve grafting. Twelve weeks later, the fluorescent tracer Fluoro-Ruby (FR) was applied 10 mm distal to the sciatic lesion in order to double-label sural and gastrocnemius neurons that had regenerated across the repair site. Counts of labeled gastrocnemius DRG neurons did not reveal any significant retrograde cell death after nerve transection. In contrast, sural axotomy induced a delayed loss of sural DRG cells, which amounted to 22% at 4 weeks and 43–48% at 8–24 weeks postoperatively. Proximal transection of the sciatic nerve at 1 week after injury to the sural or gastrocnemius nerves neither further increased retrograde DRG degeneration, nor did it affect survival of sural or gastrocnemius motoneurons. Primary repair or peripheral nerve grafting supported regeneration of 53–60% of the spinal motoneurons and 47–49% of the muscular DRG neurons at 13 weeks postoperatively. In the cutaneous DRG neurons, primary repair or peripheral nerve grafting increased survival by 19–30% and promoted regeneration of 46–66% of the cells. The present results suggest that cutaneous DRG neurons are more sensitive to peripheral nerve injury than muscular DRG cells, but that their regenerative capacity does not differ from that of the latter cells. However, the retrograde loss of cutaneous DRG cells taking place despite immediate nerve repair would still limit the recovery of cutaneous sensory functions.     

纤溶酶原激活剂及其相关分子在小鼠视神经损伤再生中的变化

目的:检测细胞外基质(ECM)中各蛋白酶在视神经损伤后的变化,分析ECM蛋白酶活性的变化与小鼠视神经损伤和损伤后再生之间的关系。方法:本实验采用建立小鼠视神经钳夹伤的动物模型,用WesternBlot方法检测小鼠视神经损伤后不同时间点神经丝(NF)、金属基质蛋白酶-9(MMP-9)、IgG的表达变化。同时采用原位酶谱分析法检测纤溶酶原激活剂(PA)活性在视神经损伤后各阶段的变化,并分析这种变化与纤维蛋白(原)沉积、髓鞘碎片清除等影响神经再生的因素之间的关系。结果:小鼠视神经损伤后发生进行性Wallerian变性,血-神经屏障(BNB)修复迟缓,沉积的纤维蛋白(原)于损伤后第2d清除。MMP-9在损伤后2d达到高峰,以后仍呈现高水平的表达,且均以前体形式出现。PA活性在损伤后第7d达到高峰,并持续至第28d。结论:视神经损伤后,损伤部位BNB重建、PA激活、纤维蛋白(原)的清除以及MMP-9的表达与周围神经截然不同,正是由于微环境的迥然差异,导致了中枢神经系统(CNS)髓鞘碎片清除不利、轴突再生障碍。     

Glial cell responses, complement and apolipoprotein J expression following axon injury in the neonatal rat

Immature motoneurons are highly susceptible to degeneration following axon injury. The response of perineuronal glia to axon injury may significantly influence neuronal survival and axon regeneration. We have examined the central reactions to neonatal facial nerve transection with emphasis on the expression of complement component C3 (C3) and the multifunctional apolipoprotein J (ApoJ). Axotomy was performed on one-day-old rats. Animals were perfused from eight hours to two weeks after the lesion. The astroglial marker, glial fibrillary acidic protein (GFAP) was increased from one day and the microglial marker OX-42 from two days after injury. ApoJ immunoreactivity was increased in axotomized neuronal perikarya and astroglial cells from one day postaxotomy, but no C3 immunoreactive profiles were found at any postoperative survival time. Cell proliferation as judged by bromodeoxyuridine labeling and immunoreactivity for the cyclin Ki-67 antigen (antibody MIB5) occurred only at two days after injury. Double immunostaining revealed that the vast majority of proliferating cells were microglia, although occasional cells double labeled astrocytes were found as well. Our results indicate that the non-neuronal response in neonatal animals differ from that of adult ones as follows: 1) microglia transform rapidly into phagocytes in parallel with the degeneration of axotomized neurons, 2) despite the presence of neuronal degeneration, no expression of C3 was found, and the upregulation of the expression of the complement C3 receptor (CR3) is delayed, 3) ApoJ is strongly upregulated in perineuronal astrocytes as well as in the axotomized motoneurons. The marked upregulation of ApoJ in both instances suggests a general role of this protein in the neuronal response to axotomy.     

Retrograde response to axotomy of motoneurons in the thoracic spinal cord of the aging cat.

The retrograde response of HRP-labelled intercostal motoneurons was compared in adult (1-2 years) and aging (10-15 years) cats, 64-68 days following crush of intercostal nerves or following nerve transection with proximal ligation. A comparison of the neuroglial response to these two lesions was also made. In both adult and aging cats, 64-68 days following nerve crush, most labelled motoneurons had a normal appearance. In contrast, 64-68 days following nerve transection and ligation the Nissl bodies of labelled motoneurons lacked the highly ordered ultrastructure characteristic of normal and control motoneurons. No axotomy-induced neuronal loss was found in aging cats. A three-fold increase in numbers of microglial cells was quantified in the ipsilateral ventral horn of aging cats following nerve transection and ligation. This increase was not seen following nerve crush in aging cats, nor following either type of nerve injury in adult cats. Numbers of astroglia and oligodendroglia were unaffected by axotomy in adult and aging animals.     

The influence of regeneration and nerve growth factor on the neuronal cell body reaction to injury

Summary The consequence of neuronal regeneration on the affected cell body has not been well documented previously. The long-term effects of either successful peripheral nerve (sciatic) regeneration or exogenously administered nerve growth factor (NGF) on dorsal root ganglion (DRG) neurons were determined. The degree of neuronal death and changes in neuronal size were measured after various injuries and treatments. The regenerative influence of the transected, distal sciatic-nerve segment on the neuronal cell body was examined under various standardized conditions (e.g. crush, transection followed by immediate epineurial anastomosis or transection with capping of the proximal nerve stump). Neuronal death was greatest in smaller neurons with diameters between 16 and 28 m. The data showed no difference in the degree of neuronal death between the crush injury and the anastomosis (both able to regenerate). However, the capped, proximal nerve (regeneration prevented) had a significantly higher incidence of neuronal death and less complete recovery from the early neuronal atrophy, which was initially observed in all three groups. The long-term effect on neuronal survival of transient NGF administration (three weeks) at the site of injury demonstrated partial protection by a decrease (55%) in the neuronal loss nine weeks after injury compared to controls. Either the distal nerve segment during regeneration or exogenously applied NGF is capable of mitigating the long-term effects of axotomy in the DRG neuronal cell body.     

Minocycline does not inhibit microglia proliferation or neuronal regeneration in the facial nucleus following crush injury

Minocycline is thought to be neuroprotective by inhibiting neuroinflammation (microglial activation) associated with neurodegenerative diseases. In this study we investigated the effect of minocycline specifically on microglial mitotic activity and neuronal regeneration within the facial nucleus following a nerve crush injury. Proliferation was measured by labeling the dividing microglia with 3H-thymidine and quantifying labeled cells throughout the facial nucleus on days 2, 3 and 4 post-axotomy. Regeneration patterns of the axotomized motoneurons were studied by labeling regenerating neurons with fluorogold at 7, 14 and 21 days post-axotomy. No significant difference was found between minocycline treated and control rats when comparing the 3H-thymidine labeled microglial cells or fluorogold labeled neurons at these post-injury time points. The findings show that microglia maintain the ability to become activated in vivo even in the presence of high levels of minocycline.     

脊髓小胶质细胞反应性在大鼠周围神经再生中的作用(英文)

为探讨大鼠坐骨神经损伤后脊髓小胶质细胞反应性、脊髓腹角运动神经元脱失与坐骨神经再生之间的关系,制备了SD大鼠右侧坐骨神经钳夹损伤模型,术后3d和7d测定相应脊髓节段小胶质细胞免疫反应性、腹角运动神经元数量,4周时于光镜和电镜下评价坐骨神经变性和再生。结果显示:(1)坐骨神经损伤后3d,脊髓腹角小胶质细胞OX-42免疫反应性开始明显增强(P<0.05);(2)脊髓腹角损伤同侧与对侧运动神经元数量比明显降低(P<0.05),说明同侧运动神经元存活数量减少;(3)组织学评价显示损伤神经再生不良;(4)simvastatin(一种降胆固醇药物,具有潜在的免疫调节作用)干预组较非simvastatin干预组小胶质细胞进一步激活,运动神经元存活数量增加,坐骨神经再生良好。本研究结果提示,脊髓腹角小胶质细胞的激活可能在大鼠周围神经损伤后的再生中发挥重要的保护作用。     

Diphenylpiperazines enhance regeneration after facial nerve injury

Immature rat facial motoneurons are very sensitive to injury with nearly 80% dying during the first week after axotomy. This motoneuron death is apoptotic, similar to that induced in neurons after tropic factor withdrawal. The diphenylpiperazines, flunarizine and cinnarizine, protect dorsal root ganglion neurons from death after withdrawal of trophic support, i.e., nerve growth factor withdrawal, in vitro. Similarly, the monoamine oxidase inhibitor, deprenyl, promotes survival of facial motoneurons after axotomy. These pharmacological agents were assessed both alone and in combination for their ability to prevent death in non-nerve growth factor dependent CNS motoneurons after facial nerve axotomy in newborn rats. Long-term experiments were done with the diphenylpiperazines to evaluate potential enhancement of regeneration. Facial nerve transection resulted in 78% neuronal loss in the injured compared with the contralateral, uninjured nucleus. Systemic administration of diphenylpiperazines for 1 week after facial nerve transection doubled the number of surviving motoneurons from 23% to 47%. Similar results were obtained with deprenyl. Combinations of diphenylpiperazines and deprenyl provide a similar degree of neuronal protection 1 week after injury as that obtained by either agent alone. We assessed the ability of diphenylpiperazines to protect facial motoneurons from death over a prolonged period and enhance subsequent regeneration. Motor neuron counts in rats treated with diphenylpiperazines for 1 month after injury and assessed 2 months later demonstrated long-term enhancement of neuronal protection with an increase of 45% in the number of horseradish peroxidase-labelled motoneurons. The diphenylpiperazines group had 80% more regenerated myelinated axons in the distal facial nerve than the control group. Thus, diphenylpiperazine treatment during the first month after injury provides long-term protection of non-nerve growth factor dependent CNS motoneurons with subsequent potentiation of long-term facial nerve regeneration.     

Choline acetyltransferase and calcitonin gene-related peptide immunoreactivity in motoneurons after different types of nerve injury

Summary This study examined changes in choline acetyltransferase and calcitonin gene-related peptide immunoreactivity in hypoglossal motoneurons of rats at 1, 3, 7, 20 and 50 days after three types of nerve injury: crush, transection and resection. Peripheral reinnervation was assayed by retrograde labelling of the motoneurons after injections of the exogenous protein, horseradish peroxidase, into the tongue. Maximal reduction in choline acetyltransferase immunostaining occurred at seven days after nerve damage and the amount of the decrease was related to the nature of the injury. The recovery of choline acetyltransferase to normal levels was related to the timing of reinnervation after nerve crush, but not after transection or resection injuries. In contrast to these findings, a rapid increase in calcitonin gene-related peptide immunoreactivity preceded the decrease in choline acetyltransferase levels. A striking increase in calcitonin gene-related peptide immunoreactivity was observed at one day postoperative and was maximal at three days postoperatively for all injuries. Later changes in calcitonin gene-related peptide levels were dependent on the type of injury. Increased calcitonin gene-related peptide staining persisted to 20 days after nerve crush. After nerve transection or resection, calcitonin gene-related peptide immunoreactivity decreased to basal levels at seven days postoperatively. This declination was followed by a second rise in calcitonin gene-related peptide immunolabeling at 20 days for nerve transection or at 50 days after resection. Nearly complete reinnervation was established by 20 days after nerve crush. At 50 days after transection, less than half the number of normally-labelled neurons contained horseradish peroxidase. At this time only 1% of those whose axons had been resected were labelled. These observations suggest that different mechanisms regulate the responses of choline acetyltransferase and calcitonin gene-related peptide to nerve injury. The present results indicate that choline acetyltransferase levels in motoneurons can not be used to predict either the likelihood of or the timing of reinnervation after nerve transection or resection. However, our results strengthen the premise that an increase of calcitonin gene-related peptide immunoreactivity serves as a reliable index for predicting nerve regeneration/reinnervation after cranial nerve injury.     

Characterisation of matrix metalloproteinases and the effects of a broad-spectrum inhibitor (BB-1101) in peripheral nerve regeneration

The effect of treatment with a broad-spectrum inhibitor (BB1101) of the matrix metalloproteinases (MMPs) on nerve regeneration and functional recovery after nerve crush was examined. Drug treatment had no effect on latency but from 63 days the compound muscle action potential was significantly increased and was no different to that in the sham-operated controls at 72 days. Levels of MMP mRNA expression, and the localisation and activity of MMP proteins, were examined in rats for a 2 month period following a nerve crush injury, and compared with sham-operated controls. The mRNA of all the MMPs studied was up-regulated by 5-10 days after nerve crush, and they remained up-regulated for 40-63 days, except for MMP-9 which was down-regulated by 10 days. MMP immunoreactivity was localised to Schwann cells, macrophages and endothelial cells, and with the exception of membrane type 1-MMP (MT1-MMP), it was more intense after nerve crush compared with sham-operated controls. Regenerating axons showed immunoreactivity for MMP-2 and MMP-3. In situ zymography confirmed that the activity of MMPs in the nerve was increased following crush but that the activity was greatly reduced in rats treated with BB-1101. Thus despite the inhibition of MMPs by BB-1101, the drug did not appear to essentially affect nerve degeneration or regeneration following nerve crush but that it could be beneficial in promoting the more effective reinnervation of muscles possibly by actions at the level of the muscles.     

Reducing transmitter release from nerve terminals influences motoneuron survival in developing rats

Motoneurons in neonatal rats die following injury to the peripheral nerve. However, this vulnerability to nerve injury declines rapidly so that nerve injury at five days of age results in little if any motoneuron death. We have proposed that the role of the target during this critical period of development is to up-regulate the release of transmitter from developing motor nerve terminals. Here we show that reducing the release of acetylcholine from nerve terminals in neonatal rats can affect motoneuron maturation and survival. The soleus muscle in neonatal rats was treated with either magnesium or hemicholinium, and the number of motoneurons that survived was established 10 weeks later by retrograde labelling. Following treatment with magnesium, only 58.1% (+/-10.4 S.E.M., n=5) of the motoneurons in the soleus motor pool survived, although hemicholinium had no effect on motoneuron survival. However, those motoneurons that survived following treatment with either magnesium or hemicholinium did not develop normally since they remained susceptible to axotomy-induced cell death for longer than normal. In adult animals in which the sciatic nerve was crushed at five days of age following prior treatment with either magnesium or hemicholinium, only 27.6% (+/-6.2 S.E.M., n=5) and 44% (+/-6.1 S.E.M., n=4) of motoneurons in the sciatic motor pool survived, respectively, although no motoneurons died following injury alone or when injury was preceded by treatment with control implants containing NaCl. These results indicate that the release of acetylcholine from motor nerve terminals plays an important role in the development and survival of motoneurons.     

Peripheral targets influence sensory-motor connectivity in the neonatal spinal cord: sciatic nerve axotomy in Bax-deficient mice

In neonatal animals, peripheral nerve axotomy induces cell death in the corresponding dorsal root ganglion neurons and motoneurons, indicating that trophic interactions between these neurons and their targets control neuronal survival at this age. However, axotomy-induced cell death masks the role of peripheral tissues in regulating the central connections between these neurons in neonates. Since we have shown in Bax-deficient mice (Bax-/-) that transection of the sciatic nerve at postnatal day (P) 0 rarely induced apoptosis in motoneurons, we examined whether peripheral nerve axotomy eliminates synaptic connections between group Ia afferents and motoneurons in Bax-/-. After the axotomy, we observed in P7 Bax-/- that many axons survived in the fourth lumber (L4) dorsal root and that primary afferent projections to L4 motor pools also remained. Sciatic nerve stimulation evoked synaptic responses in L4 ventral roots in these mice although the amplitudes were considerably smaller and the onset latencies longer compared with the controls. Our results suggest that the monosynaptic connection between group Ia afferents and motoneurons is morphologically and functionally preserved following axotomy. Peripheral tissues may modulate synaptic connectivity but do not contribute to the maintenance of primary afferent projections in the stretch reflex pathway at an immature stage.     

兔坐骨神经急性损伤的高频超声影像学观察

目的用高频超声观察兔坐骨神经急性损伤的超声图像表现,评价其临床诊断价值。方法16只健康家兔随机分为4组,建立兔坐骨神经急性损伤模型,分别在损伤后第1、2、4、8周,应用高频超声在同部位上观察双侧坐骨神经的声像图变化。结果坐骨神经损伤后,在不同阶段,高频超声均可观察到相应变化图像改变与神经损伤后退变、再生及肢体功能在动态变化上相一致。结论高频超声可实时准确反映神经退变和再生的过程,为诊断外周神经损伤提供新方法,对临床判断和预后提供客观依据。     

Effect of skilled and unskilled training on nerve regeneration and functional recovery

The most disabling aspect of human peripheral nerve injuries, the majority of which affect the upper limbs, is the loss of skilled hand movements. Activity-induced morphological and electrophysiological remodeling of the neuromuscular junction has been shown to influence nerve repair and functional recovery. In the current study, we determined the effects of two different treatments on the functional and morphological recovery after median and ulnar nerve injury. Adult Wistar male rats weighing 280 to 330 g at the time of surgery (N = 8-10 animals/group) were submitted to nerve crush and 1 week later began a 3-week course of motor rehabilitation involving either “skilled” (reaching for small food pellets) or “unskilled” (walking on a motorized treadmill) training. During this period, functional recovery was monitored weekly using staircase and cylinder tests. Histological and morphometric nerve analyses were used to assess nerve regeneration at the end of treatment. The functional evaluation demonstrated benefits of both tasks, but found no difference between them (P > 0.05). The unskilled training, however, induced a greater degree of nerve regeneration as evidenced by histological measurement (P < 0.05). These data provide evidence that both of the forelimb training tasks used in this study can accelerate functional recovery following brachial plexus injury.     

Over-expression of parvalbumin in transgenic mice rescues motoneurons from injury-induced cell death

Following nerve injury in neonatal rats, a large proportion of motoneurons die, possibly as a consequence of an increase in vulnerability to the excitotoxic effects of glutamate. Calcium-dependent glutamate excitotoxicity is thought to play a significant role not only in injury-induced motoneuron death, but also in motoneuron degeneration in diseases such as amyotrophic lateral sclerosis (ALS). Motoneurons are particularly vulnerable to calcium influx following glutamate receptor activation, as they lack a number of calcium binding proteins, such as calbindin-D(28k) and parvalbumin. Therefore, it is possible that increasing the ability of motoneurons to buffer intracellular calcium may protect them from cell death and prevent the decline in motor function that usually occurs as a consequence of motoneuron loss. In this study we have tested this possibility by examining the effect of neonatal axotomy on motoneuron survival and muscle force production in normal and transgenic mice that over-express parvalbumin in their motoneurons.The sciatic nerve was crushed in one hindlimb of new-born transgenic and wildtype mice. The effect on motoneuron survival was assessed 8 weeks later by retrograde labelling of motoneurons innervating the tibialis anterior muscle. Following nerve injury in wildtype mice, only 20.2% (+/-2.2, S.E.M.; n=4) of injured motoneurons survive long term compared with 47.2% (+/-4.4, S.E.M.; n=4) in parvalbumin over-expressing mice. Surprisingly, this dramatic increase in motoneuron survival was not reflected in a significant improvement in muscle function, since 8 weeks after injury there was no improvement in either maximal twitch and tetanic force, or muscle weights.Thus, inducing spinal motoneurons to express parvalbumin protects a large proportion of motoneurons from injury-induced cell death, but this is not sufficient to restore muscle function.     

失神经支配肌肉提取液对创伤性运动神经元胞体死亡的保护作用

周围神经损伤后的功能恢复常不尽如人意，原因之一是周围神经损伤会导致一定数量的神经元胞体死亡。对于感觉神经元胞体的退变死亡，于损伤局部连续施用神经生长因子即可取得较好的保护效应，但对于运动神经元胞体的损伤性死亡，目前尚无一种有效的保护因子。作者从失神经支配肌肉能诱导其邻近的正常运动神经纤维发芽生长这一现象受到启发，研究了失神经支配肌肉提取液（ＤＭＥ）对周围神经损伤所导致的运动神经无胞体死亡的保护作用。结果表明，用失去神经支配后５ｄ的骨骼肌制成的提取液最具运动神经元营养活性。经乳鼠坐骨神经损伤实验模型检测，这种自制的ＤＭＥ能保护８７．６％的脊髓腰段前角运动神经元在坐骨神经损伤后一个月继续存活，而正常骨骼肌提取液的保护率仅为３７．３％。如不加以保护，则神经元胞体的存活率仅为８％。本研究结果提示骨骼肌的失神经支配可能会引起肌肉的某些代谢的改变，从而合成和分泌一些靶源性运动神经营养因子。     

Regeneration in theXenopus tadpole optic nerve is preceded by a massive macrophage/microglial response

Summary Changes in the optic nerve following a crush lesion and during axonal regeneration have been studied inXenopus tadpoles, using ultrastructural and immunohistological methods. Degeneration of both unmyelinated and myelinated axons is very rapid and leads to the formation, within 5 days, of a nerve which consists largely of degeneration debris and cells. Immunohistological analysis with monoclonal antibody 5F4 shows that there is a rapid and extensive microglial/macrophage response to crush of the nerve. Regenerating axons have begun to enter the distal stump by 5 days and grow along the outer part of the nerve in close approximation to the astrocytic glia limitans. Between 5 and 10 days after nerve crush, regenerating axons reach and pass the chiasma. Macrophages are seen in the nerve at the site of the lesion within 1 h, and the response peaks between 3–5 days, just before axonal regeneration gets under way.     

Delayed loss of spinal motoneurons after peripheral nerve injury in adult rats: a quantitative morphological study

The existence of retrograde cell death in sensory dorsal root ganglion (DRG) cells after peripheral nerve injury is well established. However, with respect to retrograde motoneuron death after peripheral nerve injury, available data are conflicting. This may partly be due to the cell counting techniques used. In the present study, quantitative morphometric methods have been used to analyse retrograde motoneuron death induced by spinal nerve injury in adult rats. For comparison, DRG cells were also included in the study. The C7 spinal nerve was transected about 10 mm distal to the DRG and exposed to the fluorescent tracer fast blue in order to retrogradely label the spinal motoneurons and DRG cells of the C7 segment. At 1–16 weeks postoperatively, the nuclei of fast-blue-labelled C7 motoneurons and DRG cells were counted in consecutive 50-μm-thick serial sections. For comparison, the physical disector technique and measurements of neuronal density were also used to calculate motoneuron number. The counts of fast-blue-labelled motoneurons revealed a delayed motoneuron loss amounting to 21% and 31% after 8 and 16 weeks, respectively (P<0.001). The remaining motoneurons exhibited 20% (P<0.05) soma atrophy. Using the physical disector technique, the motoneuron loss was 23% (P<0.001) after 16 weeks. Calculations of neuronal density in Nissl-stained sections failed to reveal any motoneuron loss, although after correction for shrinkage of the ventral horn a 14% (P<0.001) motoneuron loss was found. The fast-blue-labelled DRG neurons displayed 51% (P<0.001) cell loss after 16 weeks, and the remaining cells showed 22% (P<0.001) soma atrophy. In summary, cervical spinal nerve injury induces retrograde degeneration of both motoneurons and DRG cells. However, to demonstrate the motoneuron loss adequate techniques for cell counts have to be employed. Electronic Publication     

Growth-associated protein-43 is elevated in the injured rat sciatic nerve after low power laser irradiation

Low power laser irradiation (LPLI) has been used in the treatment of peripheral nerve injury. In this study, we verified its therapeutic effect on neuronal regeneration by finding elevated immunoreactivities (IRs) of growth-associated protein-43 (GAP-43), which is up-regulated during neuronal regeneration. Twenty Sprague-Dawley rats received a standardized crush injury of the sciatic nerve, mimicking the clinical situations accompanying partial axonotmesis. The injured nerve received calculated LPLI therapy immediately after injury and for 4 consecutive days thereafter. The walking movements of the animals were scored using the sciatic functional index (SFI). In the laser treated rats, the SFI level was higher in the laser treated animals at 3-4 weeks while the SFIs of the laser treated and untreated rats reached normal levels at 5 weeks after surgery. In immunocytochemical study, although GAP-43 IRs increased both in the untreated control and the LPLI treated groups after injury, the number of GAP-43 IR nerve fibers was much more increased in the LPLI group than those in the control group. The elevated numbers of GAP-43 IR nerve fibers reached a peak 3 weeks after injury, and then declined in both the untreated control and the LPLI groups at 5 weeks, with no differences in the numbers of GAP-43 IR nerve fibers of the two groups at this stage. This immunocytochemical study using GAP-43 antibody study shows for the first time that LPLI has an effect on the early stages of the nerve recovery process following sciatic nerve injury.