Measurement of hydroxylysine glycosides in urine and its application to spinal cord injury

Amyotrophic Lateral Sclerosis and Metabolomics: Clinical Implication and Therapeutic Approach

Amyotrophic lateral sclerosis (ALS) is one of the most common motor neurodegenerative disorders, primarily affecting upper and lower motor neurons in the brain, brainstem, and spinal cord, resulting in paralysis due to muscle weakness and atrophy. The majority of patients die within 3–5 years of symptom onset as a consequence of respiratory failure. Due to relatively fast progression of the disease, early diagnosis is essential. Metabolomics offer a unique opportunity to understand the spatiotemporal metabolic crosstalks through the assessment of body fluids and tissue. So far, one of the most challenging issues related to ALS is to understand the variation of metabolites in body fluids and CNS with the progression of disease. In this paper we will review the changes in metabolic profile in response to disease progression condition and also see the therapeutic implication of various drugs in ALS patients.

An evidence-based review of aging of the body systems following spinal cord injury

STUDY DESIGN

Systematic review.

OBJECTIVE

To systematically review evidence on aging of the body systems after spinal cord injury (SCI).

SETTING

Toronto, Ontario and Vancouver, British Columbia, Canada.

METHODS

Electronic databases (MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO), were searched for studies published between 1980 and 2009. The search was augmented by reviewing the reference lists of relevant papers. Non-intervention studies that were longitudinal or cross-sectional with able-bodied controls that were at minimum matched on chronological age were included for review. Levels of evidence were assigned to the study design using a modified Sackett scale.

RESULTS

Of the 74 studies selected for inclusion, 16 were longitudinal in design. The hypothesis that SCI represents a model for premature aging is supported by a large proportion of level 5 evidence for the cardiovascular and endocrine systems, level 2, 4 and 5 evidence for the musculoskeletal system, and limited level 5 evidence for the immune system. Only a few level 4 and 5 studies for the respiratory system were found. The evidence on the genitourinary system, gastrointestinal system, and for skin and subcutaneous tissues provide level 4 and 5 evidence that premature aging may not be occurring. The evidence on the nervous system does not provide evidence of premature aging as a result of SCI.

CONCLUSIONS

Premature aging appears to occur in some systems after SCI. Additional longitudinal studies are required to confirm these findings.

Physiological changes in tissues denervated by spinal cord injury tissues and possible effects on wound healing

There are many metabolic and physiological changes that happen to the tissues below the level of a spinal cord injury. These deficits are examined in relation to the series of events that has to take place for wound healing - the "wound healing cascade". The conclusion is that every step of the wound healing process is impaired by the physiological deficits inherent post-spinal cord injury. This may explain, in part, why pressure ulcers on these patients are so difficult to close and to maintain closed.