KB-2796, a calcium channel blocker, ameliorates ischemic spinal cord damage in rabbits

Neuroprotective effect of calcium channel blocker against retinal ganglion cell damage under hypoxia

The purpose of this study was to determine whether iganidipine, nimodipine and lomerizine, potentially useful calcium channel blockers for ophthalmic treatment, have direct retinal neuroprotective effects against hypoxic damage in experimental in vitro model. We used purified retinal ganglion cells (RGCs) from newborn rats. RGCs were incubated in controlled-atmosphere incubator in which oxygen levels were reduced to 5% normal partial pressure and cell viability was assessed. We also examined the effect of calcium channel blockers on the calcium ion concentration in RGC under hypoxic stress by calcium imaging. Iganidipine, nimodipine and lomerizine (0.01-1 microM) increased the RGC viability. Increase in intra-RGC calcium ion concentration by hypoxic damage was reduced by these calcium channel blockers. In conclusion, iganidipine, nimodipine and lomerizine were effective against hypoxic RGC damage in vitro. This neuroprotective effect was thought to be mediated by blocking calcium ion influx into RGC. These findings suggest that iganidipine, nimodipine and lomerizine have a direct neuroprotective effect against RGC damage related to hypoxia.

Pharmacologic neuroprotection in experimental spinal cord ischemia: a systematic review

Various surgical procedures may cause temporary interruption of spinal cord blood supply and may result in irreversible ischemic injury and neurological deficits. The cascade of events that leads to neuronal death following ischemia may be amenable to pharmacological manipulations that aim to increase the tolerable duration of ischemia. Many agents have been evaluated in experimental spinal cord ischemia (SCI). In order to investigate whether an agent is available that justifies clinical evaluation, the literature on pharmacological neuroprotection in experimental SCI was systematically reviewed to assess the neuroprotective efficacy of the various agents. In addition, the strength of the evidence for neuroprotection was investigated by analyzing the methodology. The authors used a systematic review to conduct this evaluation. The included studies were analyzed for neuroprotection and methodology. In order to be able to compare the various agents for neuroprotective efficacy, relative risks and confidence intervals were calculated from the data in the results sections. A total of 103 studies were included. Seventy-nine different agents were tested. Only 14 of the agents tested did not afford protection at all. A large variation was observed in the experimental models to produce SCI. This variation limited comparison of the individual agents. In 48 studies involving 31 single agents, the relative risks and confidence intervals could be calculated. An analysis of the methodology revealed poor temperature management and lack of statistical power in the majority of the 103 studies. The results suggest that numerous agents may protect the spinal cord from transient ischemia. However, poor temperature management and lack of statistical power severely weakened the evidence. Consequently, clinical evaluation of pharmacological neuroprotection in surgical procedures that carry a risk of ischemic spinal cord damage is not justified on the basis of this study.