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Martin-Rojas T, Sastre-Oliva T, Esclarín-Ruz A, Gil-Dones F, Mourino-Alvarez L, Corbacho-Alonso N, Moreno-Luna R, Hernandez-Fernandez G, Lopez JA, Oliviero A, Barderas MG. Effects of Growth Hormone Treatment and Rehabilitation in Incomplete Chronic Traumatic Spinal Cord Injury: Insight from Proteome Analysis. J Pers Med 2020; 10:jpm10040183. [PMID: 33096745 PMCID: PMC7720149 DOI: 10.3390/jpm10040183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 11/16/2022] Open
Abstract
Despite promising advances in the medical management of spinal cord injury (SCI), there is still no available effective therapy to repair the neurological damage in patients who experience this life-transforming condition. Recently, we performed a phase II/III placebo-controlled randomized trial of safety and efficacy of growth hormone (GH) treatment in incomplete chronic traumatic spinal cord injury. The main findings were that the combined treatment of GH plus rehabilitation treatment is feasible and safe, and that GH but not placebo slightly improves the SCI individual motor score. Moreover, we found that an intensive and long-lasting rehabilitation program per se increases the functional outcome of SCI individuals. To understand the possible mechanisms of the improvement due to GH treatment (motor score) and due to rehabilitation (functional outcome), we used a proteomic approach. Here, we used a multiple proteomic strategy to search for recovery biomarkers in blood plasma with the potential to predict response to somatropin treatment and to delayed intensive rehabilitation. Forty-six patients were recruited and followed for a minimum period of 1 year. Patients were classified into two groups based on their treatment: recombinant somatropin (0.4 mg) or placebo. Both groups received rehabilitation treatment. Our strategy allowed us to perform one of the deepest plasma proteomic analyses thus far, which revealed two proteomic signatures with predictive value: (i) response to recombinant somatropin treatment and (ii) response to rehabilitation. The proteins implicated in these signatures are related to homeostasis, inflammation, and coagulation functions. These findings open novel possibilities to assess and therapeutically manage patients with SCI, which could have a positive impact on their clinical response.
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Affiliation(s)
- Tatiana Martin-Rojas
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
| | - Tamara Sastre-Oliva
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
| | - Ana Esclarín-Ruz
- Department of Physical Medicine and Rehabilitation, Hospital Nacional de Parapléjicos, SESCAM, 45071 Toledo, Spain;
| | - Felix Gil-Dones
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
- Department of Genetic, Facultad de Ciencias Biológicas, UCM, 28040 Madrid, Spain
| | - Laura Mourino-Alvarez
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
| | - Nerea Corbacho-Alonso
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
| | - Rafael Moreno-Luna
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
- Department of Neuroinflammation, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45004 Toledo, Spain
| | - German Hernandez-Fernandez
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
| | | | - Antonio Oliviero
- FENNSI Group, Hospital Nacional de Parapléjicos, SESCAM, 45071 Toledo, Spain
- Correspondence: (A.O.); (M.G.B.); Fax: +34-925-247-745 (M.G.B.)
| | - María G. Barderas
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
- Correspondence: (A.O.); (M.G.B.); Fax: +34-925-247-745 (M.G.B.)
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