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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(02): 207-213
DOI: 10.1055/s-0041-1736467
Análise Sistemática e Metanálise
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Effect of Tacrolimus and Cyclosporine Immunosuppressants on Peripheral Nerve Regeneration: Systematic Review and Meta-analysis

Article in several languages: português | English
Stéphanie Farias Seixas 
1   Serviço de Cirurgia da Mão e Microcirurgia Reconstrutiva, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
,
Gabriele Carra Forte 
3   Departamento de Radiologia, Pontifícia Universidade Católica do Rio Grande do Sul, RS, Brasil
,
Gabriela Agne Magnus 
4   Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS Brasil
,
Valentina Stanham 
4   Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS Brasil
,
Rita Mattiello 
2   Programa de Pós-graduação em Pediatria e Saúde da Criança; Programa de Pós-graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
,
Jefferson Braga Silva 
1   Serviço de Cirurgia da Mão e Microcirurgia Reconstrutiva, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
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Abstract

Peripheral nerve damage is an important cause of seeking medical attention. It occurs when the continuity of structures is interrupted and the propagation of nervous impulses is blocked, affecting the functional capacity of individuals. To assess the effects of the immunosuppressants tacrolimus and cyclosporine on the regeneration of peripheral nerves, a systematic review of the literature was carried out. The articles included were published until September 2018 and proposed to evaluate the effects of the immunosuppressants tacrolimus and cyclosporine on nerve regeneration and neuroprotection, available in the MEDLINE, EMBASE, Cochrane Library, Web of Science, Oxford Pain Relief Database, and LILACS databases. The research analysed a total of 56 articles, of which 22 were included in the meta-analysis. Statistical analysis suggests the protective effect of tacrolimus in the regeneration of the number of myelinated axons (95% confidence interval [CI]: 0.93–2.39; p < 0.01); however, such effect was not observed in relation to cyclosporine (95%CI: - 0.38–1.18; p = 0.08) It also suggests that there is a significant relationship between the use of tacrolimus and myelin thickness (95%CI= 2.00–5.71; p < 0. 01). The use of immunosuppressants in the regeneration of peripheral nerve damage promotes an increase in the number of myelinated axons in general, regardless of the administered dose. In addition, it ensures greater myelin thickness, muscle weight and recovery of the sciatic functional index. However, heterogeneity was high in most analyses performed.

Keywords

nerve regeneration - peripheral nerve - immunosuppressive agents - FK506 - tacrolimus - cyclosporine

Material Suplementar

Supplementary Material



Publication History

Received: 18 January 2021

Accepted: 12 April 2021

Article published online:
27 May 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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