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Quadri SA, Farooqui M, Ikram A, Zafar A, Khan MA, Suriya SS, Claus CF, Fiani B, Rahman M, Ramachandran A, Armstrong IIT, Taqi MA, Mortazavi MM. Recent update on basic mechanisms of spinal cord injury. Neurosurg Rev 2018; 43:425-441. [PMID: 29998371 DOI: 10.1007/s10143-018-1008-3] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/20/2018] [Accepted: 07/06/2018] [Indexed: 12/20/2022]
Abstract
Spinal cord injury (SCI) is a life-shattering neurological condition that affects between 250,000 and 500,000 individuals each year with an estimated two to three million people worldwide living with an SCI-related disability. The incidence in the USA and Canada is more than that in other countries with motor vehicle accidents being the most common cause, while violence being most common in the developing nations. Its incidence is two- to fivefold higher in males, with a peak in younger adults. Apart from the economic burden associated with medical care costs, SCI predominantly affects a younger adult population. Therefore, the psychological impact of adaptation of an average healthy individual as a paraplegic or quadriplegic with bladder, bowel, or sexual dysfunction in their early life can be devastating. People with SCI are two to five times more likely to die prematurely, with worse survival rates in low- and middle-income countries. This devastating disorder has a complex and multifaceted mechanism. Recently, a lot of research has been published on the restoration of locomotor activity and the therapeutic strategies. Therefore, it is imperative for the treating physicians to understand the complex underlying pathophysiological mechanisms of SCI.
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Affiliation(s)
- Syed A Quadri
- California Institute of Neuroscience, 2100 Lynn Road, Suite 120, Thousand Oaks, CA, 91360, USA. .,National Skull Base Center, Thousand Oaks, CA, USA.
| | - Mudassir Farooqui
- Department of Neurology, University of New Mexico, Albuquerque, NM, USA
| | - Asad Ikram
- Department of Neurology, University of New Mexico, Albuquerque, NM, USA
| | - Atif Zafar
- Department of Neurology, University of New Mexico, Albuquerque, NM, USA
| | - Muhammad Adnan Khan
- California Institute of Neuroscience, 2100 Lynn Road, Suite 120, Thousand Oaks, CA, 91360, USA.,National Skull Base Center, Thousand Oaks, CA, USA
| | - Sajid S Suriya
- California Institute of Neuroscience, 2100 Lynn Road, Suite 120, Thousand Oaks, CA, 91360, USA.,National Skull Base Center, Thousand Oaks, CA, USA
| | - Chad F Claus
- Department of Neurosurgery, St. John Providence Hospital and Medical Centers, Michigan State University, Southfield, MI, USA
| | - Brian Fiani
- Department of Neurosurgery, Desert Regional Medical Center, Palm Springs, CA, USA
| | - Mohammed Rahman
- Department of Neurology, Desert Regional Medical Center, Palm Springs, CA, USA
| | - Anirudh Ramachandran
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA
| | - Ian I T Armstrong
- California Institute of Neuroscience, 2100 Lynn Road, Suite 120, Thousand Oaks, CA, 91360, USA.,National Skull Base Center, Thousand Oaks, CA, USA
| | - Muhammad A Taqi
- California Institute of Neuroscience, 2100 Lynn Road, Suite 120, Thousand Oaks, CA, 91360, USA.,National Skull Base Center, Thousand Oaks, CA, USA
| | - Martin M Mortazavi
- California Institute of Neuroscience, 2100 Lynn Road, Suite 120, Thousand Oaks, CA, 91360, USA.,National Skull Base Center, Thousand Oaks, CA, USA
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Kushchayev SV, Giers MB, Hom Eng D, Martirosyan NL, Eschbacher JM, Mortazavi MM, Theodore N, Panitch A, Preul MC. Hyaluronic acid scaffold has a neuroprotective effect in hemisection spinal cord injury. J Neurosurg Spine 2016; 25:114-24. [PMID: 26943251 DOI: 10.3171/2015.9.spine15628] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Spinal cord injury occurs in 2 phases. The initial trauma is followed by inflammation that leads to fibrous scar tissue, glial scarring, and cavity formation. Scarring causes further axon death around and above the injury. A reduction in secondary injury could lead to functional improvement. In this study, hyaluronic acid (HA) hydrogels were implanted into the gap formed in the hemisected spinal cord of Sprague-Dawley rats in an attempt to attenuate damage and regenerate tissue.
METHODS
A T-10 hemisection spinal cord injury was created in adult male Sprague-Dawley rats; the rats were assigned to a sham, control (phosphate-buffered saline), or HA hydrogel–treated group. One cohort of 23 animals was followed for 12 weeks and underwent weekly behavioral assessments. At 12 weeks, retrograde tracing was performed by injecting Fluoro-Gold in the left L-2 gray matter. At 14 weeks, the animals were killed. The volume of the lesion and the number of cells labeled from retrograde tracing were calculated. Animals in a separate cohort were killed at 8 or 16 weeks and perfused for immunohistochemical analysis and transmission electron microscopy. Samples were stained using H & E, neurofilament stain (neurons and axons), silver stain (disrupted axons), glial fibrillary acidic protein stain (astrocytes), and Iba1 stain (mononuclear cells).
RESULTS
The lesions were significantly smaller in size and there were more retrograde-labeled cells in the red nuclei of the HA hydrogel–treated rats than in those of the controls; however, the behavioral assessments revealed no differences between the groups. The immunohistochemical analyses revealed decreased fibrous scarring and increased retention of organized intact axonal tissue in the HA hydrogel–treated group. There was a decreased presence of inflammatory cells in the HA hydrogel–treated group. No axonal or neuronal regeneration was observed.
CONCLUSIONS
The results of these experiments show that HA hydrogel had a neuroprotective effect on the spinal cord by decreasing the magnitude of secondary injury after a lacerating spinal cord injury. Although regeneration and behavioral improvement were not observed, the reduction in disorganized scar tissue and the retention of neurons near and above the lesion are important for future regenerative efforts. In addition, this gel would be useful as the base substrate in the development of a more complex scaffold.
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Affiliation(s)
- Sergiy V. Kushchayev
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix
| | - Morgan B. Giers
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix
| | - Doris Hom Eng
- 2School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona; and
| | - Nikolay L. Martirosyan
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix
| | - Jennifer M. Eschbacher
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix
| | - Martin M. Mortazavi
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix
| | - Nicholas Theodore
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix
| | - Alyssa Panitch
- 3Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana
| | - Mark C. Preul
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix
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Mortazavi MM, Jaber M, Adeeb N, Deep A, Hose N, Rezaei M, Fard SA, Kateb B, Yashar P, Liker MA, Tubbs RS. Engraftment of neural stem cells in the treatment of spinal cord injury. TRANSLATIONAL RESEARCH IN ANATOMY 2015. [DOI: 10.1016/j.tria.2015.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Teixeira FG, Carvalho MM, Sousa N, Salgado AJ. Mesenchymal stem cells secretome: a new paradigm for central nervous system regeneration? Cell Mol Life Sci 2013; 70:3871-82. [PMID: 23456256 PMCID: PMC11113366 DOI: 10.1007/s00018-013-1290-8] [Citation(s) in RCA: 220] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 01/22/2013] [Accepted: 02/04/2013] [Indexed: 12/15/2022]
Abstract
The low regeneration potential of the central nervous system (CNS) represents a challenge for the development of new therapeutic strategies. Mesenchymal stem cells (MSCs) have been proposed as a possible therapeutic tool for CNS disorders. In addition to their differentiation potential, it is well accepted nowadays that their beneficial actions can also be mediated by their secretome. Indeed, it was already demonstrated, both in vitro and in vivo, that MSCs are able to secrete a broad range of neuroregulatory factors that promote an increase in neurogenesis, inhibition of apoptosis and glial scar formation, immunomodulation, angiogenesis, neuronal and glial cell survival, as well as relevant neuroprotective actions on different pathophysiological contexts. Considering their protective action in lesioned sites, MSCs' secretome might also improve the integration of local progenitor cells in neuroregeneration processes, opening a door for their future use as therapeutical strategies in human clinical trials. Thus, in this review we analyze the current understanding of MSCs secretome as a new paradigm for the treatment of CNS neurodegenerative diseases.
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Affiliation(s)
- Fábio G. Teixeira
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Miguel M. Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - António J. Salgado
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Cao HQ, Dong ED. An update on spinal cord injury research. Neurosci Bull 2012; 29:94-102. [PMID: 23124646 DOI: 10.1007/s12264-012-1277-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 07/26/2012] [Indexed: 02/06/2023] Open
Abstract
Spinal cord injury (SCI) can have a range of debilitating effects and permanently alter the capabilities and quality of life of survivors. The first specialized centers of care for SCI were established in 1944 and since then an increasing amount of research has been carried out in this area. Despite this, the present treatment and care levels for SCI are not comparable to those in other areas of medicine. In the clinic, the aim of SCI treatment is primarily to limit secondary damage by reducing compression in trauma spots and stabilizing the spinal column. Currently, no effective strategy for functional recovery is offered. In this review, we focus on research progress on the molecular mechanisms underlying SCI, and assess the treatment outcomes of SCI in animal models, i.e., neurotrophins and stem cells are discussed as pre-clinical therapies in animal models. We also assess the resources available and national research projects carried out on SCI in China in recent years, as well as making recommendations for the future allocation of funds in this area.
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Affiliation(s)
- He-Qi Cao
- Division of Neurological Disorders and Mental Health, Department of Health Sciences, National Natural Science Foundation of China, Beijing, 100085, China.
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Galli R, Uckermann O, Winterhalder MJ, Sitoci-Ficici KH, Geiger KD, Koch E, Schackert G, Zumbusch A, Steiner G, Kirsch M. Vibrational Spectroscopic Imaging and Multiphoton Microscopy of Spinal Cord Injury. Anal Chem 2012; 84:8707-14. [DOI: 10.1021/ac301938m] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | | | - Martin J. Winterhalder
- Department of Chemistry, University of Konstanz, Universitaetsstrasse 10, D-78464
Konstanz, Germany
| | | | | | | | | | - Andreas Zumbusch
- Department of Chemistry, University of Konstanz, Universitaetsstrasse 10, D-78464
Konstanz, Germany
| | | | - Matthias Kirsch
- Center for Regenerative Therapies Dresden, DFG Research Center and Cluster of Excellence, Fetscherstrasse 105, D-01307 Dresden, Germany
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Calderón-Vallejo D, Quintanar JL. Gonadotropin-releasing hormone treatment improves locomotor activity, urinary function and neurofilament protein expression after spinal cord injury in ovariectomized rats. Neurosci Lett 2012; 515:187-90. [DOI: 10.1016/j.neulet.2012.03.052] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 03/02/2012] [Accepted: 03/18/2012] [Indexed: 11/29/2022]
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Abstract
PURPOSE OF REVIEW Central to the obstacles to be overcome in moving promising cell-based therapies from the laboratory to the clinic is that of determining which of the many cell types being examined are optimal for repairing particular lesions. RECENT FINDINGS Our studies on astrocyte replacement therapies demonstrate clearly that some cells are far better than others at promoting recovery in spinal cord injury and that, at least in some cases, transplanting undifferentiated precursor cells is far less useful than transplanting specific astrocytes derived from those precursor cells. But further comparison between different approaches is hindered by the difficulties in replicating results between laboratories, even for well defined pharmacological agents and bioactive proteins. These difficulties in replication appear most likely to be due to unrecognized nuances in lesion characteristics and in the details of delivery of therapies. SUMMARY We propose that the challenge of reproducibility provides a critical opportunity for refining cell-based therapies. If the utility of a particular approach is so restricted that even small changes in lesions or treatment protocols eliminate benefit, then the variability inherent in clinical injuries will frustrate translation. In contrast, rising to this challenge may enable discovery of refinements needed to confer the robustness needed for successful clinical trials.
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Noor NM, Steer DL, Wheaton BJ, Ek CJ, Truettner JS, Dietrich WD, Dziegielewska KM, Richardson SJ, Smith AI, VandeBerg JL, Saunders NR. Age-dependent changes in the proteome following complete spinal cord transection in a postnatal South American opossum (Monodelphis domestica). PLoS One 2011; 6:e27465. [PMID: 22110655 PMCID: PMC3217969 DOI: 10.1371/journal.pone.0027465] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 10/17/2011] [Indexed: 12/15/2022] Open
Abstract
Recovery from severe spinal injury in adults is limited, compared to immature animals who demonstrate some capacity for repair. Using laboratory opossums (Monodelphis domestica), the aim was to compare proteomic responses to injury at two ages: one when there is axonal growth across the lesion and substantial behavioural recovery and one when no axonal growth occurs. Anaesthetized pups at postnatal day (P) 7 or P28 were subjected to complete transection of the spinal cord at thoracic level T10. Cords were collected 1 or 7 days after injury and from age-matched controls. Proteins were separated based on isoelectric point and subunit molecular weight; those whose expression levels changed following injury were identified by densitometry and analysed by mass spectrometry. Fifty-six unique proteins were identified as differentially regulated in response to spinal transection at both ages combined. More than 50% were cytoplasmic and 70% belonged to families of proteins with characteristic binding properties. Proteins were assigned to groups by biological function including regulation (40%), metabolism (26%), inflammation (19%) and structure (15%). More changes were detected at one than seven days after injury at both ages. Seven identified proteins: 14-3-3 epsilon, 14-3-3 gamma, cofilin, alpha enolase, heart fatty acid binding protein (FABP3), brain fatty acid binding protein (FABP7) and ubiquitin demonstrated age-related differential expression and were analysed by qRT-PCR. Changes in mRNA levels for FABP3 at P7+1day and ubiquitin at P28+1day were statistically significant. Immunocytochemical staining showed differences in ubiquitin localization in younger compared to older cords and an increase in oligodendrocyte and neuroglia immunostaining following injury at P28. Western blot analysis supported proteomic results for ubiquitin and 14-3-3 proteins. Data obtained at the two ages demonstrated changes in response to injury, compared to controls, that were different for different functional protein classes. Some may provide targets for novel drug or gene therapies.
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Affiliation(s)
- Natassya M. Noor
- Department of Pharmacology, the University of Melbourne, Parkville, Victoria, Australia
| | - David L. Steer
- Department of Biochemistry & Molecular Biology, Monash University, Clayton, Victoria, Australia
| | - Benjamin J. Wheaton
- Department of Pharmacology, the University of Melbourne, Parkville, Victoria, Australia
| | - C. Joakim Ek
- Department of Pharmacology, the University of Melbourne, Parkville, Victoria, Australia
| | - Jessie S. Truettner
- The Miami Project to Cure Paralysis, University of Miami, Miller School of Medicine, Miami, Florida, United States of America
| | - W. Dalton Dietrich
- The Miami Project to Cure Paralysis, University of Miami, Miller School of Medicine, Miami, Florida, United States of America
| | | | - Samantha J. Richardson
- School of Medical Sciences and Health Innovations Research Institute, RMIT University, Bundoora, Victoria, Australia
| | - A. Ian Smith
- Department of Biochemistry & Molecular Biology, Monash University, Clayton, Victoria, Australia
| | - John L. VandeBerg
- Texas Biomedical Research Institute, San Antonio, Texas, United States of America
| | - Norman R. Saunders
- Department of Pharmacology, the University of Melbourne, Parkville, Victoria, Australia
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Esposito E, Cuzzocrea S. Targeting the peroxisome proliferator-activated receptors (PPARs) in spinal cord injury. Expert Opin Ther Targets 2011; 15:943-59. [DOI: 10.1517/14728222.2011.581231] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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