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image of Corticosteroids for Nerve Regeneration: A Narrative Review

Abstract

Despite the use of advanced microsurgical techniques, around one-third of peripheral nerve injuries still show inadequate functional regeneration and incomplete healing. Peri- and intraneural nerve damage leads to pathophysiologic alterations, including morphological and metabolic changes, where the nerve is disrupted. Animal research shows no proven adjustment drugs for peripheral nerve regeneration, but studies suggest medicines can speed up regeneration using functional and histological parameters after nerve injury. Factors affecting nerve regeneration effectiveness include injury type, age, regeneration time, procedures, and materials. Complete regeneration and functional recovery are rarely achieved, regardless of the kind of pharmaceutical therapy used, necessitating further research into nerve regeneration. Future research could enhance corticosteroid doses with additional drugs, increasing clinical use. This review explores the mechanism of action of corticosteroids Dexamethasone, Betamethasone, and Methylprednisolone in peripheral nerve regeneration experiments, highlighting the potential for enhanced nerve injury.

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2025-06-19
2025-09-01
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References

  1. Catala M. Kubis N. Gross anatomy and development of the peripheral nervous system. Handb. Clin. Neurol. 2013 115 29 41 10.1016/B978‑0‑444‑52902‑2.00003‑5
    [Google Scholar]
  2. Splittgerber R. Snell’s Clinical Neuroanatomy 8th Ed., Lippincott Williams & Wilkins. Philadelphia, Pennsylvania, United States 2018.
  3. Ross MH, Pawlina W. Histology 5th Ed., Lippincott Williams & Wilkins. Philadelphia, Pennsylvania, United States 2006.
  4. Gamble H.J. Eames R.A. An electron microscope study of the connective tissues of the human peripheral nerve. J. Anat. 1964 98 Pt 4 655 663 14229996
    [Google Scholar]
  5. Parmantier E. Lynn B. Lawson D. Turmaine M. Namini S.S. Chakrabarti L. McMahon A.P. Jessen K.R. Mirsky R. Schwann cell-derived desert hedgehog controls the development of peripheral nerve sheaths. Neuron 1999 23 4 713 724 10482238
    [Google Scholar]
  6. Geuna S. Raimondo S. Ronchi G. Di Scipio F. Tos P. Czaja K. Fornaro M. Histology of the peripheral nerve and changes occurring during nerve regeneration. Int. Rev. Neurobiol. 2009 87 27 46 10.1016/S0074‑7742(09)87003‑7 19682632
    [Google Scholar]
  7. Lee S.K. Wolfe S.W. Peripheral nerve injury and repair. J. Am. Acad. Orthop. Surg. 2000 8 4 243 252 10951113
    [Google Scholar]
  8. Moon L.D.F. Chromatolysis: Do injured axons regenerate poorly when ribonucleases attack rough endoplasmic reticulum, ribosomes and RNA? Dev. Neurobiol. 2018 78 10 1011 1024 10.1002/dneu.22625 30027624
    [Google Scholar]
  9. Seddon HJ. Lesions of individual nerves: Lower limb. Surgical Disorders of the Peripheral Nerves. Williams & Wilkins, Baltimore, United States 1972: 505-79.
  10. Menorca R.M.G. Fussell T.S. Elfar J.C. Nerve physiology. Hand Clin. 2013 29 3 317 330 10.1016/j.hcl.2013.04.002 23895713
    [Google Scholar]
  11. Aguayo A.J. Peyronnard J.M. Bray G.M. A quantitative ultrastructural study of regeneration from isolated proximal stumps of transected unmyelinated nerves. J. Neuropathol. Exp. Neurol. 1973 32 2 256 270 10.1097/00005072‑197304000‑00006 4576231
    [Google Scholar]
  12. Lunn E.R. Brown M.C. Perry V.H. The pattern of axonal degeneration in the peripheral nervous system varies with different types of lesion. Neuroscience 1990 35 1 157 165 10.1016/0306‑4522(90)90130‑V 2359492
    [Google Scholar]
  13. Guenard V Dinarello C Weston P Aebischer P Peripheral nerve regeneration is impeded by interleukin-1 receptor antagonist released from a polymeric guidance channel. J. Neurosci. Res. 1991 29 2 396 400 10.1002/jnr.490290315
    [Google Scholar]
  14. Battiston B. Papalia I. Tos P. Geuna S. Peripheral nerve repair and regeneration research: A historical note. Int. Rev. Neurobiol. 2009 87 1 7 10.1016/S0074‑7742(09)87001‑3 19682630
    [Google Scholar]
  15. Schro¨der J.M. Altered ratio between axon diameter and myelin sheath thickness in regenerated nerve fibers. Brain Res. 1972 45 1 49 65 10.1016/0006‑8993(72)90215‑6 4561629
    [Google Scholar]
  16. Stoll G. Griffin J.W. Li C.Y. Trapp B.D. Wallerian degeneration in the peripheral nervous system: Participation of both Schwann cells and macrophages in myelin degradation. J. Neurocytol. 1989 18 5 671 683 10.1007/BF01187086 2614485
    [Google Scholar]
  17. Williams D.M. Clinical pharmacology of corticosteroids. Respir. Care 2018 63 6 655 670 10.4187/respcare.06314 29794202
    [Google Scholar]
  18. Shaikh S Verma H Yadav N Jauhari M Bullangowda J Applications of steroid in clinical practice: A review. ISRN Anesthesiol. 2012 2012 7 1 8 10.5402/2012/985495
    [Google Scholar]
  19. Moss G.P. Nomenclature of steroids (Recommendations 1989). Pure Appl. Chem. 1989 61 10 1783 1822 10.1351/pac198961101783
    [Google Scholar]
  20. Ciobotaru O.R. Lupu M.N. Rebegea L. Ciobotaru O.C. Duca O.M. Tatu A.L. Voinescu C.D. Stoleriu G. Earar K. Miulescu M. Dexamethasone-chemical structure and mechanisms of action in prophylaxis of postoperative side effects. Revista de Chimie 2019 70 3 843 847 10.37358/RC.19.3.7017
    [Google Scholar]
  21. Sairam KV Thejaswini J. Raju M.P. Chandan R. Gurupadayya B. Mruthunjaya K. RP-HPLC method development for the quantitative determination of dexamethasone in herbal formulation. World J. Pharm. Res. 2014 4 2 1148 1157
    [Google Scholar]
  22. Feng X Yuan W Dexamethasone enhanced functional recovery after sciatic nerve crush injury in rats. Biomed. Res. Int. 2015 2015 627923 10.1155/2015/627923
    [Google Scholar]
  23. Gao W. Tong D. Li Q. Huang P. Zhang F. Dexamethasone promotes regeneration of crushed inferior alveolar nerve by inhibiting NF-κB activation in adult rats. Arch. Oral Biol. 2017 80 101 109 10.1016/j.archoralbio.2017.03.025 28412609
    [Google Scholar]
  24. Mohammadi R. Amini K. Eskafian H. Betamethasone-enhanced vein graft conduit accelerates functional recovery in the rat sciatic nerve gap. J. Oral Maxillofac. Surg. 2013 71 4 786 792 10.1016/j.joms.2012.08.009 23084563
    [Google Scholar]
  25. Uzun T Toptas O Saylan A Carver H Turkoglu SA Evaluation and comparison of the effects of artesunate, dexamethasone, and tacrolimus on sciatic nerve regeneration. J. Oral. Maxillofac. Surg. 2019 77 5 1092.e1-2 10.1016/j.joms.2018.12.019
    [Google Scholar]
  26. Sun H. Yang T. Li Q. Zhu Z. Wang L. Bai G. Li D. Li Q. Wang W. Experimetal research dexamethasone and vitamin B12 synergistically promote peripheral nerve regeneration in rats by upregulating the expression of brain-derived neurotrophic factor. Arch. Med. Sci. 2012 5 5 924 930 10.5114/aoms.2012.31623 23185205
    [Google Scholar]
  27. Betamethasone, betamethasone sodium phosphate and betamethasone acetate (Monograph). 2024 Available from: https://www.drugs.com/monograph/betamethasone-systemic.html#ra
  28. de Groot AC Monographs in Contact Allergy Boca Raton, Florida, CRC Press 2021
    [Google Scholar]
  29. Sadraie SH Parivar K Arabi F Moattari M Kaka G Mansouri K Study of transected sciatic nerve repair by amniotic membrane with betamethasone in adult Albino Wistar rats. Arch. Iran Med. 2016 19 9 612 617 27631175
    [Google Scholar]
  30. Al-Bishri A. Forsgren S. Al-Thobaiti Y. Sunzel B. Rosenquist J. Effect of betamethasone on the degree of macrophage recruitment and nerve growth factor receptor p75 immunoreaction during recovery of the sciatic nerve after injury: An experimental study in rats. Br. J. Oral Maxillofac. Surg. 2008 46 6 455 459 10.1016/j.bjoms.2008.01.020 18499314
    [Google Scholar]
  31. Moattari M. Kouchesfehani H. Kaka G. Sadraie H. Naghdi M. Study of transected sciatic nerve repair by biodegradable membrane and betamethasone in adult Albino Wistar rats. Turk Neurosurg. 2017 28 645 653 10.5137/1019‑5149.JTN.20047‑17.1 29708578
    [Google Scholar]
  32. Sencar L. Güven M. Şaker D. Sapmaz T. Tuli A. Polat S. Ultrastructural effects of nerve growth factor and betamethasone on nerve regeneration after experimental nerve injury. Ultrastruct. Pathol. 2020 44 4-6 436 449 10.1080/01913123.2020.1850965 33213258
    [Google Scholar]
  33. Langhoff E. Ladefoged J. Relative immunosuppressive potency of various corticosteroids measured in vitro. Eur. J. Clin. Pharmacol. 1983 25 4 459 462 10.1007/BF00542111 6653640
    [Google Scholar]
  34. Timmermans S. Souffriau J. Libert C. A general introduction to glucocorticoid biology. Front. Immunol. 2019 10 1545 10.3389/fimmu.2019.01545 31333672
    [Google Scholar]
  35. Methylprednisolone. 2004 Available from: https://pubchem.ncbi.nlm.nih.gov/compound/Methylprednisolone#section=Collision-Cross-Section
  36. Bracken M.B. Shepard M.J. Collins W.F. Holford T.R. Young W. Baskin D.S. Eisenberg H.M. Flamm E. Leo-Summers L. Maroon J. Marshall L.F. Perot P.L. Jr Piepmeier J. Sonntag V.K.H. Wagner F.C. Wilberger J.E. Winn H.R. A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the second national acute spinal cord injury study. N. Engl. J. Med. 1990 322 20 1405 1411 10.1056/NEJM199005173222001 2278545
    [Google Scholar]
  37. Ozturk O. Tezcan A.H. Adali Y. Yıldırım C.H. Aksoy O. Yagmurdur H. Bilge A. Effect of ozone and methylprednisolone treatment following crush type sciatic nerve injury. Acta Cir. Bras. 2016 31 11 730 735 10.1590/s0102‑865020160110000005 27982260
    [Google Scholar]
  38. Mehrshad A. Shahraki M. Ehteshamfar S. Local administration of methylprednisolone laden hydrogel enhances functional recovery of transected sciatic nerve in rat. Bull. Emerg. Trauma 2017 5 4 231 239 10.18869/acadpub.beat.5.4.509 29177169
    [Google Scholar]
  39. Karlidag T. Yildiz M. Yalcin S. Colakoglu N. Kaygusuz I. Sapmaz E. Evaluation of the effect of methylprednisolone and N-acetylcystein on anastomotic degeneration and regeneraton of the facial nerve. Auris Nasus Larynx 2012 39 2 145 150 21601394
    [Google Scholar]
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