Nerve preservation is important in almost every kind of surgery, but it can be challenging, said Doctor Quyen T. Nguyen, assistant professor of Head and Neck Surgery. "For example, if the nerves are invaded by a tumor. Or, if surgery is required in the setting of trauma or infection, the affected nerves might not look as they normally would, or their location may be distorted."
Nguyen and colleagues developed and injected a systemic, fluorescently labeled peptide (a protein fragment consisting of amino acids) into mice. The peptide preferentially binds to peripheral nerve tissue, creating a distinct contrast (up to tenfold) from adjacent non-nerve tissues. The effect occurs within two hours and lasts for six to eight hours, with no observable effect upon the activity of the fluorescent nerves or behavior of the animals.
"Of course, we have yet to test the peptide in patients, but we have shown that the fluorescent probe also labels nerves in human tissue samples," Nguyen said. Interestingly, fluorescence labeling occurs even in nerves that have been damaged or severed, provided they retain a blood supply. The discovery suggests fluorescence labeling might be a useful tool in future surgeries to repair injured nerves.
Currently, the ability to avoid accidental damage to nerves depends upon the skill of the surgeon, and electromyographic monitoring. This technique employs stimulating electrodes to identify motor nerves, but not sensory nerves such as the neurovascular bundle around the prostate gland.
The researchers continue to refine their probes in animal models and prepare for eventual human clinical trials.
MEDICA.de; Source: University of California - San Diego