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Liu C, Yu H, Li Z, Chen S, Li X, Chen X, Chen B. The future of artificial hibernation medicine: protection of nerves and organs after spinal cord injury. Neural Regen Res 2024; 19:22-28. [PMID: 37488839 PMCID: PMC10479867 DOI: 10.4103/1673-5374.375305] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/05/2023] [Accepted: 04/17/2023] [Indexed: 07/26/2023] Open
Abstract
Spinal cord injury is a serious disease of the central nervous system involving irreversible nerve injury and various organ system injuries. At present, no effective clinical treatment exists. As one of the artificial hibernation techniques, mild hypothermia has preliminarily confirmed its clinical effect on spinal cord injury. However, its technical defects and barriers, along with serious clinical side effects, restrict its clinical application for spinal cord injury. Artificial hibernation is a future-oriented disruptive technology for human life support. It involves endogenous hibernation inducers and hibernation-related central neuromodulation that activate particular neurons, reduce the central constant temperature setting point, disrupt the normal constant body temperature, make the body "adapt" to the external cold environment, and reduce the physiological resistance to cold stimulation. Thus, studying the artificial hibernation mechanism may help develop new treatment strategies more suitable for clinical use than the cooling method of mild hypothermia technology. This review introduces artificial hibernation technologies, including mild hypothermia technology, hibernation inducers, and hibernation-related central neuromodulation technology. It summarizes the relevant research on hypothermia and hibernation for organ and nerve protection. These studies show that artificial hibernation technologies have therapeutic significance on nerve injury after spinal cord injury through inflammatory inhibition, immunosuppression, oxidative defense, and possible central protection. It also promotes the repair and protection of respiratory and digestive, cardiovascular, locomotor, urinary, and endocrine systems. This review provides new insights for the clinical treatment of nerve and multiple organ protection after spinal cord injury thanks to artificial hibernation. At present, artificial hibernation technology is not mature, and research faces various challenges. Nevertheless, the effort is worthwhile for the future development of medicine.
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Affiliation(s)
- Caiyun Liu
- School of Acupuncture & Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Research Center of Experimental Acupucture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Haixin Yu
- School of Acupuncture & Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Research Center of Experimental Acupucture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhengchao Li
- Characteristic Medical Center of Chinese People’s Armed Police Force, Tianjin, China
| | - Shulian Chen
- Characteristic Medical Center of Chinese People’s Armed Police Force, Tianjin, China
| | - Xiaoyin Li
- Characteristic Medical Center of Chinese People’s Armed Police Force, Tianjin, China
| | - Xuyi Chen
- Characteristic Medical Center of Chinese People’s Armed Police Force, Tianjin, China
| | - Bo Chen
- School of Acupuncture & Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Research Center of Experimental Acupucture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Binhai New Area Hospital of TCM, Tianjin, China
- Fourth Teaching Hospital of Tianjin University of TCM, Tianjin, China
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Hypothermia Therapy for Traumatic Spinal Cord Injury: An Updated Review. J Clin Med 2022; 11:jcm11061585. [PMID: 35329911 PMCID: PMC8949322 DOI: 10.3390/jcm11061585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 11/16/2022] Open
Abstract
Although hypothermia has shown to protect against ischemic and traumatic neuronal death, its potential role in neurologic recovery following traumatic spinal cord injury (TSCI) remains incompletely understood. Herein, we systematically review the safety and efficacy of hypothermia therapy for TSCI. The English medical literature was reviewed using PRISMA guidelines to identify preclinical and clinical studies examining the safety and efficacy of hypothermia following TSCI. Fifty-seven articles met full-text review criteria, of which twenty-eight were included. The main outcomes of interest were neurological recovery and postoperative complications. Among the 24 preclinical studies, both systemic and local hypothermia significantly improved neurologic recovery. In aggregate, the 4 clinical studies enrolled 60 patients for treatment, with 35 receiving systemic hypothermia and 25 local hypothermia. The most frequent complications were respiratory in nature. No patients suffered neurologic deterioration because of hypothermia treatment. Rates of American Spinal Injury Association (AIS) grade conversion after systemic hypothermia (35.5%) were higher when compared to multiple SCI database control studies (26.1%). However, no statistical conclusions could be drawn regarding the efficacy of hypothermia in humans. These limited clinical trials show promise and suggest therapeutic hypothermia to be safe in TSCI patients, though its effect on neurological recovery remains unclear. The preclinical literature supports the efficacy of hypothermia after TSCI. Further clinical trials are warranted to conclusively determine the effects of hypothermia on neurological recovery as well as the ideal means of administration necessary for achieving efficacy in TSCI.
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Li N, Chau CYC, Liu J, Yao M, Kiang KMY, Zhu Z, Zhang P, Cheng H, Leung GKK. Postcooling But Not Precooling Benefits Motor Recovery by Suppressing Cell Death After Surgical Spinal Cord Injury in Rats. World Neurosurg 2022; 159:e356-e364. [PMID: 34942389 DOI: 10.1016/j.wneu.2021.12.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Surgical spinal cord injury (SSCI) is often inevitable in patients with intramedullary lesions. Although regional hypothermia (RH) has been demonstrated neuroprotective, the value of priming RH in SSCI has never been studied. Herein, the authors investigated the impact of pre- and post-RH on neurologic recovery in a clinically relevant model. METHODS An SSCI model was established at T10. RH was conducted by focal 4oC saline perfusion; room temperature (RT) saline was used as controls. Animals were randomized into 6 groups: SHAM-RT/RH, Pre-RT/RH, and Post-RT/RH. Motor and sensory functions were evaluated using the Basso, Beattie, and Bresnahan rating scale and Plantar test 2 weeks after surgery. TUNEL assay and Fluoro-Jade C staining were conducted to examine the cell death, and the alterations of apoptotic markers including total and cleaved casepase 3, Bcl-2, and Bax, as well as the pyroptotic proteins including NLRP3, ASC, and caspase 1, were determined. RESULTS RH perfusion successfully created an intramedullary hypothermia approximately at 24oC, while RT controls remained above 30oC. Animals receiving postinjury RH had the least cell death and the best motor performance, while pre-RH showed the most dead cells and worst hind limb movements. Immunoblotting depicted that post-RH suppressed both apoptotic and pyroptotic death as the cleaved/total caspase 3, Bcl-2/Bax ratio, and NLRP3/ASC/caspase 1 signaling were inhibited. Priming cooling, on the contrary, elevated pyroptosis and did not affect apoptosis significantly. CONCLUSIONS Priming RH before surgical incision could not be supported as it caused excessive cell death. In contrast, instant introduction of RH is beneficial in rescuing neurologic function.
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Affiliation(s)
- Ning Li
- Department of Neurosurgery, Zhongda Hospital, Southeast University, Nanjing, China; Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Charlene Y C Chau
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Jiaxin Liu
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Min Yao
- School of Pharmaceutical Sciences, Health Science Center, Shenzhen University, Shenzhen, China
| | - Karrie M Y Kiang
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Zhiyuan Zhu
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Pingde Zhang
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Huilin Cheng
- Department of Neurosurgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Gilberto K K Leung
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR.
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Chen C, Xu HH, Liu XY, Zhang YS, Zhong L, Wang YW, Xu L, Wei P, Chen YX, Liu P, Hao CR, Jia XL, Hu N, Wu XY, Gu XS, Chen LQ, Li XH. 3D printed collagen/silk fibroin scaffolds carrying the secretome of human umbilical mesenchymal stem cells ameliorated neurological dysfunction after spinal cord injury in rats. Regen Biomater 2022; 9:rbac014. [PMID: 35480857 PMCID: PMC9036898 DOI: 10.1093/rb/rbac014] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 02/05/2023] Open
Abstract
Abstract
Although implantation of biomaterials carrying mesenchymal stem cells (MSCs) is considered as a promising strategy for ameliorating neural function after spinal cord injury (SCI), there are still some challenges including poor cell survival rate, tumorigenicity and ethics concerns. The performance of the secretome derived from MSCs was more stable, and its clinical transformation was more operable. Cytokine antibody array demonstrated that the secretome of MSCs contained 79 proteins among the 174 proteins analyzed. 3D printed collagen/silk fibroin scaffolds carrying MSCs secretome improved hindlimb locomotor function according to the BBB scores, the inclined-grid climbing test and electrophysiological analysis. Parallel with locomotor function recovery, 3D printed collagen/silk fibroin scaffolds carrying MSCs secretome could further facilitate nerve fiber regeneration, enhance remyelination and accelerate the establishment of synaptic connections at the injury site compared to 3D printed collagen/silk fibroin scaffolds alone group according to magnetic resonance imaging (MRI), diffusion Tensor imaging (DTI), hematoxylin and eosin (HE) staining, Bielschowsky’s silver staining immunofluorescence staining and transmission electron microscopy (TEM). These results indicated the implantation of 3D printed collagen/silk fibroin scaffolds carrying MSCs secretome might be a potential treatment for SCI.
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Affiliation(s)
- Chong Chen
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
- Tianjin Key Laboratory of Neurotrauma Repair, Pingjin Hospital Brain Center, Characteristic Medical Center of People’s Armed Police Forces, Tianjin, 300162, China
| | - Hai-Huan Xu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
- Tianjin Key Laboratory of Neurotrauma Repair, Pingjin Hospital Brain Center, Characteristic Medical Center of People’s Armed Police Forces, Tianjin, 300162, China
| | - Xiao-Yin Liu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
- Department of Neurosurgery, West China Medical School, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu, Sichuan, 610064, China
| | - Yu-Sheng Zhang
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu, Sichuan, 610064, China
| | - Lin Zhong
- Department of Hematology, the first affiliated hospital of Chengdu medical college, Chengdu, Sichuan, 610500, China
| | - You-Wei Wang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
| | - Lin Xu
- Medical Psychology Section, Hubei General Hospital of Armed Police Force, Wuhan, Hubei, 430071, China
| | - Pan Wei
- Department of Neurosurgery, The First People's Hospital Of Long Quan yi District, Cheng Du 610000, Si Chuan, China
| | - Ya-Xing Chen
- Department of Neurosurgery, West China Medical School, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Peng Liu
- Department of Neurosurgery, West China Medical School, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Chen-Ru Hao
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
| | - Xiao-Li Jia
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
| | - Nan Hu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
| | - Xiao-Yang Wu
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu, Sichuan, 610064, China
| | - Xiao-Song Gu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
| | - Li-Qun Chen
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
| | - Xiao-Hong Li
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
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Yousefifard M, Vazirizadeh-Mahabadi MH, Haghani L, Shokraneh F, Vaccaro AR, Rahimi-Movaghar V, Hosseini M. Early General Hypothermia Improves Motor Function after Spinal Cord Injury in Rats; a Systematic Review and Meta-Analysis. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2020; 8:e80. [PMID: 33251525 PMCID: PMC7682943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION There is still controversy about the effect of early hypothermia on the outcome of spinal cord injury (SCI). The aim of this review article is to investigate the effect of local or general hypothermia on improving the locomotion after traumatic SCI. METHODS Electronic databases (Medline and Embase) were searched from inception until May 7, 2018. Two independent reviewers screened and summarized the relevant experimental studies on hypothermia efficacy in traumatic SCI. The data were analyzed and the findings were presented as pooled standardized mean difference (SMD) and 95% confidence interval (95% CI). RESULTS 20 papers containing 30 separate experiments were included in meta-analysis. The onset of hypothermia varied between 0 and 240 minutes after SCI. Administration of hypothermia has a positive effect on locomotion following SCI (SMD=0.56 95% CI: 0.18-0.95, p=0.004). Subgroup analysis showed that general hypothermia improves locomotion recovery (SMD =0.89, 95% CI: 0.42 to 1.36; p <0.0001), while local hypothermia does not have a significant effect on motor recovery (SMD=0.20, 95 % CI: -0.36-0.76, p=0.478). In addition, general hypothermia was found to affect motor recovery only if its duration was between 2 and 8 hours (SMD=0.89; p<0.0001) and the target temperature for induction of hypothermia was between 32 and 35° C (SMD=0.83; p<0.0001). CONCLUSION We found that general hypothermia improves locomotion after SCI in rats. Duration of induction and the target temperature are two essential considerations for general therapeutic hypothermia.
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Affiliation(s)
- Mahmoud Yousefifard
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Leila Haghani
- School of Medicine, International Campus, Tehran University of Medical Science, Tehran, Iran
| | - Farhad Shokraneh
- Cochrane Schizophrenia Group, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Alexander R. Vaccaro
- Department of Orthopedics and Neurosurgery, Rothman Institute, Thomas Jefferson University, Philadelphia, USA
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Brain and Spinal Injuries Research Center (BASIR), Neuroscience Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Corresponding authors: 1- Mostafa Hosseini ,Department of Epidemiology and Biostatistics School of Public Health, Tehran University of Medical Sciences, Poursina Ave, Tehran, Iran; ; Tel: +982188989125; Fax: +982188989127. 2- Vafa Rahimi-Movaghar, Professor of Neurosurgery, Department of Neurosurgery, Sina Trauma and Surgery Research Center, Sina Hospital, Tel: +98216675002 Fax: +982166757009, E-mail: ;
| | - Mostafa Hosseini
- Pediatric Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Corresponding authors: 1- Mostafa Hosseini ,Department of Epidemiology and Biostatistics School of Public Health, Tehran University of Medical Sciences, Poursina Ave, Tehran, Iran; ; Tel: +982188989125; Fax: +982188989127. 2- Vafa Rahimi-Movaghar, Professor of Neurosurgery, Department of Neurosurgery, Sina Trauma and Surgery Research Center, Sina Hospital, Tel: +98216675002 Fax: +982166757009, E-mail: ;
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Kafka J, Lukacova N, Sulla I, Maloveska M, Vikartovska Z, Cizkova D. Hypothermia in the course of acute traumatic spinal cord injury. Acta Neurobiol Exp (Wars) 2020. [DOI: 10.21307/ane-2020-016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Liu XY, Liang J, Wang Y, Zhong L, Zhao CY, Wei MG, Wang JJ, Sun XZ, Wang KQ, Duan JH, Chen C, Tu Y, Zhang S, Ming D, Li XH. Diffusion tensor imaging predicting neurological repair of spinal cord injury with transplanting collagen/chitosan scaffold binding bFGF. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:123. [PMID: 31686219 DOI: 10.1007/s10856-019-6322-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
Prognosis and treatment evaluation of spinal cord injury (SCI) are still in the long-term research stage. Prognostic factors for SCI treatment need effective biomarker to assess therapeutic effect. Quantitative diffusion tensor imaging (DTI) may become a potential indicators for assessing SCI repair. However, its correlation with the results of locomotor function recovery and tissue repair has not been carefully studied. The aim of this study was to use quantitative DTI to predict neurological repair of SCI with transplanting collagen/chitosan scaffold binding basic fibroblast growth factor (bFGF). To achieve our research goals, T10 complete transection SCI model was established. Then collagen/chitosan mixture adsorbed with bFGF (CCS/bFGF) were implanted into rats with SCI. At 8 weeks after modeling, implanting CCS/bFGF demonstrated more significant improvements in locomotor function according to Basso-Beattie-Bresnahan (BBB) score, inclined-grid climbing test, and electrophysiological examinations. DTI was carried out to evaluate the repair of axons by diffusion tensor tractgraphy (DTT), fractional anisotropy (FA) and apparent diffusion coefficient (ADC), a numerical measure of relative white matter from the rostral to the caudal. Parallel to locomotor function recovery, the CCS/bFGF group could significantly promote the regeneration of nerve fibers tracts according to DTT, magnetic resonance imaging (MRI), Bielschowsky's silver staining and immunofluorescence staining. Positive correlations between imaging and locomotor function or histology were found at all locations from the rostral to the caudal (P < 0.0001). These results demonstrated that DTI might be used as an effective predictor for evaluating neurological repair after SCI in experimental trails and clinical cases.
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Affiliation(s)
- Xiao-Yin Liu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
- Tianjin Key Laboratory of Neurotrauma Repair, Pingjin Hospital Brain Center, Characteristic Medical Center of PAPF, Tianjin, 300162, China
- Tianjin Medical University, Qixiangtai Road No. 22, Tianjin, 300070, China
| | - Jun Liang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
| | - Yi Wang
- Department of Neurology, Tianjin Hospital of Tianjin, Tianjin, 300211, China
| | - Lin Zhong
- Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, China
| | - Chang-Yu Zhao
- Tianjin Key Laboratory of Neurotrauma Repair, Pingjin Hospital Brain Center, Characteristic Medical Center of PAPF, Tianjin, 300162, China
| | - Meng-Guang Wei
- Tianjin Key Laboratory of Neurotrauma Repair, Pingjin Hospital Brain Center, Characteristic Medical Center of PAPF, Tianjin, 300162, China
| | - Jing-Jing Wang
- Tianjin Key Laboratory of Neurotrauma Repair, Pingjin Hospital Brain Center, Characteristic Medical Center of PAPF, Tianjin, 300162, China
| | - Xiao-Zhe Sun
- Tianjin Key Laboratory of Neurotrauma Repair, Pingjin Hospital Brain Center, Characteristic Medical Center of PAPF, Tianjin, 300162, China
| | - Ke-Qiang Wang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
| | - Jing-Hao Duan
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
| | - Chong Chen
- Tianjin Key Laboratory of Neurotrauma Repair, Pingjin Hospital Brain Center, Characteristic Medical Center of PAPF, Tianjin, 300162, China
| | - Yue Tu
- Tianjin Key Laboratory of Neurotrauma Repair, Pingjin Hospital Brain Center, Characteristic Medical Center of PAPF, Tianjin, 300162, China
| | - Sai Zhang
- Tianjin Key Laboratory of Neurotrauma Repair, Pingjin Hospital Brain Center, Characteristic Medical Center of PAPF, Tianjin, 300162, China
| | - Dong Ming
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China.
| | - Xiao-Hong Li
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China.
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Zavodska M, Galik J, Marsala M, Papcunova S, Pavel J, Racekova E, Martoncikova M, Sulla I, Gajdos M, Lukac I, Kafka J, Ledecky V, Sulla I, Reichel P, Trbolova A, Capik I, Bimbova K, Bacova M, Stropkovska A, Kisucka A, Miklisova D, Lukacova N. Hypothermic treatment after computer-controlled compression in minipig: A preliminary report on the effect of epidural vs. direct spinal cord cooling. Exp Ther Med 2018; 16:4927-4942. [PMID: 30542449 PMCID: PMC6257352 DOI: 10.3892/etm.2018.6831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 06/29/2018] [Indexed: 11/24/2022] Open
Abstract
The aim of the present study was to investigate the therapeutic efficacy of local hypothermia (beginning 30 min post-injury persisting for 5 h) on tissue preservation along the rostro-caudal axis of the spinal cord (3 cm cranially and caudally from the lesion site), and the prevention of injury-induced functional loss in a newly developed computer-controlled compression model in minipig (force of impact 18N at L3 level), which mimics severe spinal cord injury (SCI). Minipigs underwent SCI with two post-injury modifications (durotomy vs. intact dura mater) followed by hypothermia through a perfusion chamber with cold (epidural t≈15°C) saline, DMEM/F12 or enriched DMEM/F12 (SCI/durotomy group) and with room temperature (t≈24°C) saline (SCI-only group). Minipigs treated with post-SCI durotomy demonstrated slower development of spontaneous neurological improvement at the early postinjury time points, although the outcome at 9 weeks of survival did not differ significantly between the two SCI groups. Hypothermia with saline (t≈15°C) applied after SCI-durotomy improved white matter integrity in the dorsal and lateral columns in almost all rostro-caudal segments, whereas treatment with medium/enriched medium affected white matter integrity only in the rostral segments. Furthermore, regeneration of neurofilaments in the spinal cord after SCI-durotomy and hypothermic treatments indicated an important role of local saline hypothermia in the functional outcome. Although saline hypothermia (24°C) in the SCI-only group exhibited a profound histological outcome (regarding the gray and white matter integrity and the number of motoneurons) and neurofilament protection in general, none of the tested treatments resulted in significant improvement of neurological status. The findings suggest that clinically-proven medical treatments for SCI combined with early 5 h-long saline hypothermia treatment without opening the dural sac could be more beneficial for tissue preservation and neurological outcome compared with hypothermia applied after durotomy.
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Affiliation(s)
- Monika Zavodska
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - Jan Galik
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - Martin Marsala
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia.,Department of Anesthesiology, Neuroregeneration Laboratory, University of California-San Diego, San Diego, CA 92093, USA
| | - Stefania Papcunova
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - Jaroslav Pavel
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - Eniko Racekova
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - Marcela Martoncikova
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - Igor Sulla
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia.,Hospital of Slovak Railways, 040 01 Košice, Slovakia
| | - Miroslav Gajdos
- Department of Neurosurgery, Faculty of Medicine, University of Pavol Jozef Safarik, 040 66 Košice, Slovakia
| | - Imrich Lukac
- Department of Neurosurgery, Faculty of Medicine, University of Pavol Jozef Safarik, 040 66 Košice, Slovakia
| | - Jozef Kafka
- Department of Neurosurgery, Faculty of Medicine, University of Pavol Jozef Safarik, 040 66 Košice, Slovakia
| | - Valent Ledecky
- Department of Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 041 81 Košice, Slovakia
| | - Igor Sulla
- Department of Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 041 81 Košice, Slovakia
| | - Peter Reichel
- Department of Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 041 81 Košice, Slovakia
| | - Alexandra Trbolova
- Department of Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 041 81 Košice, Slovakia
| | - Igor Capik
- Department of Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 041 81 Košice, Slovakia
| | - Katarina Bimbova
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - Maria Bacova
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - Andrea Stropkovska
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - Alexandra Kisucka
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - Dana Miklisova
- Department of Vector-borne Diseases, Institute of Parasitology, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - Nadezda Lukacova
- Institute of Neurobiology, Biomedical Research Center, Slovak Academy of Sciences, 040 01 Košice, Slovakia
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