FK506 accelerates functional recovery following nerve grafting in a rat model

The sometimes dramatic and permanent functional deficits that result from severe peripheral nerve injuries provide compelling incentives to identify exogenous agents that may expedite axonal regrowth and avoid prolonged denervation of end organs. The purpose of this study was to identify whether the regular systemic administration of tacrolimus (FK506) or cyclosporin A (CsA) would influence the speed and efficiency of nerve regeneration through short nerve grafts. A total of 35 Buffalo rats each received a 2-cm posterior tibial nerve graft and were randomized to one of three experimental groups. Group I animals were left untreated, group II received daily CsA (5 mg/kg intraperitoneally), and group III received daily FK506 (1 mg/kg intraperitoneally). Walking tracks were obtained starting 3 weeks after graft placement and continuing biweekly for the next 7 weeks. FK506-treated animals fully recovered hindlimb function 7 days earlier than CsA-treated animals or untreated control animals. Regenerated nerves from one-half of each treatment group were harvested for histomorphometric analysis at 7 weeks, shortly after recovery was complete in the FK506-treatment group but not in the other two groups, and once again at 10.5 weeks when recovery of function had stabilized in all groups. At 7 weeks, FK506-treated animals had significantly greater fiber density and percentage of neural tissue per nerve and a significantly larger population of mature, myelinated fibers in comparison with either CsA-treated or untreated animals. The authors concluded that the daily, systemic administration of low-dose FK506 facilitates peripheral nerve recovery and regeneration after nerve grafting.