Saturday, April 27, 2013

Mammalian neurons usually do not divide, and their degeneration represents a permanent loss. Peripheral nerve fibers can regenerate if their perikaryons are not destroyed.

In contrast to nerve cells, neuroglia of the central nervous system—and Schwann cells and ganglionic satellite cells of the peripheral nervous system—are able to divide by mitosis. Spaces in the central nervous system left by nerve cells lost by disease or injury are invaded by neuroglia.

Because nerves are widely distributed throughout the body, they are often injured. When a nerve axon is transected, degenerative changes take place, followed by a reparative phase.

In a wounded nerve fiber, it is important to distinguish the changes occurring in the proximal segment from those in the distal segment. The proximal segment maintains its continuity with the trophic center (perikaryon) and frequently regenerates. The distal segment, separated from the nerve cell body, degenerates.

Axonal injury causes several changes in the perikaryon: chromatolysis, ie, dissolution of Nissl substances with a consequent decrease in cytoplasmic basophilia; an increase in the volume of the perikaryon; and migration of the nucleus to a peripheral position in the perikaryon.

In the nerve stub distal to the injury, both the axon and the myelin sheath degenerate completely, and their remnants, excluding their connective tissue and perineurial sheaths, are removed by macrophages. While these regressive changes take place, Schwann cells proliferate within the remaining connective tissue sleeve, giving rise to solid cellular columns. These rows of Schwann cells serve as guides to the sprouting axons formed during the reparative phase.

After the regressive changes, the proximal segment of the axon grows and branches, forming several filaments that progress in the direction of the columns of Schwann cells. Only fibers that penetrate these Schwann cell columns will continue to grow and reach an effector organ.

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