Evaluation and comparison of the effects of artesunate, dexamethasone, and tacrolimus in rat sciatic nerve regeneration

Peripheral nerve injury is commonly encountered condition in clinical practice. Numerous methods and agents have been tried to accelerate nerve regeneration after injury. The effects of dexamethasone and tacrolimus, which were proven to have positive effects experimentally on nerve regeneration previously, were compared in the present study. There is no study in the literature comparing the effects of these two agents on nerve regeneration. Artesunate is an agent which has been used in traditional Chinese medicine for centuries. Today, in addition to being the most effective option for chloroquine-resistant malaria, there are also many studies demonstrating the anticancer, antiviral and anti-inflammatory effects of artesunate. In the literature, there is no study investigating the effect of artesunate on nerve regeneration. The present study investigated the efficacy of artesunate in nerve regeneration and it was compared with the effects of tacrolimus and dexamethasone. Thirty-six Wistar female rats were used in the study. The right sciatic nerves of the rats were exposed using blunt dissection under ketamine and xylazine anesthesia and then compression was applied to the nerve. In the sham group, the nerve was exposed but no compression was applied. Saline, vaseline, artesunate, tacrolimus, and dexamethasone impregnated gelatine sponges were administered to each of compression-treated groups. Walking track analysis and EMG measurement were performed in the rats at the end of the fourth week postoperatively. After the sacrification of the subjects, the nerve tissues were examined histopathologically. The data were assessed statistically using the Kruskal-Wallis test and one-way ANOVA analysis, and p<0.05 considered significant. According to the results of sciatic function index and EMG analysis, a statistically significant increase was observed in terms of nerve regeneration in the artesunate, tacrolimus and dexamethasone groups compared to the vaseline and saline groups. No statistical difference was noted among the artesunate, tacrolimus and dexamethasone groups. The present study revealed a positive effect of artesunate on nerve regeneration. This effect of artesunate is probably due to its anti-inflammatory characteristic. Based on the results of our study, tacrolimus, dexamethasone, and artesunate showed similar effects in terms of nerve regeneration. There is a need for new research investigating the effect of artesunate on nerve regeneration.