Evaluation and Comparison of the Effects of Artesunate, Dexamethasone, and Tacrolimus on Sciatic Nerve Regeneration

Purpose: To examine the effect of topical artesunate treatment on peripheral nerve regeneration and compare it with the effects of topical tacrolimus and dexamethasone on nerve regeneration.

Materials And Methods: Thirty-two Wistar albino rats were used in this study. The rats were divided into 6 groups: sham, saline, petrolatum, artesunate, tacrolimus, and dexamethasone. A compression injury was generated in the right sciatic nerve in all groups except the sham group. In the sham group, the nerve was dissected but compression was not applied. In the groups in which compression was applied, the agents were absorbed through resorbable gelatin sponges applied to the injured region. At the end of 4 weeks, walking analysis, electromyographic measurements, and histopathologic examinations were conducted.

Results: When the sciatic function index and electrophysiologic measurements were evaluated, artesunate, tacrolimus, and dexamethasone exhibited positive effects on nerve regeneration (P < .05); there were no significant differences among these 3 agents (P > .05). Histopathologic examination showed that artesunate decreased fibrosis scores and inflammation and increased the diameter of myelinated axons; tacrolimus decreased fibroblast scores; and dexamethasone only decreased fibrosis scores (P < .05). Immunohistochemical analysis showed that the artesunate and dexamethasone groups had more positive immunoreactivity to nerve growth factor than did the saline group (P < .05).

Conclusions: Topical artesunate treatment had a positive effect on peripheral nerve regeneration. There were no relevant differences between the topical forms of dexamethasone and tacrolimus for peripheral nerve regeneration.