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Coleman JR, Gumina R, Hund T, Cohen M, Neal MD, Townsend K, Kerlin BA. Sex dimorphisms in coagulation: Implications in trauma-induced coagulopathy and trauma resuscitation. Am J Hematol 2024; 99 Suppl 1:S28-S35. [PMID: 38567625 DOI: 10.1002/ajh.27296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/17/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024]
Abstract
Trauma-induced coagulopathy (TIC) is one of the leading causes of preventable death in injured patients. Consequently, it is imperative to understand the mechanisms underlying TIC and how to mitigate this mortality. An opportunity for advancement stems from the awareness that coagulation demonstrates a strong sex-dependent effect. Females exhibit a relative hypercoagulability compared to males, which persists after injury and confers improved outcomes. The mechanisms underlying sex dimorphisms in coagulation and its protective effect after injury have yet to be elucidated. This review explores sex dimorphisms in enzymatic hemostasis, fibrinogen, platelets, and fibrinolysis, with implications for resuscitation of patients with TIC.
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Affiliation(s)
- Julia R Coleman
- Division of Trauma, Critical Care, and Burn, Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Division of Interventional Cardiology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Richard Gumina
- Division of Interventional Cardiology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Thomas Hund
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, USA
| | - Mitchell Cohen
- Department of Surgery, University of Colorado Medical Center, Aurora, Colorado, USA
| | - Matthew D Neal
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Kristy Townsend
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, USA
| | - Bryce A Kerlin
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, USA
- Center for Clinical and Translational Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Division of Pediatric Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, Ohio, USA
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2
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Sánchez-Torres S, Orozco-Barrios C, Salgado-Ceballos H, Segura-Uribe JJ, Guerra-Araiza C, León-Cholula Á, Morán J, Coyoy-Salgado A. Tibolone Improves Locomotor Function in a Rat Model of Spinal Cord Injury by Modulating Apoptosis and Autophagy. Int J Mol Sci 2023; 24:15285. [PMID: 37894971 PMCID: PMC10607734 DOI: 10.3390/ijms242015285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Spinal cord injury (SCI) harms patients' health and social and economic well-being. Unfortunately, fully effective therapeutic strategies have yet to be developed to treat this disease, affecting millions worldwide. Apoptosis and autophagy are critical cell death signaling pathways after SCI that should be targeted for early therapeutic interventions to mitigate their adverse effects and promote functional recovery. Tibolone (TIB) is a selective tissue estrogen activity regulator (STEAR) with neuroprotective properties demonstrated in some experimental models. This study aimed to investigate the effect of TIB on apoptotic cell death and autophagy after SCI and verify whether TIB promotes motor function recovery. A moderate contusion SCI was produced at thoracic level 9 (T9) in male Sprague Dawley rats. Subsequently, animals received a daily dose of TIB orally and were sacrificed at 1, 3, 14 or 30 days post-injury. Tissue samples were collected for morphometric and immunofluorescence analysis to identify tissue damage and the percentage of neurons at the injury site. Autophagic (Beclin-1, LC3-I/LC3-II, p62) and apoptotic (Caspase 3) markers were also analyzed via Western blot. Finally, motor function was assessed using the BBB scale. TIB administration significantly increased the amount of preserved tissue (p < 0.05), improved the recovery of motor function (p < 0.001) and modulated the expression of autophagy markers in a time-dependent manner while consistently inhibiting apoptosis (p < 0.05). Therefore, TIB could be a therapeutic alternative for the recovery of motor function after SCI.
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Affiliation(s)
- Stephanie Sánchez-Torres
- Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (S.S.-T.); (H.S.-C.); (Á.L.-C.)
- Consejo Nacional de Ciencia y Tecnología, Mexico City 03940, Mexico
| | - Carlos Orozco-Barrios
- CONACyT-Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico;
| | - Hermelinda Salgado-Ceballos
- Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (S.S.-T.); (H.S.-C.); (Á.L.-C.)
| | - Julia J. Segura-Uribe
- Subdirección de Gestión de la Investigación, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Mexico City 04530, Mexico;
| | - Christian Guerra-Araiza
- Unidad de Investigación Médica en Farmacología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico;
| | - Ángel León-Cholula
- Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (S.S.-T.); (H.S.-C.); (Á.L.-C.)
| | - Julio Morán
- División de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico;
| | - Angélica Coyoy-Salgado
- CONACyT-Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico;
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3
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Gilbert EAB, Livingston J, Garcia-Flores E, Kehtari T, Morshead CM. Metformin Improves Functional Outcomes, Activates Neural Precursor Cells, and Modulates Microglia in a Sex-Dependent Manner After Spinal Cord Injury. Stem Cells Transl Med 2023:7174953. [PMID: 37209417 DOI: 10.1093/stcltm/szad030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/20/2023] [Indexed: 05/22/2023] Open
Abstract
Spinal cord injury (SCI) results in devastating patient outcomes with few treatment options. A promising approach to improve outcomes following SCI involves the activation of endogenous precursor populations including neural stem and progenitor cells (NSPCs) which are located in the periventricular zone (PVZ), and oligodendrocyte precursor cells (OPCs) found throughout the parenchyma. In the adult spinal cord, resident NSPCs are primarily mitotically quiescent and aneurogenic, while OPCs contribute to ongoing oligodendrogenesis into adulthood. Each of these populations is responsive to SCI, increasing their proliferation and migration to the site of injury; however, their activation is not sufficient to support functional recovery. Previous work has shown that administration of the FDA-approved drug metformin is effective at promoting endogenous brain repair following injury, and this is correlated with enhanced NSPC activation. Here, we ask whether metformin can promote functional recovery and neural repair following SCI in both males and females. Our results reveal that acute, but not delayed metformin administration improves functional outcomes following SCI in both sexes. The functional improvement is concomitant with OPC activation and oligodendrogenesis. Our data also reveal sex-dependent effects of metformin following SCI with increased activation of NSPCs in females and reduced microglia activation in males. Taken together, these findings support metformin as a viable therapeutic strategy following SCI and highlight its pleiotropic effects in the spinal cord.
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Affiliation(s)
- Emily A B Gilbert
- Division of Anatomy, Department of Surgery, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, ON, Canada
| | - Jessica Livingston
- Division of Anatomy, Department of Surgery, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, ON, Canada
| | - Emilio Garcia-Flores
- Division of Anatomy, Department of Surgery, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Tarlan Kehtari
- Division of Anatomy, Department of Surgery, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, ON, Canada
| | - Cindi M Morshead
- Division of Anatomy, Department of Surgery, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
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4
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The neuroprotective effects of estrogen and estrogenic compounds in spinal cord injury. Neurosci Biobehav Rev 2023; 146:105074. [PMID: 36736846 DOI: 10.1016/j.neubiorev.2023.105074] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
Spinal cord injury (SCI) occurs when the spinal cord is damaged from either a traumatic event or disease. SCI is characterised by multiple injury phases that affect the transmission of sensory and motor signals and lead to temporary or long-term functional deficits. There are few treatments for SCI. Estrogens and estrogenic compounds, however, may effectively mitigate the effects of SCI and therefore represent viable treatment options. This review systematically examines the pre-clinical literature on estrogen and estrogenic compound neuroprotection after SCI. Several estrogens were examined by the included studies: estrogen, estradiol benzoate, Premarin, isopsoralen, genistein, and selective estrogen receptor modulators. Across these pharmacotherapies, we find significant evidence that estrogens indeed offer protection against myriad pathophysiological effects of SCI and lead to improvements in functional outcomes, including locomotion. A STRING functional network analysis of proteins modulated by estrogen after SCI demonstrated that estrogen simultaneously upregulates known neuroprotective pathways, such as HIF-1, and downregulates pro-inflammatory pathways, including IL-17. These findings highlight the strong therapeutic potential of estrogen and estrogenic compounds after SCI.
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5
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Stewart A, Glaser E, Mott CA, Bailey WM, Sulllivan PG, Patel S, Gensel J. Advanced Age and Neurotrauma Diminish Glutathione and Impair Antioxidant Defense after Spinal Cord Injury. J Neurotrauma 2022; 39:1075-1089. [PMID: 35373589 PMCID: PMC9347421 DOI: 10.1089/neu.2022.0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- Andrew Stewart
- University of Kentucky, Physiology, 741 S. Limestone Street, BBSRB B483, Lexington, Kentucky, United States, 40536-0509,
| | - Ethan Glaser
- University of Kentucky, Physiology, Lexington, Kentucky, United States,
| | - Caitlin A Mott
- University of Kentucky, Physiology, Lexington, Kentucky, United States,
| | - William M Bailey
- University of Kentucky, Spinal Cord and Brain Injury Research Center, Physiology, Lexington, Kentucky, United States
| | - Patrick G Sulllivan
- University of Kentucky College of Medicine, Spinal Cord & Brain Injury Research Cent, 475 BBSRB, Lexington, United States, 40536-0509,
| | - Samir Patel
- University of Kentucky, 4530, Spinal Cord and Brain Injury Research Center, Physiology, Lexington, Kentucky, United States
| | - John Gensel
- University of Kentucky, Physiology, 741 S. Limestone Street, B436 BBSRB, Lexington, Kentucky, United States, 40536-0509
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6
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Li Y, Ritzel RM, Lei Z, Cao T, He J, Faden AI, Wu J. Sexual dimorphism in neurological function after SCI is associated with disrupted neuroinflammation in both injured spinal cord and brain. Brain Behav Immun 2022; 101:1-22. [PMID: 34954073 PMCID: PMC8885910 DOI: 10.1016/j.bbi.2021.12.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/29/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022] Open
Abstract
Whereas human spinal cord injury (SCI) is more common in men, the prevalence is growing in women. However, little is known about the effect of biological sex on brain dysfunction and injury mechanisms. To model the highest per capita rate of injury (ages between 16 and 30 years old) in humans, in the present study, young adult or a young/middle-aged male and female C57BL/6 mice were subjected to moderate contusion SCI. When mice were injured at 10-12-week-old, transcriptomic analysis of inflammation-related genes and flow cytometry revealed a more aggressive neuroinflammatory profile in male than females following 3 d SCI, ostensibly driven by sex-specific changes myeloid cell function rather than cell number. Female mice were generally more active at baseline, as evidenced by greater distance traveled in the open field. After SCI, female mice had more favorable locomotor function than male animals. At 13 weeks post-injury, male mice showed poor performance in cognitive and depressive-like behavioral tests, while injured female mice showed fewer deficits in these tasks. However, when injured at 6 months old followed by 8 months post-injury, male mice had considerably less inflammatory activation compared with female animals despite having similar or worse outcomes in affective, cognitive, and motor tasks. Collectively, these findings indicate that sex differences in functional outcome after SCI are associated with the age at onset of injury, as well as disrupted neuroinflammation not only at the site of injury but also in remote brain regions. Thus, biological sex should be considered when designing new therapeutic agents.
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Affiliation(s)
- Yun Li
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD, 21201 USA
| | - Rodney M. Ritzel
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD, 21201 USA
| | - Zhuofan Lei
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD, 21201 USA
| | - Tuoxin Cao
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD, 21201 USA
| | - Junyun He
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD, 21201 USA
| | - Alan I Faden
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD, 21201 USA,University of Maryland Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD, 21201 USA
| | - Junfang Wu
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD 21201, USA; University of Maryland Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD 21201, USA.
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7
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Baine RE, Johnston DT, Strain MM, Henwood MK, Davis JA, Reynolds JA, Giles ED, Grau JW. Noxious Stimulation Induces Acute Hemorrhage and Impairs Long-Term Recovery after Spinal Cord Injury (SCI) in Female Rats: Evidence Estrous Cycle May Have a Modulatory Effect. Neurotrauma Rep 2022; 3:70-86. [PMID: 35112109 PMCID: PMC8804264 DOI: 10.1089/neur.2021.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Spinal cord injuries (SCIs) are often the result of traumatic accidents, which also produce multiple other injuries (polytrauma). Nociceptive input from associated injuries has been shown to significantly impair recovery post-SCI. Historically, work in our laboratory has focused exclusively on male animals; however, increasing incidence of SCI in females requires research to determine whether pain (nociceptive) input poses the same risk to their recovery. Some animal studies have shown that females demonstrate greater tissue preservation and better locomotor recovery post-SCI. Given this, we examined the effect of sex on SCI recovery in two pain models—intermittent electrical stimulation (shock) to the tail or capsaicin injection to the hindpaw. Female rats received a lower thoracic contusion injury and were exposed to noxious stimulation the next day. The acute effect of noxious input on cardiovascular function, locomotor performance, and hemorrhage were assessed. Treatment with capsaicin or noxious electrical stimulation disrupted locomotor performance, increased blood pressure, and disrupted stepping. Additional experiments examined the long-term consequences of noxious input, demonstrating that both noxious electrical stimulation and capsaicin impair long-term recovery in female rats. Interestingly, injury had a greater effect on behavioral performance when progesterone and estrogen were low (metestrus). Conversely, nociceptive input led to a greater disruption in locomotor performance and produced a greater rise in blood pressure in animals injured during estrus.
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Affiliation(s)
- Rachel E. Baine
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
| | - David T. Johnston
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
| | - Misty M. Strain
- Department of Cellular and Integrative Physiology, University of Texas Health Science, San Antonio, Texas, USA
| | - Melissa K. Henwood
- Department of Neuroscience, Cell Biology, Anatomy, University of Texas Medical Branch, Galveston, Texas, USA
| | - Jacob A. Davis
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
| | - Joshua A. Reynolds
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
| | - Erin D. Giles
- Department of Nutrition, Texas A&M University, College Station, Texas, USA
| | - James W. Grau
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
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8
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Khan M, Qiao F, Kumar P, Touhidul Islam SM, Singh AK, Won J, Singh I. Neuroprotective effects of Alda-1 mitigate spinal cord injury in mice: involvement of Alda-1-induced ALDH2 activation-mediated suppression of reactive aldehyde mechanisms. Neural Regen Res 2022; 17:185-193. [PMID: 34100455 PMCID: PMC8451565 DOI: 10.4103/1673-5374.314312] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Spinal cord injury (SCI) is associated with high production and excessive accumulation of pathological 4-hydroxy-trans-2-nonenal (4-HNE), a reactive aldehyde, formed by SCI-induced metabolic dysregulation of membrane lipids. Reactive aldehyde load causes redox alteration, neuroinflammation, neurodegeneration, pain-like behaviors, and locomotion deficits. Pharmacological scavenging of reactive aldehydes results in limited improved motor and sensory functions. In this study, we targeted the activity of mitochondrial enzyme aldehyde dehydrogenase 2 (ALDH2) to detoxify 4-HNE for accelerated functional recovery and improved pain-like behavior in a male mouse model of contusion SCI. N-(1,3-benzodioxol-5-ylmethyl)-2,6-dichlorobenzamide (Alda-1), a selective activator of ALDH2, was used as a therapeutic tool to suppress the 4-HNE load. SCI was induced by an impactor at the T9–10 vertebral level. Injured animals were initially treated with Alda-1 at 2 hours after injury, followed by once-daily treatment with Alda-1 for 30 consecutive days. Locomotor function was evaluated by the Basso Mouse Scale, and pain-like behaviors were assessed by mechanical allodynia and thermal algesia. ALDH2 activity was measured by enzymatic assay. 4-HNE protein adducts and enzyme/protein expression levels were determined by western blot analysis and histology/immunohistochemistry. SCI resulted in a sustained and prolonged overload of 4-HNE, which parallels with the decreased activity of ALDH2 and low functional recovery. Alda-1 treatment of SCI decreased 4-HNE load and enhanced the activity of ALDH2 in both the acute and the chronic phases of SCI. Furthermore, the treatment with Alda-1 reduced neuroinflammation, oxidative stress, and neuronal loss and increased adenosine 5′-triphosphate levels stimulated the neurorepair process and improved locomotor and sensory functions. Conclusively, the results provide evidence that enhancing the ALDH2 activity by Alda-1 treatment of SCI mice suppresses the 4-HNE load that attenuates neuroinflammation and neurodegeneration, promotes the neurorepair process, and improves functional outcomes. Consequently, we suggest that Alda-1 may have therapeutic potential for the treatment of human SCI. Animal procedures were approved by the Institutional Animal Care and Use Committee (IACUC) of MUSC (IACUC-2019-00864) on December 21, 2019.
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Affiliation(s)
- Mushfiquddin Khan
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Fei Qiao
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Pavan Kumar
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - S M Touhidul Islam
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Avtar K Singh
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Jeseong Won
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Inderjit Singh
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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9
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The Pathophysiology of Osteoporosis after Spinal Cord Injury. Int J Mol Sci 2021; 22:ijms22063057. [PMID: 33802713 PMCID: PMC8002377 DOI: 10.3390/ijms22063057] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Spinal cord injury (SCI) affects approximately 300,000 people in the United States. Most individuals who sustain severe SCI also develop subsequent osteoporosis. However, beyond immobilization-related lack of long bone loading, multiple mechanisms of SCI-related bone density loss are incompletely understood. Recent findings suggest neuronal impairment and disability may lead to an upregulation of receptor activator of nuclear factor-κB ligand (RANKL), which promotes bone resorption. Disruption of Wnt signaling and dysregulation of RANKL may also contribute to the pathogenesis of SCI-related osteoporosis. Estrogenic effects may protect bones from resorption by decreasing the upregulation of RANKL. This review will discuss the current proposed physiological and cellular mechanisms explaining osteoporosis associated with SCI. In addition, we will discuss emerging pharmacological and physiological treatment strategies, including the promising effects of estrogen on cellular protection.
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10
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Stewart AN, MacLean SM, Stromberg AJ, Whelan JP, Bailey WM, Gensel JC, Wilson ME. Considerations for Studying Sex as a Biological Variable in Spinal Cord Injury. Front Neurol 2020; 11:802. [PMID: 32849242 PMCID: PMC7419700 DOI: 10.3389/fneur.2020.00802] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/26/2020] [Indexed: 12/13/2022] Open
Abstract
In response to NIH initiatives to investigate sex as a biological variable in preclinical animal studies, researchers have increased their focus on male and female differences in neurotrauma. Inclusion of both sexes when modeling neurotrauma is leading to the identification of novel areas for therapeutic and scientific exploitation. Here, we review the organizational and activational effects of sex hormones on recovery from injury and how these changes impact the long-term health of spinal cord injury (SCI) patients. When determining how sex affects SCI it remains imperative to expand outcomes beyond locomotor recovery and consider other complications plaguing the quality of life of patients with SCI. Interestingly, the SCI field predominately utilizes female rodents for basic science research which contrasts most other male-biased research fields. We discuss the unique caveats this creates to the translatability of preclinical research in the SCI field. We also review current clinical and preclinical data examining sex as biological variable in SCI. Further, we report how technical considerations such as housing, size, care management, and age, confound the interpretation of sex-specific effects in animal studies of SCI. We have uncovered novel findings regarding how age differentially affects mortality and injury-induced anemia in males and females after SCI, and further identified estrus cycle dysfunction in mice after injury. Emerging concepts underlying sexually dimorphic responses to therapy are also discussed. Through a combination of literature review and primary research observations we present a practical guide for considering and incorporating sex as biological variable in preclinical neurotrauma studies.
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Affiliation(s)
- Andrew N Stewart
- Department of Physiology, University of Kentucky, Lexington, KY, United States.,Spinal Cord and Brain Injury Research Center, College of Medicine, University of Kentucky, Lexington, KY, United States
| | - Steven M MacLean
- Department of Physiology, University of Kentucky, Lexington, KY, United States.,Spinal Cord and Brain Injury Research Center, College of Medicine, University of Kentucky, Lexington, KY, United States
| | - Arnold J Stromberg
- Department of Statistics, College of Arts and Sciences, University of Kentucky, Lexington, KY, United States
| | - Jessica P Whelan
- Department of Physiology, University of Kentucky, Lexington, KY, United States.,Spinal Cord and Brain Injury Research Center, College of Medicine, University of Kentucky, Lexington, KY, United States
| | - William M Bailey
- Department of Physiology, University of Kentucky, Lexington, KY, United States.,Spinal Cord and Brain Injury Research Center, College of Medicine, University of Kentucky, Lexington, KY, United States
| | - John C Gensel
- Department of Physiology, University of Kentucky, Lexington, KY, United States.,Spinal Cord and Brain Injury Research Center, College of Medicine, University of Kentucky, Lexington, KY, United States
| | - Melinda E Wilson
- Department of Physiology, University of Kentucky, Lexington, KY, United States
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11
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Fukutoku T, Kumagai G, Fujita T, Sasaki A, Wada K, Liu X, Tanaka T, Kudo H, Asari T, Nikaido Y, Ueno S, Ishibashi Y. Sex-Related Differences in Anxiety and Functional Recovery after Spinal Cord Injury in Mice. J Neurotrauma 2020; 37:2235-2243. [PMID: 32486893 DOI: 10.1089/neu.2019.6929] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
It has been reported that female rats have a sex-related advantage in functional recovery and neuroprotection after spinal cord injury (SCI). However, the association between anxiety and neurological function after SCI in female and male rats remains unclear. The aim of this study was to examine sex-related differences in anxiety and neurological dysfunction after SCI in adult C57/BL6 male and female mice. After laminectomy at the 10th thoracic level, a contusive SCI was induced. The sham group received only a T10 laminectomy. Behavior testing (anxiety, motor/sensory function) was performed for 6 weeks after SCI. The spinal cord and preserved myelinated areas at the epicenter were histologically evaluated. Correlations between anxiety and motor/sensory function or histological parameters were analyzed using the Spearman correlation coefficient. Female and male mice showed significantly higher anxiety-like behaviors after SCI than before SCI. Anxiousness was significantly higher in female mice than in male mice after SCI. There was no significant difference in motor/sensory functions and histological features between the two groups. Anxiety-like behaviors were significantly correlated with sensory function at 2 weeks after SCI in female mice and with motor function at 2, 4, and 6 weeks after SCI in male mice. Anxiety-like behaviors were not significantly correlated with the spinal cord area at the epicenter in female and male mice. Our results revealed that female mice became more anxious than male mice after SCI. Anxiety-like behavior after SCI may be associated with functional recovery, and improving anxiety may affect functional recovery after injury.
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Affiliation(s)
- Tatsuhiro Fukutoku
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Gentaro Kumagai
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Taku Fujita
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Ayako Sasaki
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kanichiro Wada
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Xizhe Liu
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Toshihiro Tanaka
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hitoshi Kudo
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Toru Asari
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yoshikazu Nikaido
- Department of Neurophysiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shinya Ueno
- Department of Neurophysiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuyuki Ishibashi
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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12
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Theis T, Kumar S, Wei E, Nguyen J, Glynos V, Paranjape N, Askarifirouzjaei H, Khajouienejad L, Berthiaume F, Young W, Schachner M. Myristoylated alanine-rich C-kinase substrate effector domain peptide improves sex-specific recovery and axonal regrowth after spinal cord injury. FASEB J 2020; 34:12677-12690. [PMID: 32729988 DOI: 10.1096/fj.202000026rr] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 11/11/2022]
Abstract
Myristoylated alanine-rich C-kinase substrate (MARCKS) is an intracellular receptor for polysialic acid. MARCKS supports development, synaptic plasticity, and regeneration after injury. MARCKS binds with its functionally essential effector domain (ED) to polysialic acid. A 25-mer peptide comprising the ED of MARCKS stimulates neuritogenesis of primary hippocampal neurons after addition to the culture. This motivated us to investigate whether ED peptide has similar effects in spinal cord injury. ED peptide supported recovery and regrowth of monoaminergic axons in female, but not in male mice. Sex-specific differences in response to ED peptide application also occurred in cultured neurons. In female but not male neurons, the ED peptide enhanced neurite outgrowth that could be suppressed by inhibitors of the estrogen receptors α and β, fibroblast growth factor receptor-1, protein kinase C, and matrix metalloproteinase 2. In addition, we observed female-specific elevation of phosphorylated MARCKS levels after ED peptide treatment. In male neurons, the ED peptide enhanced neuritogenesis in the presence of an androgen receptor inhibitor to the extent seen in ED peptide-treated female neurons. However, inhibition of androgen receptor did not lead to increased phosphorylation of MARCKS. These results provide insights into the functions of a novel compound contributing to gender-dependent regeneration.
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Affiliation(s)
- Thomas Theis
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Suneel Kumar
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ, USA
| | - Elena Wei
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Jennifer Nguyen
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Vicci Glynos
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Nikita Paranjape
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Hadi Askarifirouzjaei
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Leila Khajouienejad
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Francois Berthiaume
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ, USA
| | - Wise Young
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Melitta Schachner
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
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13
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McFarlane K, Otto TE, Bailey WM, Veldhorst AK, Donahue RR, Taylor BK, Gensel JC. Effect of Sex on Motor Function, Lesion Size, and Neuropathic Pain after Contusion Spinal Cord Injury in Mice. J Neurotrauma 2020; 37:1983-1990. [PMID: 32597310 PMCID: PMC7470221 DOI: 10.1089/neu.2019.6931] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Spinal cord injury (SCI) causes neurodegeneration, impairs locomotor function, and impacts the quality of life particularly in those individuals in whom neuropathic pain develops. Whether the time course of neurodegeneration, locomotor impairment, or neuropathic pain varies with sex, however, remains understudied. Therefore, the objective of this study in male and female C57BL/6 mice was to evaluate the following outcomes for six weeks after a 75-kdyn thoracic contusion SCI: locomotor function using the Basso Mouse Scale (BMS); spinal cord tissue sparing and rostral-caudal lesion length; and mechanical allodynia and heat hyperalgesia using hindpaw application of Von Frey filaments or radiant heat stimuli, respectively. Although motor function was largely similar between sexes, all of the males, but only half of the females, recovered plantar stepping. Rostral-caudal lesion length was shorter in females than in males. Mechanical allodynia and heat hyperalgesia after SCI developed in all animals, regardless of sex; there were no differences in pain outcomes between sexes. We conclude that contusion SCI yields subtle sex differences in mice depending on the outcome measure but no significant differences in behavioral signs of neuropathic pain.
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Affiliation(s)
- Katelyn McFarlane
- Spinal Cord and Brain Injury Research Center and Department of Physiology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Taylor E Otto
- Spinal Cord and Brain Injury Research Center and Department of Physiology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - William M Bailey
- Spinal Cord and Brain Injury Research Center and Department of Physiology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Amy K Veldhorst
- Spinal Cord and Brain Injury Research Center and Department of Physiology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Renée R Donahue
- Spinal Cord and Brain Injury Research Center and Department of Physiology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Bradley K Taylor
- Department of Anesthesia and Perioperative Medicine, Pittsburgh Center for Pain Research, and Pittsburgh Project to End Opioid Misuse, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - John C Gensel
- Spinal Cord and Brain Injury Research Center and Department of Physiology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
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14
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Mayo JN, Kauer SD, Brumley MR, Bearden SE. Pericytes improve locomotor recovery after spinal cord injury in male and female neonatal rats. Microcirculation 2020; 27:e12646. [PMID: 32608116 DOI: 10.1111/micc.12646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/06/2020] [Accepted: 06/23/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE It is not known how activation of the hypoxia-inducible factor (HIF) pathway in pericytes, cells of the microvascular wall, influences new capillary growth. We tested the hypothesis that HIF-activated pericytes promote angiogenesis in a neonatal model of spinal cord injury (SCI). METHODS Human placental pericytes stimulated with cobalt chloride and naïve pericytes were injected into the site of a thoracic hemi-section of the spinal cord in rat pups on postnatal day three (P3). Hindlimb motor recovery and Doppler blood flow perfusion at the site of transection were measured on P10. Immunohistochemistry was used to visualize vessel and neurofilament density for quantification. RESULTS Injection of HIF-activated pericytes resulted in greater vascular density in males but did not result in improved motor function for males or females. Injection of non-HIF-activated pericytes resulted improved motor function recovery in both sexes (males, 2.722 ± 0.31-fold score improvement; females, 3.824 ± 0.58-fold score improvement, P < .05) but produced no significant changes in vessel density. CONCLUSIONS HIF-activated pericytes promote vascular density in males post-SCI. Acute delivery of non-HIF-activated pericytes at the site of injury can improve motor recovery post-SCI.
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Affiliation(s)
- Jamie N Mayo
- IDEAS 2.0 Centre of Innovation, VA Salt Lake City Health Care System, Salt Lake City, UT, USA.,Division of Epidemiology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.,Department of Biological Sciences, Idaho State University, Pocatello, ID, USA
| | - Sierra D Kauer
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Michele R Brumley
- Department of Psychology, Idaho State University, Pocatello, ID, USA
| | - Shawn E Bearden
- Department of Biological Sciences, Idaho State University, Pocatello, ID, USA
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15
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Melo MC, Macedo DR, Soares AB. Divergent Findings in Brain Reorganization After Spinal Cord Injury: A Review. J Neuroimaging 2020; 30:410-427. [PMID: 32418286 DOI: 10.1111/jon.12711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/02/2020] [Accepted: 03/24/2020] [Indexed: 12/12/2022] Open
Abstract
Spinal cord injury (SCI) leads to a general lack of sensory and motor functions below the level of injury and may promote deafferentation-induced brain reorganization. Functional magnetic resonance imaging (fMRI) has been established as an essential tool in neuroscience research and can precisely map the spatiotemporal distribution of brain activity. Task-based fMRI experiments associated with the tongue, upper limbs, or lower limbs have been used as the primary paradigms to study brain reorganization following SCI. A review of the current literature on the subject shows one common trait: while most articles agree that brain networks are usually preserved after SCI, and that is not the case as some articles describe possible alterations in brain activation after the lesion. There is no consensus if those alterations indeed occur. In articles that show alterations, there is no agreement if they are transient or permanent. Besides, there is no consensus on which areas are most prone to activation changes, or on the intensity and direction (increase vs. decrease) of those possible changes. In this article, we present a critical review of the literature and trace possible reasons for those contradictory findings on brain reorganization following SCI. fMRI studies based on the ankle dorsiflexion, upper-limb, and tongue paradigms are used as case studies for the analyses.
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Affiliation(s)
- Mariana Cardoso Melo
- Biomedical Engineering Lab, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Dhainner Rocha Macedo
- Biomedical Engineering Lab, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Alcimar Barbosa Soares
- Biomedical Engineering Lab, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
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16
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Kim T, Chelluboina B, Chokkalla AK, Vemuganti R. Age and sex differences in the pathophysiology of acute CNS injury. Neurochem Int 2019; 127:22-28. [PMID: 30654116 PMCID: PMC6579702 DOI: 10.1016/j.neuint.2019.01.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 01/11/2019] [Indexed: 12/21/2022]
Abstract
Despite the immeasurable burden on patients and families, no effective therapies to protect the CNS after an acute injury are available yet. Furthermore, the underlying mechanisms that promote neuronal death and functional deficits after injury remain to be poorly understood. The prevalence, age of onset, pathophysiology, and symptomatology of many CNS insults differ significantly between males and females. In the case of stroke, younger males tend to show a higher risk than younger females, while this trend reverses with age. Accumulating evidence from preclinical studies have shown that sex hormones play a crucial role in providing neuroprotection following ischemic stroke and other acute CNS injuries. Estrogen, in particular, exerts a neuroprotective effect by modulating the immune responses after injury. In addition, there exists a sexual dimorphism in cell death pathways between males and females that are independent of hormones. Meanwhile, recent studies suggest that microRNAs are critically involved in the sex-specific mechanisms of cell death. This review discusses the current knowledge on the contribution of sex and age to outcome after stroke. Implication of the interplay between these two factors on other CNS injuries (spinal cord injury and traumatic brain injury) from the experimental evidence were also discussed.
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Affiliation(s)
- TaeHee Kim
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA
| | - Bharath Chelluboina
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA
| | - Anil K Chokkalla
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA; Cellular and Molecular Pathology Program, University of Wisconsin, Madison, WI, USA
| | - Raghu Vemuganti
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA; Cellular and Molecular Pathology Program, University of Wisconsin, Madison, WI, USA; William S. Middleton Veterans Administration Hospital, Madison, WI, USA.
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17
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Gaudet AD, Fonken LK, Ayala MT, Dangelo HM, Smith EJ, Bateman EM, Schleicher WE, Maier SF, Watkins LR. Spinal Cord Injury in Rats Dysregulates Diurnal Rhythms of Fecal Output and Liver Metabolic Indicators. J Neurotrauma 2019; 36:1923-1934. [PMID: 30501584 PMCID: PMC10027348 DOI: 10.1089/neu.2018.6101] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Spinal cord injury (SCI) dysregulates metabolic homeostasis. Metabolic homeostasis is optimized across the day by the circadian system. Despite the prevalence of metabolic pathologies after SCI, post-SCI circadian regulation of metabolism remains understudied. Here, we hypothesized that SCI in rats would disrupt circadian regulation of key metabolic organs, leading to metabolic dysregulation. Female and male Sprague-Dawley rats received moderate thoracic (T)-9 contusion SCI (or sham surgery). First, SCI disrupted diurnal rhythms in two metabolic behaviors: fecal production and food intake rhythms were ablated acutely. SCI also expedited whole-gut transit time. In parallel, acute SCI increased plasma glucose. Diurnal glucose storage-release cycles regulated by the liver were disrupted by SCI, which also increased liver glucose metabolism messenger RNAs (mRNAs). Further, SCI disrupted liver clock gene expression and suppressed inflammatory gene rhythms. Together, our novel data suggest that SCI disrupts typical metabolic and circadian function. Improving post-SCI metabolic function could enhance recovery of homeostasis.
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Affiliation(s)
- Andrew D Gaudet
- 1 Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado
- 2 Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado
- 3 Department of Psychology, University of Texas at Austin, Austin, Texas
- 4 Department of Neurology, University of Texas at Austin, Austin, Texas
| | - Laura K Fonken
- 5 Division of Pharmacology and Toxicology, University of Texas at Austin, Austin, Texas
| | - Monica T Ayala
- 1 Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado
- 2 Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado
| | - Heather M Dangelo
- 1 Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado
- 2 Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado
| | - Elana J Smith
- 1 Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado
- 2 Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado
| | - Emily M Bateman
- 1 Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado
- 2 Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado
| | - Wolfgang E Schleicher
- 1 Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado
- 2 Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado
| | - Steven F Maier
- 1 Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado
- 2 Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado
| | - Linda R Watkins
- 1 Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado
- 2 Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado
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18
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Namjoo Z, Mortezaee K, Joghataei MT, Moradi F, Piryaei A, Abbasi Y, Hosseini A, Majidpoor J. Targeting axonal degeneration and demyelination using combination administration of 17β‐estradiol and Schwann cells in the rat model of spinal cord injury. J Cell Biochem 2018; 119:10195-10203. [DOI: 10.1002/jcb.27361] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 06/26/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Zeinab Namjoo
- Department of Anatomy School of Medicine, Iran University of Medical Sciences Tehran Iran
| | - Keywan Mortezaee
- Department of Anatomy School of Medicine, Kurdistan University of Medical Sciences Sanandaj Iran
| | - Mohammad T. Joghataei
- Department of Anatomy School of Medicine, Iran University of Medical Sciences Tehran Iran
- Cellular and Molecular Research Center Faculty of Medicine, Iran University of Medical Sciences Tehran Iran
| | - Fateme Moradi
- Department of Anatomy School of Medicine, Iran University of Medical Sciences Tehran Iran
- Cellular and Molecular Research Center Faculty of Medicine, Iran University of Medical Sciences Tehran Iran
| | - Abbas Piryaei
- Department of Biology and Anatomical Sciences School of Medicine, Shahid Beheshti University of Medical Sciences Tehran Iran
- Department of Tissue Engineering and Applied Cell Sciences School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Yusef Abbasi
- Department of Anatomy School of Medicine, Iran University of Medical Sciences Tehran Iran
| | - Amir Hosseini
- Department of Anatomy School of Medicine, Iran University of Medical Sciences Tehran Iran
| | - Jamal Majidpoor
- Department of Anatomy School of Medicine, Iran University of Medical Sciences Tehran Iran
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19
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Sengelaub DR, Han Q, Liu NK, Maczuga MA, Szalavari V, Valencia SA, Xu XM. Protective Effects of Estradiol and Dihydrotestosterone following Spinal Cord Injury. J Neurotrauma 2018; 35:825-841. [PMID: 29132243 PMCID: PMC5863086 DOI: 10.1089/neu.2017.5329] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Spinal cord injury (SCI) results in lesions that destroy tissue and disrupt spinal tracts, producing deficits in locomotor and autonomic function. We previously demonstrated that motoneurons and the muscles they innervate show pronounced atrophy after SCI, and these changes are prevented by treatment with testosterone. Here, we assessed whether the testosterone active metabolites estradiol and dihydrotestosterone have similar protective effects after SCI. Young adult female rats received either sham or T9 spinal cord contusion injuries and were treated with estradiol, dihydrotestosterone, both, or nothing via Silastic capsules. Basso-Beattie-Bresnahan locomotor testing was performed weekly and voiding behavior was assessed at 3 weeks post-injury. Four weeks after SCI, lesion volume and tissue sparing, quadriceps muscle fiber cross-sectional area, and motoneuron dendritic morphology were assessed. Spontaneous locomotor behavior improved after SCI, but hormone treatments had no effect. Voiding behavior was disrupted after SCI, but was significantly improved by treatment with either estradiol or dihydrotestosterone; combined treatment was maximally effective. Treatment with estradiol reduced lesion volume, but dihydrotestosterone alone and estradiol combined with dihydrotestosterone were ineffective. SCI-induced decreases in motoneuron dendritic length were attenuated by all hormone treatments. SCI-induced reductions in muscle fiber cross-sectional areas were prevented by treatment with either dihydrotestosterone or estradiol combined with dihydrotestosterone, but estradiol treatment was ineffective. These findings suggest that deficits in micturition and regressive changes in motoneuron and muscle morphology seen after SCI are ameliorated by treatment with estradiol or dihydrotestosterone, further supporting a role for steroid hormones as neurotherapeutic agents in the injured nervous system.
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Affiliation(s)
- Dale R. Sengelaub
- Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
| | - Qi Han
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Nai-Kui Liu
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Melissa A. Maczuga
- Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
| | - Violetta Szalavari
- Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
| | | | - Xiao-Ming Xu
- Spinal Cord and Brain Injury Research Group, Indiana University School of Medicine, Indianapolis, Indiana
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20
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Colón JM, González PA, Cajigas Á, Maldonado WI, Torrado AI, Santiago JM, Salgado IK, Miranda JD. Continuous tamoxifen delivery improves locomotor recovery 6h after spinal cord injury by neuronal and glial mechanisms in male rats. Exp Neurol 2018; 299:109-121. [PMID: 29037533 PMCID: PMC5723542 DOI: 10.1016/j.expneurol.2017.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 10/03/2017] [Accepted: 10/05/2017] [Indexed: 12/13/2022]
Abstract
No treatment is available for patients with spinal cord injury (SCI). Patients often arrive to the hospital hours after SCI suggesting the need of a therapy that can be used on a clinically relevant window. Previous studies showed that Tamoxifen (TAM) treatment 24h after SCI benefits locomotor recovery in female rats. Tamoxifen exerts beneficial effects in male and female rodents but a gap of knowledge exists on: the therapeutic window of TAM, the spatio-temporal mechanisms activated and if this response is sexually dimorphic. We hypothesized that TAM will favor locomotor recovery when administered up-to 24h after SCI in male Sprague-Dawley rats. Rats received a thoracic (T10) contusion using the MACSIS impactor followed by placebo or TAM (15mg/21days) pellets in a therapeutic window of 0, 6, 12, or 24h. Animals were sacrificed at 2, 7, 14, 28 or 35days post injury (DPI) to study the molecular and cellular changes in the acute and chronic stages. Immediate or delayed therapy (t=6h) improved locomotor function, increased white matter spared tissue, and neuronal survival. TAM reduced reactive gliosis during chronic stages and increased the expression of Olig-2. A significant difference was observed in estrogen receptor alpha between male and female rodents from 2 to 28 DPI suggesting a sexually dimorphic characteristic that could be related to the behavioral differences observed in the therapeutic window of TAM. This study supports the use of TAM in the SCI setting due to its neuroprotective effects but with a significant sexually dimorphic therapeutic window.
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Affiliation(s)
- Jennifer M Colón
- University of Puerto Rico Medical Sciences Campus, Department of Physiology, San Juan, PR 00936, USA.
| | - Pablo A González
- University of Puerto Rico Medical Sciences Campus, Department of Physiology, San Juan, PR 00936, USA.
| | - Ámbar Cajigas
- University of Puerto Rico Medical Sciences Campus, Department of Physiology, San Juan, PR 00936, USA.
| | - Wanda I Maldonado
- University of Puerto Rico Carolina Campus, Neuroregeneration Division, Neuroscience Research Laboratory, Natural Sciences Department, Carolina, PR 00984, USA.
| | - Aranza I Torrado
- University of Puerto Rico Medical Sciences Campus, Department of Physiology, San Juan, PR 00936, USA.
| | - José M Santiago
- University of Puerto Rico Carolina Campus, Neuroregeneration Division, Neuroscience Research Laboratory, Natural Sciences Department, Carolina, PR 00984, USA.
| | - Iris K Salgado
- University of Puerto Rico Medical Sciences Campus, Department of Physiology, San Juan, PR 00936, USA.
| | - Jorge D Miranda
- University of Puerto Rico Medical Sciences Campus, Department of Physiology, San Juan, PR 00936, USA.
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21
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James ML, Langefeld CD, Sekar P, Moomaw CJ, Elkind MSV, Worrall BB, Sheth KN, Martini SR, Osborne J, Woo D. Assessment of the interaction of age and sex on 90-day outcome after intracerebral hemorrhage. Neurology 2017; 89:1011-1019. [PMID: 28710330 PMCID: PMC5589792 DOI: 10.1212/wnl.0000000000004255] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 01/25/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Because age affects hormonal production differently in women compared with men, we sought to define sex and age interactions across a multiracial/ethnic population after intracerebral hemorrhage (ICH) to uncover evidence that loss of gonadal hormone production would result in loss of the known neuroprotective effects of gonadal hormones. METHODS Clinical and radiographic data from participants in the Ethnic/Racial Variations of Intracerebral Hemorrhage study and the Genetic and Environmental Risk Factors for Hemorrhagic Stroke study prior to December 2013 were used. Relationships among sex, age, and outcome after ICH in 616 non-Hispanic black, 590 Hispanic, and 868 non-Hispanic white participants were evaluated using multivariable logistic regression analysis. Poor outcome was defined as modified Rankin Scale score ≥3 at 90 days after ICH. RESULTS Sex differences were found in multiple variables among the racial/ethnic groups, including age at onset, premorbid neurologic status, and neurologic outcome after ICH. Overall, no sex-age interaction effect was found for mortality (p = 0.183) or modified Rankin Scale score (p = 0.378) at 90 days after ICH. In racial/ethnic subgroups, only the non-Hispanic black cohort provided possible evidence of a sex-age interaction on 90-day modified Rankin Scale score (p = 0.003). CONCLUSION Unlike in ischemic stroke, there was no evidence that patient sex modified the effect of age on 90-day outcomes after ICH in a large multiracial/ethnic population. Future studies should evaluate biological reasons for these differences between stroke subtypes. CLINICALTRIALSGOV IDENTIFIER NCT01202864.
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Affiliation(s)
- Michael L James
- From the Brain Injury Translational Research Center, Department of Anesthesiology, and Department of Neurology (M.L.J.), Duke University, Durham; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati, OH; Department of Neurology, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia, Charlottesville; Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University, New Haven, CT; and Department of Neurology (S.R.M.), Baylor College of Medicine, Houston, TX.
| | - Carl D Langefeld
- From the Brain Injury Translational Research Center, Department of Anesthesiology, and Department of Neurology (M.L.J.), Duke University, Durham; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati, OH; Department of Neurology, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia, Charlottesville; Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University, New Haven, CT; and Department of Neurology (S.R.M.), Baylor College of Medicine, Houston, TX
| | - Padmini Sekar
- From the Brain Injury Translational Research Center, Department of Anesthesiology, and Department of Neurology (M.L.J.), Duke University, Durham; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati, OH; Department of Neurology, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia, Charlottesville; Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University, New Haven, CT; and Department of Neurology (S.R.M.), Baylor College of Medicine, Houston, TX
| | - Charles J Moomaw
- From the Brain Injury Translational Research Center, Department of Anesthesiology, and Department of Neurology (M.L.J.), Duke University, Durham; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati, OH; Department of Neurology, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia, Charlottesville; Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University, New Haven, CT; and Department of Neurology (S.R.M.), Baylor College of Medicine, Houston, TX
| | - Mitchell S V Elkind
- From the Brain Injury Translational Research Center, Department of Anesthesiology, and Department of Neurology (M.L.J.), Duke University, Durham; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati, OH; Department of Neurology, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia, Charlottesville; Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University, New Haven, CT; and Department of Neurology (S.R.M.), Baylor College of Medicine, Houston, TX
| | - Bradford B Worrall
- From the Brain Injury Translational Research Center, Department of Anesthesiology, and Department of Neurology (M.L.J.), Duke University, Durham; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati, OH; Department of Neurology, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia, Charlottesville; Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University, New Haven, CT; and Department of Neurology (S.R.M.), Baylor College of Medicine, Houston, TX
| | - Kevin N Sheth
- From the Brain Injury Translational Research Center, Department of Anesthesiology, and Department of Neurology (M.L.J.), Duke University, Durham; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati, OH; Department of Neurology, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia, Charlottesville; Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University, New Haven, CT; and Department of Neurology (S.R.M.), Baylor College of Medicine, Houston, TX
| | - Sharyl R Martini
- From the Brain Injury Translational Research Center, Department of Anesthesiology, and Department of Neurology (M.L.J.), Duke University, Durham; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati, OH; Department of Neurology, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia, Charlottesville; Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University, New Haven, CT; and Department of Neurology (S.R.M.), Baylor College of Medicine, Houston, TX
| | - Jennifer Osborne
- From the Brain Injury Translational Research Center, Department of Anesthesiology, and Department of Neurology (M.L.J.), Duke University, Durham; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati, OH; Department of Neurology, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia, Charlottesville; Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University, New Haven, CT; and Department of Neurology (S.R.M.), Baylor College of Medicine, Houston, TX
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miR-155 Deletion in Mice Overcomes Neuron-Intrinsic and Neuron-Extrinsic Barriers to Spinal Cord Repair. J Neurosci 2017; 36:8516-32. [PMID: 27511021 DOI: 10.1523/jneurosci.0735-16.2016] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 07/08/2016] [Indexed: 12/20/2022] Open
Abstract
UNLABELLED Axon regeneration after spinal cord injury (SCI) fails due to neuron-intrinsic mechanisms and extracellular barriers including inflammation. microRNA (miR)-155-5p is a small, noncoding RNA that negatively regulates mRNA translation. In macrophages, miR-155-5p is induced by inflammatory stimuli and elicits a response that could be toxic after SCI. miR-155 may also independently alter expression of genes that regulate axon growth in neurons. Here, we hypothesized that miR-155 deletion would simultaneously improve axon growth and reduce neuroinflammation after SCI by acting on both neurons and macrophages. New data show that miR-155 deletion attenuates inflammatory signaling in macrophages, reduces macrophage-mediated neuron toxicity, and increases macrophage-elicited axon growth by ∼40% relative to control conditions. In addition, miR-155 deletion increases spontaneous axon growth from neurons; adult miR-155 KO dorsal root ganglion (DRG) neurons extend 44% longer neurites than WT neurons. In vivo, miR-155 deletion augments conditioning lesion-induced intraneuronal expression of SPRR1A, a regeneration-associated gene; ∼50% more injured KO DRG neurons expressed SPRR1A versus WT neurons. After dorsal column SCI, miR-155 KO mouse spinal cord has reduced neuroinflammation and increased peripheral conditioning-lesion-enhanced axon regeneration beyond the epicenter. Finally, in a model of spinal contusion injury, miR-155 deletion improves locomotor function at postinjury times corresponding with the arrival and maximal appearance of activated intraspinal macrophages. In miR-155 KO mice, improved locomotor function is associated with smaller contusion lesions and decreased accumulation of inflammatory macrophages. Collectively, these data indicate that miR-155 is a novel therapeutic target capable of simultaneously overcoming neuron-intrinsic and neuron-extrinsic barriers to repair after SCI. SIGNIFICANCE STATEMENT Axon regeneration after spinal cord injury (SCI) fails due to neuron-intrinsic mechanisms and extracellular barriers, including inflammation. Here, new data show that deleting microRNA-155 (miR-155) affects both mechanisms and improves repair and functional recovery after SCI. Macrophages lacking miR-155 have altered inflammatory capacity, which enhances neuron survival and axon growth of cocultured neurons. In addition, independent of macrophages, adult miR-155 KO neurons show enhanced spontaneous axon growth. Using either spinal cord dorsal column crush or contusion injury models, miR-155 deletion improves indices of repair and recovery. Therefore, miR-155 has a dual role in regulating spinal cord repair and may be a novel therapeutic target for SCI and other CNS pathologies.
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Chakrabarti M, Das A, Samantaray S, Smith JA, Banik NL, Haque A, Ray SK. Molecular mechanisms of estrogen for neuroprotection in spinal cord injury and traumatic brain injury. Rev Neurosci 2016; 27:271-81. [DOI: 10.1515/revneuro-2015-0032] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 08/27/2015] [Indexed: 01/18/2023]
Abstract
AbstractEstrogen (EST) is a steroid hormone that exhibits several important physiological roles in the human body. During the last few decades, EST has been well recognized as an important neuroprotective agent in a variety of neurological disorders in the central nervous system (CNS), such as spinal cord injury (SCI), traumatic brain injury (TBI), Alzheimer’s disease, and multiple sclerosis. The exact molecular mechanisms of EST-mediated neuroprotection in the CNS remain unclear due to heterogeneity of cell populations that express EST receptors (ERs) in the CNS as well as in the innate and adaptive immune system. Recent investigations suggest that EST protects the CNS from injury by suppressing pro-inflammatory pathways, oxidative stress, and cell death, while promoting neurogenesis, angiogenesis, and neurotrophic support. In this review, we have described the currently known molecular mechanisms of EST-mediated neuroprotection and neuroregeneration in SCI and TBI. At the same time, we have emphasized on the recent in vitro and in vivo findings from our and other laboratories, implying potential clinical benefits of EST in the treatment of SCI and TBI.
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Affiliation(s)
- Mrinmay Chakrabarti
- 1Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine, 6439 Garners Ferry Road, Columbia, SC 29209, USA
| | - Arabinda Das
- 2Department of Neurosurgery and Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Supriti Samantaray
- 2Department of Neurosurgery and Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Joshua A. Smith
- 2Department of Neurosurgery and Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Naren L. Banik
- 2Department of Neurosurgery and Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Azizul Haque
- 3Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Swapan K. Ray
- 1Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine, 6439 Garners Ferry Road, Columbia, SC 29209, USA
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Use of the CatWalk Gait Device to Assess Differences in Locomotion between Genders in Rats Inherently and following Spinal Cord Injury. ACTA ACUST UNITED AC 2016. [DOI: 10.1155/2016/6276348] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A possible cause of differences in recovery after spinal cord injury (SCI) is gender. The effect of gender on locomotor recovery following SCI, however, remains controversial and has produced conflicting results regarding gender’s impact on outcome. A significant shortcoming of previous studies was small sample size. The current work tested what, if any, significant differences existed between genders after SCI with CatWalk Gait Analysis that uses an automated device to measure the foot placement and gait of animals as they voluntarily cross an illuminated glass runway. We hypothesized that, by employing larger sample sizes in a reproducible and clinically relevant contusive SCI paradigm, subtle distinctions in locomotor recovery between sexes, if they exist, would be elucidated. During 13 weeks of functional assessment after SCI, a number of CatWalk parameters, including swing, single stance, and stride length, were significantly affected by gender only as identified by use of ANCOVA analysis, considering age, weight, and baseline performance as covariates. We report here our findings for 197 parameters that were assessed before and after SCI. Evaluating differences in locomotor recovery between sexes after SCI could point to a gender-related advantage and provide novel directions for the development of future therapeutics.
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Yang L, Yao M, Lan Y, Mo W, Sun YL, Wang J, Wang YJ, Cui XJ. Melatonin for Spinal Cord Injury in Animal Models: A Systematic Review and Network Meta-Analysis. J Neurotrauma 2016; 33:290-300. [PMID: 26414869 DOI: 10.1089/neu.2015.4038] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Long Yang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Spine Disease, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Yao
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Spine Disease, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yun Lan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Spine Disease, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Mo
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Spine Disease, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yue-li Sun
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Spine Disease, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yong-jun Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Spine Disease, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xue-jun Cui
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Spine Disease, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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26
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Datto JP, Yang J, Dietrich WD, Pearse DD. Does being female provide a neuroprotective advantage following spinal cord injury? Neural Regen Res 2015; 10:1533-6. [PMID: 26692831 PMCID: PMC4660727 DOI: 10.4103/1673-5374.165213] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
It has been controversial whether gender has any effect on recovery following spinal cord injury (SCI). Past experimental and clinical research aimed at addressing this subject has led to constrasting findings on whether females hold any advantage in locomotor recovery. Additionally, for studies supporting the notion of a female gender related advantage, a definite cause has not been explained. In a recent study, using large sample sizes for comparative male and female spinal cord injury cohorts, we reported that a significant gender advantage favoring females existed in both tissue preservation and functional recovery after taking into consideration discrepancies in age and weight of the animals across sexes. Prior animal research frequently used sample sizes that were too small to determine significance with certainty and also did not account for two other factors that influence locomotor performance: age and weight. Our finding is important in light of controversy surrounding the effect of gender on outcome and the fact that SCI affects more than ten thousand new individuals annually, a population that is disproportionately male. By deepening our understanding of why a gender advantage exists, potential new therapeutics can be designed to improve recovery for the male population following the initial trauma or putatively augment the neuroprotective privilege in females for enhanced outcomes.
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Affiliation(s)
- Jeffrey P Datto
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jackie Yang
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA
| | - W Dalton Dietrich
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA ; The Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA ; The Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA ; The Department of Cell Biology, University of Miami Miller School of Medicine, Miami, FL, USA ; The Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, USA ; The Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Damien D Pearse
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA ; The Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA ; The Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, USA ; The Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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27
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Datto JP, Bastidas JC, Miller NL, Shah AK, Arheart KL, Marcillo AE, Dietrich WD, Pearse DD. Female Rats Demonstrate Improved Locomotor Recovery and Greater Preservation of White and Gray Matter after Traumatic Spinal Cord Injury Compared to Males. J Neurotrauma 2015; 32:1146-57. [PMID: 25715192 DOI: 10.1089/neu.2014.3702] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The possibility of a gender-related difference in recovery after spinal cord injury (SCI) remains a controversial subject. Current empirical animal research lacks sizable test groups to definitively determine whether significant differences exist. Evaluating locomotor recovery variances between sexes following a precise, clinically relevant spinal cord contusion model can provide valuable insight into a possible gender-related advantage in outcome post-SCI. In the current study, we hypothesized that by employing larger sample sizes in a reproducible contusive SCI paradigm, subtle distinctions in locomotor recovery between sexes, if they exist, would be elucidated through a broad range of behavioral tests. During 13 weeks of functional assessment after a thoracic (T8) contusive SCI in rat, significant differences owing to gender existed for the Basso, Beattie, and Bresnahan score and CatWalk hindlimb swing, support four, and single stance analyses. Significant differences in locomotor performance were noticeable as early as 4 weeks post-SCI. Stereological tissue-volume analysis determined that females, more so than males, also exhibited greater volumes of preserved gray and white matter within the injured cord segment as well as more spared ventral white matter area at the center of the lesion. The stereological tissue analysis differences favoring females directly correlated with the female rats' greater functional improvement observed at endpoint.
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Affiliation(s)
- Jeffrey P Datto
- 1 The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, Florida
| | - Johana C Bastidas
- 1 The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, Florida
| | - Nicole L Miller
- 1 The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, Florida
| | - Anna K Shah
- 1 The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, Florida
| | - Kristopher L Arheart
- 2 The Departments of Public Health Sciences, University of Miami Miller School of Medicine , Miami, Florida
| | - Alexander E Marcillo
- 1 The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, Florida
| | - W Dalton Dietrich
- 1 The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, Florida.,3 The Department of Neurological Surgery, University of Miami Miller School of Medicine , Miami, Florida.,4 The Department of Cell Biology, University of Miami Miller School of Medicine , Miami, Florida.,5 The Department of Neurology, University of Miami Miller School of Medicine , Miami, Florida.,6 The Neuroscience Program, University of Miami Miller School of Medicine , Miami, Florida
| | - Damien D Pearse
- 1 The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, Florida.,3 The Department of Neurological Surgery, University of Miami Miller School of Medicine , Miami, Florida.,6 The Neuroscience Program, University of Miami Miller School of Medicine , Miami, Florida.,7 The Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine , Miami, Florida
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Hooshmand MJ, Galvan MD, Partida E, Anderson AJ. Characterization of recovery, repair, and inflammatory processes following contusion spinal cord injury in old female rats: is age a limitation? IMMUNITY & AGEING 2014; 11:15. [PMID: 25512759 PMCID: PMC4265993 DOI: 10.1186/1742-4933-11-15] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 10/12/2014] [Indexed: 01/14/2023]
Abstract
Background Although the incidence of spinal cord injury (SCI) is steadily rising in the elderly human population, few studies have investigated the effect of age in rodent models. Here, we investigated the effect of age in female rats on spontaneous recovery and repair after SCI. Young (3 months) and aged (18 months) female rats received a moderate contusion SCI at T9. Behavioral recovery was assessed, and immunohistocemical and stereological analyses performed. Results Aged rats demonstrated greater locomotor deficits compared to young, beginning at 7 days post-injury (dpi) and lasting through at least 28 dpi. Unbiased stereological analyses revealed a selective increase in percent lesion area and early (2 dpi) apoptotic cell death caudal to the injury epicenter in aged versus young rats. One potential mechanism for these differences in lesion pathogenesis is the inflammatory response; we therefore assessed humoral and cellular innate immune responses. No differences in either acute or chronic serum complement activity, or acute neutrophil infiltration, were observed between age groups. However, the number of microglia/macrophages present at the injury epicenter was increased by 50% in aged animals versus young. Conclusions These data suggest that age affects recovery of locomotor function, lesion pathology, and microglia/macrophage response following SCI.
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Affiliation(s)
- Mitra J Hooshmand
- Institute for Memory Impairments and Neurological Disorders, University of California Irvine, 2001 Sue and Bill Gross Stem Cell Research, Irvine, CA 92697-4292, USA.,Sue and Bill Gross Stem Cell Research Center, University of California Irvine, Irvine, CA 92697, USA
| | - Manuel D Galvan
- Reeve-Irvine Research Center, University of California Irvine, Irvine, CA 92697, USA.,Anatomy and Neurobiology, University of California Irvine, Irvine, CA 92697, USA
| | - Elizabeth Partida
- Reeve-Irvine Research Center, University of California Irvine, Irvine, CA 92697, USA
| | - Aileen J Anderson
- Institute for Memory Impairments and Neurological Disorders, University of California Irvine, 2001 Sue and Bill Gross Stem Cell Research, Irvine, CA 92697-4292, USA.,Sue and Bill Gross Stem Cell Research Center, University of California Irvine, Irvine, CA 92697, USA
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Mosquera L, Colón JM, Santiago JM, Torrado AI, Meléndez M, Segarra AC, Rodríguez-Orengo JF, Miranda JD. Tamoxifen and estradiol improved locomotor function and increased spared tissue in rats after spinal cord injury: their antioxidant effect and role of estrogen receptor alpha. Brain Res 2014; 1561:11-22. [PMID: 24637260 DOI: 10.1016/j.brainres.2014.03.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/20/2014] [Accepted: 03/05/2014] [Indexed: 12/17/2022]
Abstract
17β-Estradiol is a multi-active steroid that imparts neuroprotection via diverse mechanisms of action. However, its role as a neuroprotective agent after spinal cord injury (SCI), or the involvement of the estrogen receptor-alpha (ER-α) in locomotor recovery, is still a subject of much debate. In this study, we evaluated the effects of estradiol and of Tamoxifen (an estrogen receptor mixed agonist/antagonist) on locomotor recovery following SCI. To control estradiol cyclical variability, ovariectomized female rats received empty or estradiol filled implants, prior to a moderate contusion to the spinal cord. Estradiol improved locomotor function at 7, 14, 21, and 28 days post injury (DPI), when compared to control groups (measured with the BBB open field test). This effect was ER-α mediated, because functional recovery was blocked with an ER-α antagonist. We also observed that ER-α was up-regulated after SCI. Long-term treatment (28 DPI) with estradiol and Tamoxifen reduced the extent of the lesion cavity, an effect also mediated by ER-α. The antioxidant effects of estradiol were seen acutely at 2 DPI but not at 28 DPI, and this acute effect was not receptor mediated. Rats treated with Tamoxifen recovered some locomotor activity at 21 and 28 DPI, which could be related to the antioxidant protection seen at these time points. These results show that estradiol improves functional outcome, and these protective effects are mediated by the ER-α dependent and independent-mechanisms. Tamoxifen׳s effects during late stages of SCI support the use of this drug as a long-term alternative treatment for this condition.
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Affiliation(s)
- Laurivette Mosquera
- Department of Physiology, University of Puerto Rico-School of Medicine, San Juan, PR 00936, USA
| | - Jennifer M Colón
- Department of Physiology, University of Puerto Rico-School of Medicine, San Juan, PR 00936, USA
| | - José M Santiago
- University of Puerto Rico Carolina Campus, Department of Natural Sciences, Carolina, PR 00984, USA
| | - Aranza I Torrado
- Department of Physiology, University of Puerto Rico-School of Medicine, San Juan, PR 00936, USA
| | | | - Annabell C Segarra
- Department of Physiology, University of Puerto Rico-School of Medicine, San Juan, PR 00936, USA
| | - José F Rodríguez-Orengo
- Department of Biochemistry, University of Puerto Rico-School of Medicine, San Juan, PR 00936, USA
| | - Jorge D Miranda
- Department of Physiology, University of Puerto Rico-School of Medicine, San Juan, PR 00936, USA.
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Elkabes S, Nicot AB. Sex steroids and neuroprotection in spinal cord injury: a review of preclinical investigations. Exp Neurol 2014; 259:28-37. [PMID: 24440641 DOI: 10.1016/j.expneurol.2014.01.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Revised: 12/25/2013] [Accepted: 01/04/2014] [Indexed: 11/30/2022]
Abstract
Spinal cord injury (SCI) is a debilitating condition that affects motor, sensory and autonomic functions. Subsequent to the first mechanical trauma, secondary events, which include inflammation and glial activation, exacerbate tissue damage and worsen functional deficits. Although these secondary injury mechanisms are amenable to therapeutic interventions, the efficacy of current approaches is inadequate. Further investigations are necessary to implement new therapies that can protect neural cells and attenuate some of the detrimental effects of inflammation while promoting regeneration. Studies on different animal models of SCI indicated that sex steroids, especially 17β-estradiol and progesterone, exert neuroprotective, anti-apoptotic and anti-inflammatory effects, ameliorate tissue sparing and improve functional deficits in SCI. As sex steroid receptors are expressed in a variety of cells including neurons, glia and immune system-related cells which infiltrate the injury epicenter, sex steroids could impact multiple processes simultaneously and in doing so, influence the outcomes of SCI. However, the translation of these pre-clinical findings into the clinical setting presents challenges such as the narrow therapeutic time window of sex steroid administration, the diversity of treatment regimens that have been employed in animal studies and the lack of sufficient information regarding the persistence of the effects in chronic SCI. The current review will summarize some of the major findings in this field and will discuss the challenges associated with the implementation of sex steroids as a promising treatment in human SCI.
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Affiliation(s)
- Stella Elkabes
- The Reynolds Family Spine Laboratory, Department of Neurological Surgery, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA.
| | - Arnaud B Nicot
- UMR 1064, INSERM, Nantes, France; Faculté de Médecine, Université de Nantes, France; ITUN, CHU de Nantes, France
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Gender and age interact to affect early outcome after intracerebral hemorrhage. PLoS One 2013; 8:e81664. [PMID: 24312335 PMCID: PMC3842307 DOI: 10.1371/journal.pone.0081664] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 10/15/2013] [Indexed: 11/19/2022] Open
Abstract
Background Intracerebral hemorrhage (ICH) is a common and devastating form of cerebrovascular disease. In ICH, gender differences in outcomes remain relatively understudied but have been examined in other neurological emergencies. Further, a potential effect of age and gender on outcomes after ICH has not been explored. This study was designed to test the hypothesis that age and gender interact to modify neurological outcomes after ICH. Methods Adult patients admitted with spontaneous primary supratentorial ICH from July 2007 through April 2010 were assessed via retrospective analysis of an existing stroke database at Duke University. Univariate analysis of collected variables was used to compare gender and outcome. Unfavorable outcome was defined as discharge to hospice or death. Using multivariate regression, the combined effect of age and gender on outcome after ICH was analyzed. Results In this study population, women were younger (61.1+14.5 versus 65.8+17.3 years, p=0.03) and more likely to have a history of substance abuse (35% versus 8.9%, p<0.0001) compared to men. Multivariable models demonstrated that advancing age had a greater effect on predicting discharge outcome in women compared to men (p=0.02). For younger patients, female sex was protective; however, at ages greater than 60 years, female sex was a risk factor for discharge to hospice or death. Conclusion While independently associated with discharge to hospice or death after ICH, the interaction effect between gender and age demonstrated significantly stronger correlation with early outcome after ICH in a single center cohort. Prospective study is required to verify these findings.
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Risk of Death After Hospital Discharge With Traumatic Spinal Cord Injury: A Population-Based Analysis, 1998–2009. Arch Phys Med Rehabil 2013; 94:1054-61. [DOI: 10.1016/j.apmr.2013.01.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 01/08/2013] [Accepted: 01/26/2013] [Indexed: 11/19/2022]
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Siriphorn A, Dunham KA, Chompoopong S, Floyd CL. Postinjury administration of 17β-estradiol induces protection in the gray and white matter with associated functional recovery after cervical spinal cord injury in male rats. J Comp Neurol 2013; 520:2630-46. [PMID: 22684936 DOI: 10.1002/cne.23056] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The majority of spinal cord injuries (SCIs) in the clinic occur at the lower cervical levels, resulting in both white and gray matter disruption. In contrast, most experimental models of SCI in rodents induce damage in the thoracic cord, resulting primarily in white matter disruption. To address this disparity, experimental cervical SCI models have been developed. Thus, we used a recently characterized model of cervical hemicontusion SCI in adult male rats to assess the potential therapeutic effect of post-SCI administration of 17β-estradiol. Rats received a hemicontusion at the level of the fifth cervical vertebra (C5) followed by administration of 17β-estradiol via a slow release pellet (0.5 or 5.0 mg/pellet) beginning at 30 minutes post-SCI. Behavioral evaluation of skilled and unskilled forelimb function and locomotor function were conducted for 7 weeks after SCI. Upon conclusion of the behavioral assessments, spinal cords were collected and histochemistry and stereology were conducted to evaluate the effect of treatment on the lesion characteristics. We found that post-SCI administration of 17β-estradiol decreased neuronal loss in the ventral horn, decreased reactive astrogliosis, decreased the immune response, and increased white mater sparing at the lesion epicenter. Additionally, post-SCI administration of 17β-estradiol improved skilled forelimb function and locomotor function. Taken together, these data suggest that post-SCI administration of 17β-estradiol protected both the gray and white matter in cervical SCI. Moreover, this treatment improved function on skilled motor tasks that involve both gray and white matter components, suggesting that this is likely a highly clinically relevant protective strategy.
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Affiliation(s)
- Akkradate Siriphorn
- Center for Glial Biology in Medicine and Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Alabama 35249, USA
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Chan WM, Mohammed Y, Lee I, Pearse DD. Effect of gender on recovery after spinal cord injury. Transl Stroke Res 2013; 4:447-61. [PMID: 24323341 DOI: 10.1007/s12975-012-0249-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 12/26/2012] [Indexed: 11/24/2022]
Abstract
Spinal cord injury (SCI) is a debilitating condition that affects thousands of new individuals each year, the majority of which are males. Males with SCI tend to be injured at an earlier age, mostly during sports or motor vehicle accidents, whereas females tend be injured later in life, particularly in the age group 65 and older. In both experimental and clinical studies, the question as to whether gender affects outcome has been addressed in a variety of patient groups and animal models. Results from experimental paradigms have suggested that a gender bias in outcome exists that favors females and appears to involve the advantageous or disadvantageous effects of the gonadal sex hormones estrogen and progesterone or testosterone, respectively. However, other studies have shown an absence of gender differences in outcome in specific SCI models and work has also questioned the involvement of female sex hormones in the observed outcome improvements in females. Similar controversy exists clinically, in studies that have examined gender disparities in outcome after SCI. The current review examines the experimental and clinical evidence for a gender bias in outcome following SCI and discusses issues that have made it difficult to conclusively answer this question.
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Affiliation(s)
- Wai-Man Chan
- Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
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Reynolds JC, Rittenberger JC, Menegazzi JJ. Female sex is not associated with improved rates of ROSC or short term survival following prolonged porcine ventricular fibrillation. Resuscitation 2012; 83:1386-90. [PMID: 22445866 PMCID: PMC3399958 DOI: 10.1016/j.resuscitation.2012.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 02/06/2012] [Accepted: 03/05/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVES There may be a survival benefit in female patients experiencing cardiac arrest, which could affect the interpretation of in vivo animal studies. We hypothesized that sex predicts return of spontaneous circulation (ROSC) and short-term survival (SURV) in porcine studies of prolonged ventricular fibrillation (VF). METHODS Retrospective analysis of eight comparable experiments performed in our lab using mixed-breed domestic swine of either sex. All experiments included prolonged untreated VF, CPR, defibrillation, and drugs. We defined ROSC as systolic blood pressure ≥80 mm Hg for ≥1 min. Short-term survival was defined 20 or 60 min, depending on protocol. Categorical variables were compared with chi-square test and Fisher's exact test. Continuous variables were compared with two-sample t-test and one-way ANOVA. Multiple logistic regression determined predictors of ROSC and SURV, utilizing cluster analysis by experimental protocol. Candidate variables were sex, weight, anesthesia duration, VF duration, and CPR ratio. RESULTS Of 263 swine analyzed (53.2% male), 58.6% of males and 68.3% of females had ROSC (p=0.10), whereas 50.0% of males and 61.0% of females experienced SURV (p=0.07). RESULTS Of 263 swine analyzed (53.2% male), 58.6% of males and 68.3% of females had ROSC (p=0.10), whereas 50.0% of males and 61.0% of females experienced SURV (p=0.07). Neither sex nor any identified candidate variable predicted ROSC or SURV. Both models had acceptable fit with Hosmer-Lemeshow values of 0.35 and 0.31, respectively. CONCLUSIONS Sex predicts neither ROSC nor SURV in a swine model of prolonged VF.
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Affiliation(s)
- Joshua C Reynolds
- Department of Emergency Medicine University of Pittsburgh, Pittsburgh, PA, USA.
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Byers JS, Huguenard AL, Kuruppu D, Liu NK, Xu XM, Sengelaub DR. Neuroprotective effects of testosterone on motoneuron and muscle morphology following spinal cord injury. J Comp Neurol 2012; 520:2683-96. [PMID: 22314886 PMCID: PMC3960947 DOI: 10.1002/cne.23066] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Treatment with testosterone is neuroprotective/neurotherapeutic after a variety of motoneuron injuries. Here we assessed whether testosterone might have similar beneficial effects after spinal cord injury (SCI). Young adult female rats received either sham or T9 spinal cord contusion injuries and were implanted with blank or testosterone-filled Silastic capsules. Four weeks later, motoneurons innervating the vastus lateralis muscle of the quadriceps were labeled with cholera toxin-conjugated horseradish peroxidase, and dendritic arbors were reconstructed in three dimensions. Soma volume, motoneuron number, lesion volume, and tissue sparing were also assessed, as were muscle weight, fiber cross-sectional area, and motor endplate size and density. Contusion injury resulted in large lesions, with no significant differences in lesion volume, percent total volume of lesion, or spared white or gray matter between SCI groups. SCI with or without testosterone treatment also had no effect on the number or soma volume of quadriceps motoneurons. However, SCI resulted in a decrease in dendritic length of quadriceps motoneurons in untreated animals, and this decrease was completely prevented by treatment with testosterone. Similarly, the vastus lateralis muscle weights and fiber cross-sectional areas of untreated SCI animals were smaller than those of sham-surgery controls, and these reductions were both prevented by testosterone treatment. No effects on motor endplate area or density were observed across treatment groups. These findings suggest that regressive changes in motoneuron and muscle morphology seen after SCI can be prevented by testosterone treatment, further supporting a role for testosterone as a neurotherapeutic agent in the injured nervous system.
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Affiliation(s)
- James S. Byers
- Program in Neuroscience and Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana 47405
| | - Anna L. Huguenard
- Program in Neuroscience and Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana 47405
| | - Dulanji Kuruppu
- Program in Neuroscience and Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana 47405
| | - Nai-Kui Liu
- Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, and Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Xiao-Ming Xu
- Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, and Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Dale R. Sengelaub
- Program in Neuroscience and Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana 47405
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Priestley JV, Michael-Titus AT, Tetzlaff W. Limiting spinal cord injury by pharmacological intervention. HANDBOOK OF CLINICAL NEUROLOGY 2012; 109:463-484. [PMID: 23098731 DOI: 10.1016/b978-0-444-52137-8.00029-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The direct primary mechanical trauma to neurons, glia and blood vessels that occurs with spinal cord injury (SCI) is followed by a complex cascade of biochemical and cellular changes which serve to increase the size of the injury site and the extent of cellular and axonal loss. The aim of neuroprotective strategies in SCI is to limit the extent of this secondary cell loss by inhibiting key components of the evolving injury cascade. In this review we will briefly outline the pathophysiological events that occur in SCI, and then review the wide range of neuroprotective agents that have been evaluated in preclinical SCI models. Agents will be considered under the following categories: antioxidants, erythropoietin and derivatives, lipids, riluzole, opioid antagonists, hormones, anti-inflammatory agents, statins, calpain inhibitors, hypothermia, and emerging strategies. Several clinical trials of neuroprotective agents have already taken place and have generally had disappointing results. In attempting to identify promising new treatments, we will therefore highlight agents with (1) low known risks or established clinical use, (2) behavioral data gained in clinically relevant animal models, (3) efficacy when administered after the injury, and (4) robust effects seen in more than one laboratory and/or more than one model of SCI.
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Kwon BK, Okon E, Hillyer J, Mann C, Baptiste D, Weaver LC, Fehlings MG, Tetzlaff W. A systematic review of non-invasive pharmacologic neuroprotective treatments for acute spinal cord injury. J Neurotrauma 2011; 28:1545-88. [PMID: 20146558 PMCID: PMC3143410 DOI: 10.1089/neu.2009.1149] [Citation(s) in RCA: 194] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
An increasing number of therapies for spinal cord injury (SCI) are emerging from the laboratory and seeking translation into human clinical trials. Many of these are administered as soon as possible after injury with the hope of attenuating secondary damage and maximizing the extent of spared neurologic tissue. In this article, we systematically review the available pre-clinical research on such neuroprotective therapies that are administered in a non-invasive manner for acute SCI. Specifically, we review treatments that have a relatively high potential for translation due to the fact that they are already used in human clinical applications, or are available in a form that could be administered to humans. These include: erythropoietin, NSAIDs, anti-CD11d antibodies, minocycline, progesterone, estrogen, magnesium, riluzole, polyethylene glycol, atorvastatin, inosine, and pioglitazone. The literature was systematically reviewed to examine studies in which an in-vivo animal model was utilized to assess the efficacy of the therapy in a traumatic SCI paradigm. Using these criteria, 122 studies were identified and reviewed in detail. Wide variations exist in the animal species, injury models, and experimental designs reported in the pre-clinical literature on the therapies reviewed. The review highlights the extent of investigation that has occurred in these specific therapies, and points out gaps in our knowledge that would be potentially valuable prior to human translation.
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Affiliation(s)
- Brian K Kwon
- University of British Columbia, Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedics, Vancouver, British Columbia, Canada.
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Low dose estrogen prevents neuronal degeneration and microglial reactivity in an acute model of spinal cord injury: effect of dosing, route of administration, and therapy delay. Neurochem Res 2011; 36:1809-16. [PMID: 21611834 DOI: 10.1007/s11064-011-0498-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2011] [Indexed: 10/18/2022]
Abstract
Spinal cord injury (SCI), depending on the severity of injury, leads to neurological dysfunction and paralysis. Methylprednisolone, the only currently available therapy renders limited protection in SCI. Therefore, other therapeutic agents must be tested to maximize neuroprotection and functional recovery. Previous data from our laboratory indicate that estrogen (17β-estradiol) at a high dose may attenuate multiple damaging pathways involved in SCI and improve locomotor outcome. Since use of high dose estrogen may have detrimental side effects and therefore may never be used in the clinic, the current study investigated the efficacy of this steroid hormone at very low doses in SCI. In particular, we tested the impact of dosing (1-10 μg/kg), mode of delivery (intravenous vs. osmotic pump), and delay in estrogen application (15 min-4 h post-SCI) on microgliosis and neuronal death in acute SCI in rats. Treatment with 17β-estradiol (1-10 μg/kg) significantly reduced microglial activation and also attenuated apoptosis of neurons compared to untreated SCI animals. The attenuation of cell death and inflammation by estrogen was observed regardless of mode and time of delivery following injury. These findings suggest estrogen as a potential agent for the treatment of individuals with SCI.
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40
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Samantaray S, Sribnick EA, Das A, Thakore NP, Matzelle D, Yu SP, Ray SK, Wei L, Banik NL. Neuroprotective efficacy of estrogen in experimental spinal cord injury in rats. Ann N Y Acad Sci 2010; 1199:90-4. [PMID: 20633113 DOI: 10.1111/j.1749-6632.2009.05357.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Spinal cord injury (SCI) leads to neurological deficits and motor dysfunction. Methylprednisolone, the only drug used for treating SCI, renders limited neuroprotection and remains controversial. Estrogen is one of the most potent multiactive neuroprotective agents and it is currently under investigation in our laboratory for its efficacy in SCI. The present review briefly summarizes our earlier findings on the therapeutic potential of pharmacological/supraphysiological levels of estrogen in SCI and outlines our ongoing research, highlighting the efficacy of physiological levels of estrogen against neuronal injury, axonal degeneration, and gliosis and also the molecular mechanisms of such neuroprotection in experimental SCI. Furthermore, our ongoing studies designed to explore the different translational potential of estrogen therapy suggest that this multiactive steroid may act as an adjunct therapy to promote angiogenesis, thus enhancing the functional recovery following chronic SCI. Taken together, these studies confirm that estrogen is a potential therapeutic agent for treating SCI.
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Affiliation(s)
- Supriti Samantaray
- Division of Neurology, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina 29425, USA
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Effects of chronic restraint stress and 17-β-estradiol replacement on oxidative stress in the spinal cord of ovariectomized female rats. Neurochem Res 2010; 35:1700-7. [PMID: 20632091 DOI: 10.1007/s11064-010-0232-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2010] [Indexed: 01/02/2023]
Abstract
Previous studies have shown sex-specific oxidative changes in spinal cord of rats submitted to chronic stress, which may be due to gonadal hormones. Here, we assessed total radical-trapping potential (TRAP), superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities and lipid peroxidation (evaluated by the TBARS test) in the spinal cord of ovariectomized (OVX) female rats. Female rats were subjected to OVX, and half of the animals received estradiol replacement. Animals were subdivided into controls and chronically stressed (for 40 days). Our findings demonstrate that chronic stress decreased TRAP, and increased SOD activity in spinal cord homogenates from ovariectomized female rats and had no effect on GPx activity. On the other hand, groups receiving 17β-estradiol replacement presented a decreased GPx activity, but no alteration in TRAP and in SOD activity. No differences in the TBARS test were found in any of the groups analyzed. In conclusion, our results support the idea that chronic stress induces an imbalance between SOD and GPx activities, additionally decreasing TRAP. Estradiol replacement did not reverse the effects of chronic stress, but induced a decrease in GPx activity. Therefore, estradiol replacement in ovariectomized chronically stressed rats could make the spinal cord more susceptible to oxidative injury.
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Kachadroka S, Hall AM, Niedzielko TL, Chongthammakun S, Floyd CL. Effect of endogenous androgens on 17beta-estradiol-mediated protection after spinal cord injury in male rats. J Neurotrauma 2010; 27:611-26. [PMID: 20001688 DOI: 10.1089/neu.2009.1069] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Several groups have recently shown that 17beta-estradiol is protective in spinal cord injury (SCI). Testosterone can be aromatized to 17beta-estradiol and may increase estrogen-mediated protection. Alternatively, testosterone has been shown to increase excitotoxicity in models of central nervous system (CNS) injury. These experiments test the hypothesis that endogenous testosterone in male rats alters 17beta-estradiol-mediated protection by evaluating a delayed administration over a clinically relevant dose range and manipulating testicular-derived testosterone. Adult male Sprague Dawley rats were either gonadectomized or left gonad-intact prior to SCI. SCI was produced by a midthoracic crush injury. At 30 min post SCI, animals received a subcutaneous pellet of 0.0, 0.05, 0.5, or 5.0 mg of 17beta-estradiol, released over 21 days. Hindlimb locomotion was analyzed weekly in the open field. Spinal cords were collected and analyzed for cell death, expression of Bcl-family proteins, and white-matter sparing. Post-SCI administration of the 0.5- or 5.0-mg pellet improved hindlimb locomotion, reduced urinary bladder size, increased neuronal survival, reduced apoptosis, improved the Bax/Bcl-xL protein ratio, and increased white-matter sparing. In the absence of endogenous testicular-derived androgens, SCI induced greater apoptosis, yet 17beta-estradiol administration reduced apoptosis to the same extent in gonadectomized and gonad-intact male rats. These data suggest that delayed post-SCI administration of a clinically relevant dose of 17beta-estradiol is protective in male rats, and endogenous androgens do not alter estrogen-mediated protection. These data suggest that 17beta-estradiol is an effective therapeutic intervention for reducing secondary damage after SCI in males, which could be readily translated to clinical trials.
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Affiliation(s)
- Supatra Kachadroka
- Department of Physical Medicine and Rehabilitation, Center for Glial Biology in Medicine, University of Alabama at Birmingham, Birmingham, Alhabama 35249, USA
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Fee DB, Swartz KR, Scheff N, Roberts K, Gabbita P, Scheff S. Melatonin-analog, β-methyl-6-chloromelatonin, supplementation in spinal cord injury. Brain Res 2010; 1340:81-5. [DOI: 10.1016/j.brainres.2010.04.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2010] [Revised: 04/16/2010] [Accepted: 04/16/2010] [Indexed: 01/30/2023]
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Hubscher CH, Fell JD, Gupta DS. Sex and hormonal variations in the development of at-level allodynia in a rat chronic spinal cord injury model. Neurosci Lett 2010; 477:153-6. [PMID: 20434524 DOI: 10.1016/j.neulet.2010.04.053] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 04/20/2010] [Accepted: 04/21/2010] [Indexed: 01/02/2023]
Abstract
The development of central neuropathic pain varies among patients with spinal cord injury (SCI). The factors contributing to the development and perpetuation of segmental pain (at-level allodynia) has been the focus of ongoing experiments in our laboratory. One such factor is hormonal status. We have shown previously, using a male rat model of SCI, that a severe contusion injury is necessary for the development of allodynia in trunk regions at and just above the level of a T8 injury. In this study, we examined at-level sensitivity for SCI ovariectomized (ovx) and cycling female rats as well as for SCI males implanted with either a placebo pellet or one that slowly releases 17beta-estradiol. The proportion of ovx SCI female rats and placebo-treated SCI males displaying pain-like behaviors to touch/pressure of at-level dermatomes up to 6 weeks post-injury (67% and 75%, respectively) was similar to our previous studies on SCI males (69%). In contrast, significantly fewer cycling SCI female rats and 17beta-estradiol treated SCI male rats showed sensitivity to touch at-level (26% and 30%, respectively). These results implicate 17beta-estradiol as a potential target that can readily be modulated to prevent segmental pain following SCI.
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Affiliation(s)
- Charles H Hubscher
- Department of Anatomical Sciences & Neurobiology, University of Louisville, Louisville, KY 40292, USA.
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Adenosine A1 receptor agonists reduce hyperalgesia after spinal cord injury in rats. Spinal Cord 2010; 48:685-90. [PMID: 20065990 DOI: 10.1038/sc.2009.194] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN An in vivo study using a spinal cord compression model in rats. OBJECTIVES To evaluate the effect of adenosine on thermal hyperalgesia after spinal cord injury (SCI). SUMMARY OF BACKGROUND DATA After SCI, some patients suffer dysesthesia that is unresponsive to conventional treatments. We previously established a rat thoracic spinal cord mild-compression model by which we were able to induce thermal hyperalgesia in the hind limbs. METHODS The thoracic spinal cord was compressed gently using a 20-g weight for 20 min. The withdrawal latency in response to thermal stimulation was monitored bilaterally in the hind limbs using Hargreaves' Plantar test apparatus. RESULTS SCI-induced thermal hyperalgesia was mimicked by the intrathecal application of 8-cyclopentyl-1,3-dipropylxanthine (DPCPX), a selective adenosine A1 receptor antagonist. Hyperalgesia induced by SCI was significantly inhibited by the intrathecal application of 10-30 nmol chloro-adenosine (Cl-adenosine), a nonselective adenosine receptor agonist. The effect of Cl-adenosine (10 nmol) on hyperalgesia after SCI was blocked by the simultaneous application of DPCPX. Intrathecal application of R(-)N6-(2phenylisopropyl) adenosine (R-PIA; 10 nmol), a selective A1 receptor agonist, also inhibited SCI-induced hyperalgesia. In contrast, intrathecal application of CGS21680, a selective adenosine A2a receptor agonist, did not inhibit SCI-induced hyperalgesia. CONCLUSIONS These results suggest that adenosine inhibits hyperalgesia through the stimulation of A1 receptors. Adenosine or adenosine A1 receptor agonists should be considered as candidates for new therapeutic methods for treating post-SCI dysesthesia.
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Swartz KR, Scheff NN, Roberts KN, Fee DB. Exacerbation of spinal cord injury due to static compression occurring early after onset. J Neurosurg Spine 2009; 11:570-4. [PMID: 19929360 DOI: 10.3171/2009.5.spine08588] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The authors used a rat model to assess spinal cord compression following an incomplete spinal cord injury (SCI). METHODS Incomplete SCI was created in the thoracic spinal cord in a novel application of a rodent spinal cord compression model. A moderate impaction force was applied instantaneously to the spinal cord and was followed by 0 seconds, 10 seconds, 30 seconds, or 5 minutes of continued compression (termed "dwell"). The different groups were assessed by behavioral testing with the Basso, Beattie, Bresnahan locomotor rating scale, and with histological injury quantification and morphometrical analysis. RESULTS Compression after the SCI resulted in worsened Basso, Beattie, Bresnahan scale scores; however, the duration of compression was not significant. Compression did not significantly affect the percentage of spared total tissue, percent spared total white matter, or percent spared total gray matter. Percent spared tissue at the epicenter of injury was statistically worsened by compression but not in a time-dependent manner. CONCLUSIONS The authors' results suggest that spinal cord compression after the initial injury is an additional mechanism by which SCI worsens, and that the mechanism of this injury occurs rapidly. These data, however, do not support duration of compression as a significant variable.
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Affiliation(s)
- Karin R Swartz
- Department of Neurosurgery, University of Kentucky, Lexington, KY 40536-0298, USA.
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Biering-Sørensen B, Kristensen IB, Kjaer M, Biering-Sørensen F. Muscle after spinal cord injury. Muscle Nerve 2009; 40:499-519. [PMID: 19705475 DOI: 10.1002/mus.21391] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The morphological and contractile changes of muscles below the level of the lesion after spinal cord injury (SCI) are dramatic. In humans with SCI, a fiber-type transformation away from type I begins 4-7 months post-SCI and reaches a new steady state with predominantly fast glycolytic IIX fibers years after the injury. There is a progressive drop in the proportion of slow myosin heavy chain (MHC) isoform fibers and a rise in the proportion of fibers that coexpress both the fast and slow MHC isoforms. The oxidative enzymatic activity starts to decline after the first few months post-SCI. Muscles from individuals with chronic SCI show less resistance to fatigue, and the speed-related contractile properties change, becoming faster. These findings are also present in animals. Future studies should longitudinally examine changes in muscles from early SCI until steady state is reached in order to determine optimal training protocols for maintaining skeletal muscle after paralysis.
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Affiliation(s)
- Bo Biering-Sørensen
- Clinic for Spinal Cord Injuries, NeuroScience Centre, Rigshospitalet, Copenhagen University Hospital, Havnevej 25, DK-3100 Hornbaek, Denmark.
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Gerzanich V, Woo SK, Vennekens R, Tsymbalyuk O, Ivanova S, Ivanov A, Geng Z, Chen Z, Nilius B, Flockerzi V, Freichel M, Simard JM. De novo expression of Trpm4 initiates secondary hemorrhage in spinal cord injury. Nat Med 2009; 15:185-91. [PMID: 19169264 DOI: 10.1038/nm.1899] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Accepted: 11/26/2008] [Indexed: 12/14/2022]
Abstract
The role of transient receptor potential M4 (Trpm4), an unusual member of the Trp family of ion channels, is poorly understood. Using rodent models of spinal cord injury, we studied involvement of Trpm4 in the progressive expansion of secondary hemorrhage associated with capillary fragmentation, the most destructive mechanism of secondary injury in the central nervous system. Trpm4 mRNA and protein were abundantly upregulated in capillaries preceding their fragmentation and formation of petechial hemorrhages. Trpm4 expression in vitro rendered COS-7 cells highly susceptible to oncotic swelling and oncotic death following ATP depletion. After spinal cord injury, in vivo gene suppression in rats treated with Trpm4 antisense or in Trpm4(-/-) mice preserved capillary structural integrity, eliminated secondary hemorrhage, yielded a threefold to fivefold reduction in lesion volume and produced a substantial improvement in neurological function. To our knowledge, this is the first example of a Trp channel that must undergo de novo expression for manifestation of central nervous system pathology.
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Affiliation(s)
- Volodymyr Gerzanich
- Department of Neurosurgery, University of Maryland School of Medicine, 22 South Greene Street, Suite S12D, Baltimore, Maryland 21201-1595, USA
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Yune TY, Park HG, Lee JY, Oh TH. Estrogen-Induced Bcl-2 Expression after Spinal Cord Injury Is Mediated through Phosphoinositide-3-Kinase/Akt-Dependent CREB Activation. J Neurotrauma 2008; 25:1121-31. [DOI: 10.1089/neu.2008.0544] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Tae Y. Yune
- Age-Related and Brain Diseases Research Center, Kyunghee University, Seoul, Korea
| | - Hong G. Park
- Age-Related and Brain Diseases Research Center, Kyunghee University, Seoul, Korea
| | - Jee Y. Lee
- Age-Related and Brain Diseases Research Center, Kyunghee University, Seoul, Korea
- Bioanalysis and Biotransformation Research Center, Korea Institute of Science and Technology, Seoul, Korea
| | - Tae H. Oh
- Age-Related and Brain Diseases Research Center, Kyunghee University, Seoul, Korea
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Eaton MJ, Pearse DD, McBroom JS, Berrocal YA. The combination of human neuronal serotonergic cell implants and environmental enrichment after contusive SCI improves motor recovery over each individual strategy. Behav Brain Res 2008; 194:236-41. [PMID: 18672005 DOI: 10.1016/j.bbr.2008.07.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Revised: 05/29/2008] [Accepted: 07/01/2008] [Indexed: 11/20/2022]
Abstract
A human neuronal cell line, hNT2.19, which secretes serotonin (5-HT) after differentiation, was used as a transplant source to improve motor dysfunction following severe contusive spinal cord injury (SCI). Also, environmental enrichment (EE) was added to the interspinal transplant treatment paradigm. Motor testing was performed weekly before and following SCI, with and without EE and/or cell transplant conditions. Motor recovery was maximal when both cell transplant and EE were used. Individual treatment paradigms also significantly improved foot rotation and reduced footfall errors but not stride length or base of support dysfunction. This recovery of motor function after SCI suggests that the combinatory use of serotonergic hNT2.19 cell grafts plus EE is a meaningful strategy to modestly improve motor dysfunction that accompanies contusive SCI.
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Affiliation(s)
- Mary J Eaton
- VA Medical Center, Miami, FL 33136, United States.
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