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Topical Dimethyl Sulfoxide for Congested Nipple-areolar Complexes in Breast Surgery: A Pilot Study. Plast Reconstr Surg Glob Open 2022; 10:e4595. [PMID: 36320619 PMCID: PMC9616635 DOI: 10.1097/gox.0000000000004595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/23/2022] [Indexed: 11/24/2022]
Abstract
UNLABELLED Necrosis of the nipple-areolar complex (NAC) is a major complication of breast surgery that most commonly results from venous congestion. Several conservative rescue therapies have been proposed for relieving NAC congestion, but each carries certain drawbacks, including cost and side effect profile. In this study, we evaluated the effectiveness of topical dimethyl sulfoxide (DMSO), an inexpensive compound with vasodilatory, free radical scavenging, and antiinflammatory properties in rescuing congested NACs. METHODS We conducted a review of all 15 patients treated with DMSO for NAC congestion at our institution between May 2019 and October 2020. DMSO was applied in liquid form on a soaked gauze pad in the hospital; patients were instructed to apply a DMSO cream to the NAC twice a day following discharge. Patient characteristics and data related to DMSO treatment and NAC healing were compared via univariate analysis. RESULTS Eighteen congested NACs from 15 patients who underwent mastectomy, breast reduction, mastopexy, or breast reconstruction were treated with DMSO. Of the 18 treated NACs, 15 healed with DMSO treatment alone. The average length of DMSO treatment was 9.4 ± 8.5 days (mean ± standard deviation); NAC healing took place over 9.9 ± 9.6 days. There were no complications related to DMSO treatment. CONCLUSIONS This pilot study shows that DMSO may be an effective topical treatment for NAC congestion following breast surgery. Given its low cost, ease of application, and lack of side effects, future studies should prospectively compare DMSO against other topical treatments, like nitroglycerin ointment.
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Baidya SK, Banerjee S, Adhikari N, Jha T. Selective Inhibitors of Medium-Size S1' Pocket Matrix Metalloproteinases: A Stepping Stone of Future Drug Discovery. J Med Chem 2022; 65:10709-10754. [PMID: 35969157 DOI: 10.1021/acs.jmedchem.1c01855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Among various matrix metalloproteinases (MMPs), MMPs having medium-size S1' pockets are established as promising biomolecular targets for executing crucial roles in cancer, cardiovascular diseases, and neurodegenerative diseases. However, no such MMP inhibitors (MMPIs) are available to date as drug candidates despite a lot of continuous research work for more than three decades. Due to a high degree of structural resemblance among these MMPs, designing selective MMPIs is quite challenging. However, the variability and uniqueness of the S1' pockets of these MMPs make them promising targets for designing selective MMPIs. In this perspective, the overall structural aspects of medium-size S1' pocket MMPs including the unique binding patterns of enzyme-inhibitor interactions have been discussed in detail to acquire knowledge regarding selective inhibitor designing. This overall knowledge will surely be a curtain raiser for the designing of selective MMPIs as drug candidates in the future.
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Affiliation(s)
- Sandip Kumar Baidya
- Natural Science Laboratory, Division of Medicinal and Pharmaceutical Chemistry, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, India
| | - Suvankar Banerjee
- Natural Science Laboratory, Division of Medicinal and Pharmaceutical Chemistry, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, India
| | - Nilanjan Adhikari
- Natural Science Laboratory, Division of Medicinal and Pharmaceutical Chemistry, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, India
| | - Tarun Jha
- Natural Science Laboratory, Division of Medicinal and Pharmaceutical Chemistry, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, India
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3
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Moore SA, Olby NJ, Brisson B, Fenn J, Flegel T, Kortz G, Lewis M, Tipold A. ACVIM consensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion. J Vet Intern Med 2022; 36:1570-1596. [PMID: 35880267 PMCID: PMC9511077 DOI: 10.1111/jvim.16480] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/12/2022] [Indexed: 12/16/2022] Open
Abstract
Background Thoracolumbar intervertebral disc extrusion (TL‐IVDE) is the most common cause of acute paraparesis and paraplegia in dogs; however, guidelines on management of the condition are lacking. Objectives To summarize the current literature as it relates to diagnosis and management of acute TL‐IVDE in dogs, and to formulate clinically relevant evidence‐based recommendations. Animals None. Methods A panel of 8 experts was convened to assess and summarize evidence from the peer‐reviewed literature in order to develop consensus clinical recommendations. Level of evidence available to support each recommendation was assessed and reported. Results The majority of available literature described observational studies. Most recommendations made by the panel were supported by a low or moderate level of evidence, and several areas of high need for further study were identified. These include better understanding of the ideal timing for surgical decompression, expected surgical vs medical outcomes for more mildly affected dogs, impact of durotomy on locomotor outcome and development of progressive myelomalacia, and refining of postoperative care, and genetic and preventative care studies. Conclusions and Clinical Importance Future efforts should build on current recommendations by conducting prospective studies and randomized controlled trials, where possible, to address identified gaps in knowledge and to develop cost effectiveness and number needed to treat studies supporting various aspects of diagnosis and treatment of TL‐IVDE.
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Affiliation(s)
- Sarah A Moore
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | | | - Brigitte Brisson
- Department of Clinical Studies, Ontario Veterinary College, Ontario Veterinary College, Guelph, Ontario, Canada
| | - Joe Fenn
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Thomas Flegel
- Department for Small Animals, Leipzig University, Leipzig, Germany
| | - Gregg Kortz
- VCA Sacramento Veterinary Referral Center, Sacramento, California, USA.,VCA Sacramento Veterinary Referral Center, UC Davis, California, USA
| | - Melissa Lewis
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hanover, Hanover, Germany
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4
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Neutrophil, Extracellular Matrix Components, and Their Interlinked Action in Promoting Secondary Pathogenesis After Spinal Cord Injury. Mol Neurobiol 2021; 58:4652-4665. [PMID: 34159551 DOI: 10.1007/s12035-021-02443-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/05/2021] [Indexed: 02/06/2023]
Abstract
Secondary pathogenesis following primary mechanical damage to the spinal cord is believed to be the ultimate reason for the limitation of currently available therapies. Precisely, the complex cascade of secondary events-mediated scar formation is the sole hurdle in the recovery process due to its inhibitory effect on axonal regeneration, plasticity, and remyelination. Neutrophils initiate this secondary injury along with other extracellular matrix components such as matrix metalloproteinase (MMPs), and chondroitin sulfate proteoglycans (CSPGs). Together, they mediate inflammation, necrosis, apoptosis, lesion, and scar formation at the injury site. Activated neutrophil releases several proteases, cytokines, and chemokines that cause complete tissue destruction. Thus, neutrophil activation and infiltration in the acute phase of injury act as a roadmap for inducing tissue destruction. MMPs, are extracellular proteolytic enzymes that degrade the ECM proteins, increases vascular permeability, and are predominantly released by neutrophils. These MMPs, in turn, cleave NG2 proteoglycan, a subtype of CSPG, into the active form. This active or shed form is involved in both the fibrotic as well as glial scar formation. Since neutrophils and ECM components are closely associated with each other in pathological conditions. Herein, we emphasize the interaction of neutrophils and their influence on ECM protein expression during the acute and chronic phases to identify a promising targets for designing a therapeutic approach in spinal cord injury.
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5
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Spitzbarth I, Moore SA, Stein VM, Levine JM, Kühl B, Gerhauser I, Baumgärtner W. Current Insights Into the Pathology of Canine Intervertebral Disc Extrusion-Induced Spinal Cord Injury. Front Vet Sci 2020; 7:595796. [PMID: 33195632 PMCID: PMC7653192 DOI: 10.3389/fvets.2020.595796] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/30/2020] [Indexed: 11/13/2022] Open
Abstract
Spinal cord injury (SCI) in dogs is commonly attributed to intervertebral disc extrusion (IVDE). Over the last years substantial progress was made in the elucidation of factors contributing to the pathogenesis of this common canine disease. A detailed understanding of the underlying histopathological and molecular alterations in the lesioned spinal cord represents a prerequisite to translate knowledge on the time course of secondary injury processes into the clinical setting. This review summarizes the current state of knowledge of the underlying pathology of canine IVDE-related SCI. Pathological alterations in the spinal cord of dogs affected by IVDE-related SCI include early and persisting axonal damage and glial responses, dominated by phagocytic microglia/macrophages. These processes are paralleled by a pro-inflammatory microenvironment with dysregulation of cytokines and matrix metalloproteinases within the spinal cord. These data mirror findings from a clinical and therapeutic perspective and can be used to identify biomarkers that are able to more precisely predict the clinical outcome. The pathogenesis of progressive myelomalacia, a devastating complication of SCI in dogs, is not understood in detail so far; however, a fulminant and exaggerating secondary injury response with massive reactive oxygen species formation seems to be involved in this unique neuropathological entity. There are substantial gaps in the knowledge of pathological changes in IVDE with respect to more advanced and chronic lesions and the potential involvement of demyelination. Moreover, the role of microglia/macrophage polarization in IVDE-related SCI still remains to be investigated. A close collaboration of clinical neurologists and veterinary pathologists will help to facilitate an integrative approach to a more detailed understanding of the molecular pathogenesis of canine IVDE and thus to identify therapeutic targets.
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Affiliation(s)
- Ingo Spitzbarth
- Faculty of Veterinary Medicine, Institute of Veterinary Pathology, Leipzig University, Leipzig, Germany
| | - Sarah A Moore
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, United States
| | - Veronika M Stein
- Department for Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Jonathan M Levine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Bianca Kühl
- Department of Pathology, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Ingo Gerhauser
- Department of Pathology, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Wolfgang Baumgärtner
- Department of Pathology, University of Veterinary Medicine Hannover, Hanover, Germany
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6
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Lewis MJ, Granger N, Jeffery ND. Emerging and Adjunctive Therapies for Spinal Cord Injury Following Acute Canine Intervertebral Disc Herniation. Front Vet Sci 2020; 7:579933. [PMID: 33195591 PMCID: PMC7593405 DOI: 10.3389/fvets.2020.579933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/04/2020] [Indexed: 11/13/2022] Open
Abstract
Some dogs do not make a full recovery following medical or surgical management of acute canine intervertebral disc herniation (IVDH), highlighting the limits of currently available treatment options. The multitude of difficulties in treating severe spinal cord injury are well-recognized, and they have spurred intense laboratory research, resulting in a broad range of strategies that might have value in treating spinal cord-injured dogs. These include interventions that aim to directly repair the spinal cord lesion, promote axonal sparing or regeneration, mitigate secondary injury through neuroprotective mechanisms, or facilitate functional compensation. Despite initial promise in experimental models, many of these techniques have failed or shown mild efficacy in clinical trials in humans and dogs, although high quality evidence is lacking for many of these interventions. However, the continued introduction of new options to the veterinary clinic remains important for expanding our understanding of the mechanisms of injury and repair and for development of novel and combined strategies for severely affected dogs. This review outlines adjunctive or emerging therapies that have been proposed as treatment options for dogs with acute IVDH, including discussion of local or lesion-based approaches as well as systemically applied treatments in both acute and subacute-to-chronic settings. These interventions include low-level laser therapy, electromagnetic fields or oscillating electrical fields, adjunctive surgical techniques (myelotomy or durotomy), systemically or locally-applied hypothermia, neuroprotective chemicals, physical rehabilitation, hyperbaric oxygen therapy, electroacupuncture, electrical stimulation of the spinal cord or specific peripheral nerves, nerve grafting strategies, 4-aminopyridine, chondroitinase ABC, and cell transplantation.
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Affiliation(s)
- Melissa J Lewis
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, United States
| | - Nicolas Granger
- The Royal Veterinary College, University of London, Hertfordshire, United Kingdom.,CVS Referrals, Bristol Veterinary Specialists at Highcroft, Bristol, United Kingdom
| | - Nick D Jeffery
- Department of Small Animal Clinical Sciences, Texas A & M College of Veterinary Medicine and Biomedical Sciences, College Station, TX, United States
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7
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Olby N, Griffith E, Levine J. Comparison of Gait Assessment Scales in Dogs with Spinal Cord Injury from Intervertebral Disc Herniation. J Neurotrauma 2020; 37:1991-1998. [PMID: 31914849 DOI: 10.1089/neu.2019.6804] [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] [Indexed: 01/18/2023] Open
Abstract
Naturally occurring thoracolumbar spinal cord injury (SCI) is common in dogs, and multi-center veterinary clinical studies can serve as translational tools to identify potentially effective therapies for human clinical trials. Assessment of gait is a key outcome, and several scales are used in dogs. The purpose of this study was to determine whether an international group of researchers could score gait reliably, to compare and contrast the performance of gait scales and to describe appropriate data analysis techniques. A training module was developed for a binary scale, modified Frankel Scale (MFS), Texas SCI Scale (TSCIS), and Open Field Scale (OFS). Raters viewed the training module, scored five training video clips to achieve proficiency, then scored 30 video clips from 10 dogs recovering from SCI. Interrater reliability was calculated, and correlation between scales was examined. Ceiling effect was described. Twenty raters with differing experience participated. The training module took 16 min to view. Raters chose identical binary outcomes in 597 of 600 observations. Intraclass correlation for MFS, TSCIS, and OFS was excellent at 0.85, 0.96, and 0.96, respectively, regardless of rater expertise. Ceiling effect occurred in all dogs that recovered ambulation, particularly using MFS and binary outcome. The TSCIS and OFS captured recovery of ambulatory dogs better, and addition of scores on hopping and proprioception mitigated ceiling effect. We conclude that gait in dogs with SCI can be scored reliably after training. A variety of different gait scales can be used in multi-center trials to capture outcome in different ways.
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Affiliation(s)
- Natasha Olby
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA.,The Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
| | - Emily Griffith
- Department of Statistics, North Carolina State University College of Sciences, Raleigh, North Carolina, USA
| | - Jon Levine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, College Station, Texas, USA
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8
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Protein Degradome of Spinal Cord Injury: Biomarkers and Potential Therapeutic Targets. Mol Neurobiol 2020; 57:2702-2726. [PMID: 32328876 DOI: 10.1007/s12035-020-01916-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/31/2020] [Indexed: 12/13/2022]
Abstract
Degradomics is a proteomics sub-discipline whose goal is to identify and characterize protease-substrate repertoires. With the aim of deciphering and characterizing key signature breakdown products, degradomics emerged to define encryptic biomarker neoproteins specific to certain disease processes. Remarkable improvements in structural and analytical experimental methodologies as evident in research investigating cellular behavior in neuroscience and cancer have allowed the identification of specific degradomes, increasing our knowledge about proteases and their regulators and substrates along with their implications in health and disease. A physiologic balance between protein synthesis and degradation is sought with the activation of proteolytic enzymes such as calpains, caspases, cathepsins, and matrix metalloproteinases. Proteolysis is essential for development, growth, and regeneration; however, inappropriate and uncontrolled activation of the proteolytic system renders the diseased tissue susceptible to further neurotoxic processes. In this article, we aim to review the protease-substrate repertoires as well as emerging therapeutic interventions in spinal cord injury at the degradomic level. Several protease substrates and their breakdown products, essential for the neuronal structural integrity and functional capacity, have been characterized in neurotrauma including cytoskeletal proteins, neuronal extracellular matrix glycoproteins, cell junction proteins, and ion channels. Therefore, targeting exaggerated protease activity provides a potentially effective therapeutic approach in the management of protease-mediated neurotoxicity in reducing the extent of damage secondary to spinal cord injury.
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9
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Partridge B, Rossmeisl JH. Companion animal models of neurological disease. J Neurosci Methods 2020; 331:108484. [PMID: 31733285 PMCID: PMC6942211 DOI: 10.1016/j.jneumeth.2019.108484] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 10/28/2019] [Accepted: 10/28/2019] [Indexed: 02/07/2023]
Abstract
Clinical translation of novel therapeutics that improve the survival and quality of life of patients with neurological disease remains a challenge, with many investigational drug and device candidates failing in advanced stage clinical trials. Naturally occurring inherited and acquired neurological diseases, such as epilepsy, inborn errors of metabolism, brain tumors, spinal cord injury, and stroke occur frequently in companion animals, and many of these share epidemiologic, pathophysiologic and clinical features with their human counterparts. As companion animals have a relatively abbreviated lifespan and genetic background, are immunocompetent, share their environment with human caregivers, and can be clinically managed using techniques and tools similar to those used in humans, they have tremendous potential for increasing the predictive value of preclinical drug and device studies. Here, we review comparative features of spontaneous neurological diseases in companion animals with an emphasis on neuroimaging methods and features, illustrate their historical use in translational studies, and discuss inherent limitations associated with each disease model. Integration of companion animals with naturally occurring disease into preclinical studies can complement and expand the knowledge gained from studies in other animal models, accelerate or improve the manner in which research is translated to the human clinic, and ultimately generate discoveries that will benefit the health of humans and animals.
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Affiliation(s)
- Brittanie Partridge
- Veterinary and Comparative Neuro-Oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, 24061, USA; Brain Tumor Center of Excellence, Wake Forest University Comprehensive Cancer Center, Medical Center Blvd, NRC 405, Winston Salem, NC, 27157, USA
| | - John H Rossmeisl
- Veterinary and Comparative Neuro-Oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, 24061, USA; Brain Tumor Center of Excellence, Wake Forest University Comprehensive Cancer Center, Medical Center Blvd, NRC 405, Winston Salem, NC, 27157, USA.
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10
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Cook L, Byron J, Moore S. Urological Sequelae to Acute Spinal Cord Injury in Pet Dogs: A Natural Disease Model of Neuropathic Bladder Dysfunction. Top Spinal Cord Inj Rehabil 2020; 25:205-213. [PMID: 31548787 DOI: 10.1310/sci2503-205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The authors review urologic dysfunction, including urine retention, incontinence, and recurrent and resistant urinary tract infection, in dogs as a sequela to acute spinal cord injury. Urologic sequelae to acute spinal cord injury (SCI) pose significant complications in human and canine patients impacting quality of life and long-term cost of treatment. Dogs with intervertebral disc extrusion may serve as a natural disease model of acute SCI for investigating translational interventions, both prophylactic and therapeutic, for urologic dysfunction in human SCI patients.
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11
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Trivedi A, Noble-Haeusslein LJ, Levine JM, Santucci AD, Reeves TM, Phillips LL. Matrix metalloproteinase signals following neurotrauma are right on cue. Cell Mol Life Sci 2019; 76:3141-3156. [PMID: 31168660 PMCID: PMC11105352 DOI: 10.1007/s00018-019-03176-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 05/22/2019] [Accepted: 05/29/2019] [Indexed: 12/20/2022]
Abstract
Neurotrauma, a term referencing both traumatic brain and spinal cord injuries, is unique to neurodegeneration in that onset is clearly defined. From the perspective of matrix metalloproteinases (MMPs), there is opportunity to define their temporal participation in injury and recovery beginning at the level of the synapse. Here we examine the diverse roles of MMPs in the context of targeted insults (optic nerve lesion and hippocampal and olfactory bulb deafferentation), and clinically relevant focal models of traumatic brain and spinal cord injuries. Time-specific MMP postinjury signaling is critical to synaptic recovery after focal axonal injuries; members of the MMP family exhibit a signature temporal profile corresponding to axonal degeneration and regrowth, where they direct postinjury reorganization and synaptic stabilization. In both traumatic brain and spinal cord injuries, MMPs mediate early secondary pathogenesis including disruption of the blood-brain barrier, creating an environment that may be hostile to recovery. They are also critical players in wound healing including angiogenesis and the formation of an inhibitory glial scar. Experimental strategies to reduce their activity in the acute phase result in long-term neurological recovery after neurotrauma and have led to the first clinical trial in spinal cord injured pet dogs.
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Affiliation(s)
- Alpa Trivedi
- Department of Laboratory Medicine, University of California, San Francisco, 513 Parnassus Avenue, HSE 760, San Francisco, CA, 94143, USA.
| | - Linda J Noble-Haeusslein
- Departments of Psychology, College of Liberal Arts, and Neurology, the Dell Medical School, University of Texas, Austin, TX, 78712, USA
| | - Jonathan M Levine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Alison D Santucci
- Department of Neuroscience, Skidmore College, Saratoga Springs, NY, 12866, USA
| | - Thomas M Reeves
- Department of Anatomy and Neurobiology, Medical Campus, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Linda L Phillips
- Department of Anatomy and Neurobiology, Medical Campus, Virginia Commonwealth University, Richmond, VA, 23298, USA
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12
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Skytte D, Schmökel H. Relationship of preoperative neurologic score with intervals to regaining micturition and ambulation following surgical treatment of thoracolumbar disk herniation in dogs. J Am Vet Med Assoc 2019; 253:196-200. [PMID: 29963949 DOI: 10.2460/javma.253.2.196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To estimate the times required for dogs to regain micturition and ambulation following surgical treatment for thoracolumbar Hansen type I intervertebral disk extrusion (IVDE) and determine whether these variables were associated with preoperative modified Frankel score (MFS). DESIGN Retrospective case series with nested cohort study. ANIMALS 54 dogs weighing < 20 kg (44 lb) that were surgically treated for Hansen type I IVDE at a referral hospital between January and December 2015. PROCEDURES Medical records and CT and MRI data were reviewed. Information was collected regarding dog signalment, type and duration of clinical signs, preoperative MFS, degree of spinal cord compression, type of medical and surgical treatment provided, and intervals from surgery to regaining micturition and ambulation (outcomes). Collected data were evaluated for correlations with outcomes. RESULTS Mean ± SD interval from surgery to regaining micturition was 4.1 ± 4.4 days, and mean interval from surgery to regaining ambulation was 13.8 ± 25.1 days. These intervals differed significantly. Significant negative correlations with MFS were identified for interval to regaining micturition (r = -0.63) and interval to regaining ambulation (r = -0.64). No other correlations with outcome were identified. CONCLUSIONS AND CLINICAL RELEVANCE The amount of time required for dogs to regain micturition and ambulation following surgery for thoracolumbar IVDE was correlated with preoperative severity of clinical signs, as reflected by preoperative MFSs. This information should be useful for pre- and postoperative decision-making and setting of expectations for owners of and clinicians treating affected dogs.
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13
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Zidan N, Fenn J, Griffith E, Early PJ, Mariani CL, Muñana KR, Guevar J, Olby NJ. The Effect of Electromagnetic Fields on Post-Operative Pain and Locomotor Recovery in Dogs with Acute, Severe Thoracolumbar Intervertebral Disc Extrusion: A Randomized Placebo-Controlled, Prospective Clinical Trial. J Neurotrauma 2018; 35:1726-1736. [DOI: 10.1089/neu.2017.5485] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Natalia Zidan
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Joe Fenn
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - Emily Griffith
- Department of Statistics, North Carolina State University, Raleigh, North Carolina
| | - Peter J. Early
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Chris L. Mariani
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Karen R. Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Julien Guevar
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Natasha J. Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
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14
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Griffin J, Levine JM. High-resolution MRI of spinal cords by compressive sensing parallel imaging. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2015:4266-9. [PMID: 26737237 DOI: 10.1109/embc.2015.7319337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Spinal Cord Injury (SCI) is a common injury due to diseases or accidents. Noninvasive imaging methods play a critical role in diagnosing SCI and monitoring the response to therapy. Magnetic Resonance Imaging (MRI), by the virtue of providing excellent soft tissue contrast, is the most promising imaging method for this application. However, spinal cord has a very small cross-section, which needs high-resolution images for better visualization and diagnosis. Acquiring high-resolution spinal cord MRI images requires long acquisition time due to the physical and physiological constraints. Moreover, long acquisition time makes MRI more susceptible to motion artifacts. In this paper, we studied the application of compressive sensing (CS) and parallel imaging to achieve high-resolution imaging from sparsely sampled and reduced k-space data acquired by parallel receive arrays. In particular, the studies are limited to the effects of 2D Cartesian sampling with different subsampling schemes and reduction factors. The results show that compressive sensing parallel MRI has the potential to provide high-resolution images of the spinal cord in 1/3 of the acquisition time required by the conventional methods.
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15
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Thompson K, Moore S, Tang S, Wiet M, Purmessur D. The chondrodystrophic dog: A clinically relevant intermediate-sized animal model for the study of intervertebral disc-associated spinal pain. JOR Spine 2018; 1:e1011. [PMID: 29984354 PMCID: PMC6018624 DOI: 10.1002/jsp2.1011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 02/23/2018] [Accepted: 02/23/2018] [Indexed: 12/16/2022] Open
Abstract
Low back pain (LBP) is the leading cause of disability worldwide, with an estimated 80% of the American population suffering from a painful back condition at some point during their lives. The most common cause of LBP is intervertebral disc (IVD) degeneration (IVDD), a condition that can be difficult to treat, either surgically or medically, with current available therapies. Thus, understanding the pathological mechanisms of IVDD and developing novel treatments are critical for improving outcome and quality of life in people living with LBP. While experimental animal models provide valuable mechanistic insight, each model has limitations that complicate translation to the clinical setting. This review focuses on the chondrodystrophic canine clinical model of IVDD as a promising model to assess IVD‐associated spinal pain and translational therapeutic strategies for LBP. The canine IVD, while smaller in size than human, goat, ovine, and bovine IVDs, is larger than most other small animal IVDD models and undergoes maturational changes similar to those of the human IVD. Furthermore, both dogs and humans develop painful IVDD as a spontaneous process, resulting in similar characteristic pathologies and clinical signs. Future exploration of the canine model as a model of IVD‐associated spinal pain and biological treatments using the canine clinical model will further demonstrate its translational capabilities with the added ethical benefit of treating an existing veterinary patient population with IVDD.
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Affiliation(s)
- Kelly Thompson
- Department of Veterinary Clinical Sciences The Ohio State University Columbus Ohio
| | - Sarah Moore
- Department of Veterinary Clinical Sciences The Ohio State University Columbus Ohio
| | - Shirley Tang
- Department of Biomedical Engineering, College of Engineering The Ohio State University Columbus Ohio
| | - Matthew Wiet
- Department of Biomedical Engineering, College of Engineering The Ohio State University Columbus Ohio
| | - Devina Purmessur
- Department of Biomedical Engineering, College of Engineering The Ohio State University Columbus Ohio.,Department of Orthopedics, College of Medicine The Ohio State University Columbus Ohio
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16
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Levine JM, Cohen ND, Fandel TM, Levine GJ, Mankin J, Griffin JF, Kerwin SC, Boudreau CE, Trivedi A, Noble-Haeusslein LJ. Early Blockade of Matrix Metalloproteinases in Spinal-Cord–Injured Dogs Results in a Long-Term Increase in Bladder Compliance. J Neurotrauma 2017; 34:2656-2667. [DOI: 10.1089/neu.2017.5001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Jonathan M. Levine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Noah D. Cohen
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Thomas M. Fandel
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Gwendolyn J. Levine
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Joseph Mankin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - John F. Griffin
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Sharon C. Kerwin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - C. Elizabeth Boudreau
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Alpa Trivedi
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Linda J. Noble-Haeusslein
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
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17
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Refaat MM, Zickri MB, Fares AE, Gabr H, El-Jaafary SI, Mahmoud BE, Madbouly MA, Abdelfadel MA, Hammad AM, Farghali HAM. Enhancement of neural regeneration after spinal cord injury using muscle graft in experimental dogs. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:9330-9340. [PMID: 31966805 PMCID: PMC6965910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 08/17/2017] [Indexed: 06/10/2023]
Abstract
AIMS Spinal cord injuries (SCIs) can cause severe disability or death. The principal treatments for traumatic SCI include surgical stabilization and decompression. Using muscle as a scaffold is a new approach. The aim of this work is to evaluate the clinical efficacy of muscle graft as a scaffold for the growing axons organizing their growth, preventing gliosis in the damaged area and enhancing neural recovery in canine model of traumatic spinal cord injury. METHODS 14 dogs were divided into group I (Control group) 4 control dogs subjected to Sham operation, group II (Trauma control group) 5 dogs subjected to dorsal laminectomy with excision of 1 cm segment of the spinal cord and group III (Muscle graft group) 5 dogs subjected to dorsal laminectomy then muscle graft was taken from the longissimus thoraces and inserted into the spinal cord gap. The animals of all groups were euthanatized after 8 weeks. Olby and modified Tarlov scores were used to clinically evaluate the therapeutic effects. Spinal cord specimens were subjected to histological, morphometric and statistical studies. RESULTS Olby and modified Tarlov scores revealed significant clinical improvement in the muscle graft group. Histological sections showed overgrowth of axons on the muscle graft and the sections started to organize as central gray matter and peripheral white matter. CD44 & CD105 stains were positive for endogenous stem cells. CONCLUSIONS This study proved the clinical efficacy of muscle grafting as a tool for induction of neuroregeneration after traumatic spinal cord injury.
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Affiliation(s)
- Mohamed M Refaat
- Department of Neurosurgery, Faculty of Medicine, Benisuef UniversityEgypt
| | - Maha Baligh Zickri
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Cairo UniversityEgypt
| | - Amal Elham Fares
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Cairo UniversityEgypt
| | - Hala Gabr
- Department of Clinical Pathology, Faculty of Medicine, Cairo UniversityEgypt
| | | | | | | | | | | | - Haithem AM Farghali
- Surgery, Anesthesiology and Radiology Department, Faculty of Veterinary Medicine, Cairo UniversityEgypt
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18
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Blau SR, Davis LM, Gorney AM, Dohse CS, Williams KD, Lim JH, Pfitzner WG, Laber E, Sawicki GS, Olby NJ. Quantifying center of pressure variability in chondrodystrophoid dogs. Vet J 2017; 226:26-31. [PMID: 28911837 DOI: 10.1016/j.tvjl.2017.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/27/2017] [Accepted: 07/14/2017] [Indexed: 10/19/2022]
Abstract
The center of pressure (COP) position reflects a combination of proprioceptive, motor and mechanical function. As such, it can be used to quantify and characterize neurologic dysfunction. The aim of this study was to describe and quantify the movement of COP and its variability in healthy chondrodystrophoid dogs while walking to provide a baseline for comparison to dogs with spinal cord injury due to acute intervertebral disc herniations. Fifteen healthy adult chondrodystrophoid dogs were walked on an instrumented treadmill that recorded the location of each dog's COP as it walked. Center of pressure (COP) was referenced from an anatomical marker on the dogs' back. The root mean squared (RMS) values of changes in COP location in the sagittal (y) and horizontal (x) directions were calculated to determine the range of COP variability. Three dogs would not walk on the treadmill. One dog was too small to collect interpretable data. From the remaining 11 dogs, 206 trials were analyzed. Mean RMS for change in COPx per trial was 0.0138 (standard deviation, SD 0.0047) and for COPy was 0.0185 (SD 0.0071). Walking speed but not limb length had a significant effect on COP RMS. Repeat measurements in six dogs had high test retest consistency in the x and fair consistency in the y direction. In conclusion, COP variability can be measured consistently in dogs, and a range of COP variability for normal chondrodystrophoid dogs has been determined to provide a baseline for future studies on dogs with spinal cord injury.
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Affiliation(s)
- S R Blau
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
| | - L M Davis
- Joint Department of Biomedical Engineering, University of North Carolina/North Carolina State University, Raleigh, NC 27695, USA
| | - A M Gorney
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
| | - C S Dohse
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
| | - K D Williams
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
| | - J-H Lim
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
| | - W G Pfitzner
- Joint Department of Biomedical Engineering, University of North Carolina/North Carolina State University, Raleigh, NC 27695, USA
| | - E Laber
- Department of Statistics, North Carolina State University, Raleigh, NC 27607, USA
| | - G S Sawicki
- Joint Department of Biomedical Engineering, University of North Carolina/North Carolina State University, Raleigh, NC 27695, USA
| | - N J Olby
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA; Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA.
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19
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Extracellular matrix inflammation in vascular cognitive impairment and dementia. Clin Sci (Lond) 2017; 131:425-437. [PMID: 28265034 DOI: 10.1042/cs20160604] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/15/2016] [Accepted: 12/19/2016] [Indexed: 12/16/2022]
Abstract
Vascular cognitive impairment and dementia (VCID) include a wide spectrum of chronic manifestations of vascular disease related to large vessel strokes and small vessel disease (SVD). Lacunar strokes and white matter (WM) injury are consequences of SVD. The main vascular risk factor for SVD is brain hypoperfusion from cerebral blood vessel narrowing due to chronic hypertension. The hypoperfusion leads to activation and degeneration of astrocytes with the resulting fibrosis of the extracellular matrix (ECM). Elasticity is lost in fibrotic cerebral vessels, reducing the response of stiffened blood vessels in times of increased metabolic need. Intermittent hypoxia/ischaemia activates a molecular injury cascade, producing an incomplete infarction that is most damaging to the deep WM, which is a watershed region for cerebral blood flow. Neuroinflammation caused by hypoxia activates microglia/macrophages to release proteases and free radicals that perpetuate the damage over time to molecules in the ECM and the neurovascular unit (NVU). Matrix metalloproteinases (MMPs) secreted in an attempt to remodel the blood vessel wall have the undesired consequences of opening the blood-brain barrier (BBB) and attacking myelinated fibres. This dual effect of the MMPs causes vasogenic oedema in WM and vascular demyelination, which are the hallmarks of the subcortical ischaemic vascular disease (SIVD), which is the SVD form of VCID also called Binswanger's disease (BD). Unravelling the complex pathophysiology of the WM injury-related inflammation in the small vessel form of VCID could lead to novel therapeutic strategies to reduce damage to the ECM, preventing the progressive damage to the WM.
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20
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Moore SA, Granger N, Olby NJ, Spitzbarth I, Jeffery ND, Tipold A, Nout-Lomas YS, da Costa RC, Stein VM, Noble-Haeusslein LJ, Blight AR, Grossman RG, Basso DM, Levine JM. Targeting Translational Successes through CANSORT-SCI: Using Pet Dogs To Identify Effective Treatments for Spinal Cord Injury. J Neurotrauma 2017; 34:2007-2018. [PMID: 28230415 DOI: 10.1089/neu.2016.4745] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Translation of therapeutic interventions for spinal cord injury (SCI) from laboratory to clinic has been historically challenging, highlighting the need for robust models of injury that more closely mirror the human condition. The high prevalence of acute, naturally occurring SCI in pet dogs provides a unique opportunity to evaluate expeditiously promising interventions in a population of animals that receive diagnoses and treatment clinically in a manner similar to persons with SCI, while adhering to National Institutes of Health guidelines for scientific rigor and transparent reporting. In addition, pet dogs with chronic paralysis are often maintained long-term by their owners, offering a similarly unique population for study of chronic SCI. Despite this, only a small number of studies have used the clinical dog model of SCI. The Canine Spinal Cord Injury Consortium (CANSORT-SCI) was recently established by a group of veterinarians and basic science researchers to promote the value of the canine clinical model of SCI. The CANSORT-SCI group held an inaugural meeting November 20 and 21, 2015 to evaluate opportunities and challenges to the use of pet dogs in SCI research. Key challenges identified included lack of familiarity with the model among nonveterinary scientists and questions about how and where in the translational process the canine clinical model would be most valuable. In light of these, we review the natural history, outcome, and available assessment tools associated with canine clinical SCI with emphasis on their relevance to human SCI and the translational process.
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Affiliation(s)
- Sarah A Moore
- 1 Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine , Columbus Ohio.,2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI)
| | - Nicolas Granger
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,3 Faculty of Health Sciences, University of Bristol , Langford, North Somerset, United Kingdom
| | - Natasha J Olby
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,4 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University , Raleigh, North Carolina.,5 Comparative Medicine Institute, North Carolina State University , Raleigh, North Carolina
| | - Ingo Spitzbarth
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,6 Department of Pathology, University of Veterinary Medicine , Hannover, Germany .,7 Center for Systems Neuroscience , Hannover, Germany
| | - Nick D Jeffery
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,8 Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University , College Station, Texas
| | - Andrea Tipold
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,7 Center for Systems Neuroscience , Hannover, Germany.,9 Department of Small Animal Medicine and Surgery, University of Veterinary Medicine , Hannover, Germany
| | - Yvette S Nout-Lomas
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,10 College of Veterinary Medicine and Biomedical Sciences, Colorado State University , Fort Collins, Colorado
| | - Ronaldo C da Costa
- 1 Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine , Columbus Ohio.,2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI)
| | - Veronika M Stein
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,11 Department of Clinical Veterinary Sciences, University of Bern , Bern, Switzerland
| | - Linda J Noble-Haeusslein
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,12 Departments of Physical Therapy and Rehabilitation Sciences and Neurological Surgery, University of California , San Francisco, San Francisco, California
| | - Andrew R Blight
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,13 Acorda Therapeutics, Inc. Ardsley, New York
| | - Robert G Grossman
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,14 Department of Neurosurgery, Houston Methodist Neurological Institute , Houston, Texas
| | - D Michele Basso
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,15 School of Health and Rehabilitation Sciences, The Ohio State University , Columbus, Ohio
| | - Jonathan M Levine
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,8 Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University , College Station, Texas
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21
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Stout Steele MW, Hodshon AW, Hopkins AL, Tracy GM, Cohen ND, Kerwin SC, Boudreau CE, Thomas WB, Mankin JM, Levine JM. Multi-Center Retrospective Evaluation of Screw and Polymethylmethacrylate Constructs for Atlantoaxial Fixation in Dogs. Vet Surg 2016; 45:909-915. [PMID: 27580972 DOI: 10.1111/vsu.12533] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate outcome and adverse events following ventral stabilization of the atlantoaxial (AA) joint in dogs with clinical AA subluxation using screw/polymethymethacrylate (PMMA) constructs in a retrospective, multi-center cohort study. STUDY DESIGN Historical cohort study. ANIMALS 35 client-owned dogs. METHODS Medical records from 3 institutions were reviewed to identify dogs with AA subluxation treated with ventral screw and PMMA constructs. Data on signalment, pre- and postoperative neurologic status, imaging performed, and adverse events were retrieved. Neurologic examination data were abstracted to generate a modified Frankel score at admission, discharge, and re-examination. Telephone interview of owners >180 days postoperative was conducted. RESULTS Thirty-five dogs with AA subluxation treated with ventral screw/PMMA constructs were included. Most dogs were young (median age 1 year), small breed dogs with acute onset of neurologic signs (median duration 22.5 hours). Most dogs were non-ambulatory at the time of admission (median modified Frankel score 3). Adverse events were identified in 15/35 dogs including 9 dogs with major adverse events. Four dogs required a second surgery due to vertebral canal violation (n = 2) or implant failure (n = 2). Re-examination at 4-6 weeks postoperative reported 15/28 dogs with improved neurologic status and 19/28 dogs were ambulatory. Telephone follow-up was available for 23/35 dogs with 23/23 reported as ambulatory (median follow-up 390 days). CONCLUSIONS Ventral application of screw and PMMA constructs for AA subluxation, as described here, is associated with clinical improvement in the majority of dog. Major adverse events are infrequent and the technique is considered relatively safe.
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Affiliation(s)
- Megan W Stout Steele
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Amy W Hodshon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | | | | | - Noah D Cohen
- Department of Veterinary Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Sharon C Kerwin
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - C Elizabeth Boudreau
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - William B Thomas
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Joseph M Mankin
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Jonathan M Levine
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
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22
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Song RB, Basso DM, da Costa RC, Fisher LC, Mo X, Moore SA. Adaptation of the Basso-Beattie-Bresnahan locomotor rating scale for use in a clinical model of spinal cord injury in dogs. J Neurosci Methods 2016; 268:117-24. [PMID: 27155106 DOI: 10.1016/j.jneumeth.2016.04.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/26/2016] [Accepted: 04/26/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Naturally occurring acute spinal cord injury (SCI) in pet dogs provides an important clinical animal model through which to confirm and extend findings from rodent studies; however, validated quantitative outcome measures for dogs are limited. NEW METHOD We adapted the Basso Beattie Bresnahan (BBB) scale for use in a clinical dog model of acute thoracolumbar SCI. Based on observation of normal dogs, modifications were made to account for species differences in locomotion. Assessments of paw and tail position, and trunk stability were modified to produce a 19 point scale suitable for use in dogs, termed the canine BBB scale (cBBB). Pet dogs with naturally occurring acute SCI were assigned cBBB scores at 3, 10 and 30days after laminectomy. RESULTS Scores assigned via the cBBB were stable across testing sessions in normal dogs but increased significantly between days 3 and 30 in SCI-affected dogs (p=0.0003). The scale was highly responsive to changes in locomotor recovery over a 30day period, with a standardized response mean of 1.34. COMPARISON WITH EXISTING METHODS Concurrent validity was good, with strong correlations observed between the cBBB and two other locomotor scales, the OSCIS (r=0.94; p<0.001) and the MFS (r=0.85; p<0.0001). cBBB scores inversely correlated with other assessments of recovery including mechanical sensory threshold (r=-0.68; p<0.0001) and coefficient of variation of stride length (r=-0.49; p<0.0001). CONCLUSIONS These results support the use of the cBBB to assess locomotor recovery in canine clinical translational models of SCI.
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Affiliation(s)
- Rachel B Song
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp St., Columbus, OH 43210, USA.
| | - D Michele Basso
- School of Health and Rehabilitation Sciences, The Ohio State Unviersity, 453 West Tenth Ave., Columbus, OH 43210, USA.
| | - Ronaldo C da Costa
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp St., Columbus, OH 43210, USA.
| | - Lesley C Fisher
- School of Health and Rehabilitation Sciences, The Ohio State Unviersity, 453 West Tenth Ave., Columbus, OH 43210, USA.
| | - Xiaokui Mo
- Center for Biostatistics, The Ohio State University, 320D Lincoln Tower, 1800 Cannon Drive, Columbus, OH 43210, USA.
| | - Sarah A Moore
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp St., Columbus, OH 43210, USA.
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23
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Anderson KM, Welsh CJ, Young C, Levine GJ, Kerwin SC, Boudreau CE, Reyes I, Mondragon A, Griffin JF, Cohen ND, Levine JM. Acute Phase Proteins in Cerebrospinal Fluid from Dogs with Naturally-Occurring Spinal Cord Injury. J Neurotrauma 2015; 32:1658-65. [PMID: 26186466 DOI: 10.1089/neu.2015.3895] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Spinal cord injury (SCI) affects thousands of people each year and there are no treatments that dramatically improve clinical outcome. Canine intervertebral disc herniation is a naturally-occurring SCI that has similarities to human injury and can be used as a translational model for evaluating therapeutic interventions. Here, we characterized cerebrospinal fluid (CSF) acute phase proteins (APPs) that have altered expression across a spectrum of neurological disorders, using this canine model system. The concentrations of C-reactive protein (CRP), haptoglobin (Hp), alpha-1-glycoprotein, and serum amyloid A were determined in the CSF of 42 acutely injured dogs, compared with 21 healthy control dogs. Concentrations of APPs also were examined with respect to initial injury severity and motor outcome 42 d post-injury. Hp concentration was significantly higher (p<0.0001) in the CSF of affected dogs, compared with healthy control dogs. Additionally, the concentrations of CRP and Hp were significantly (p=0.0001 and p=0.0079, respectively) and positively associated with CSF total protein concentration. The concentrations of CRP and Hp were significantly higher (p=0.0071 and p=0.0197, respectively) in dogs with severe injury, compared with those with mild-to-moderate SCI, but there was no significant correlation between assessed CSF APP concentrations and 42 d motor outcome. This study demonstrated that CSF APPs were dysregulated in dogs with naturally-occurring SCI and could be used as markers for SCI severity. As Hp was increased following severe SCI and is neuroprotective across a number of model systems, it may represent a viable therapeutic target.
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Affiliation(s)
- Kimberly M Anderson
- 1 Department of Small Animal Clinical Sciences, Texas A&M University , College Station, Texas
| | - C Jane Welsh
- 2 Department of Veterinary Integrative Biosciences, Texas A&M University , College Station, Texas
| | - Colin Young
- 2 Department of Veterinary Integrative Biosciences, Texas A&M University , College Station, Texas
| | - Gwendolyn J Levine
- 4 Department of Veterinary Pathobiology, Texas A&M University , College Station, Texas
| | - Sharon C Kerwin
- 1 Department of Small Animal Clinical Sciences, Texas A&M University , College Station, Texas
| | - C Elizabeth Boudreau
- 1 Department of Small Animal Clinical Sciences, Texas A&M University , College Station, Texas
| | - Ismael Reyes
- 2 Department of Veterinary Integrative Biosciences, Texas A&M University , College Station, Texas
| | - Armando Mondragon
- 2 Department of Veterinary Integrative Biosciences, Texas A&M University , College Station, Texas
| | - John F Griffin
- 3 Department of Large Animal Clinical Sciences, Texas A&M University , College Station, Texas
| | - Noah D Cohen
- 3 Department of Large Animal Clinical Sciences, Texas A&M University , College Station, Texas
| | - Jonathan M Levine
- 1 Department of Small Animal Clinical Sciences, Texas A&M University , College Station, Texas
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24
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Ramer LM, Ramer MS, Bradbury EJ. Restoring function after spinal cord injury: towards clinical translation of experimental strategies. Lancet Neurol 2014; 13:1241-56. [PMID: 25453463 DOI: 10.1016/s1474-4422(14)70144-9] [Citation(s) in RCA: 196] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Spinal cord injury is currently incurable and treatment is limited to minimising secondary complications and maximising residual function by rehabilitation. Improved understanding of the pathophysiology of spinal cord injury and the factors that prevent nerve and tissue repair has fuelled a move towards more ambitious experimental treatments aimed at promoting neuroprotection, axonal regeneration, and neuroplasticity. By necessity, these new options are more invasive. However, in view of recent advances in spinal cord injury research and demand from patients, clinicians, and the scientific community to push promising experimental treatments to the clinic, momentum and optimism exist for the translation of candidate experimental treatments to clinical spinal cord injury. The ability to rescue, reactivate, and rewire spinal systems to restore function after spinal cord injury might soon be within reach.
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Affiliation(s)
- Leanne M Ramer
- King's College London, Regeneration Group, Wolfson Centre for Age-Related Diseases, Guy's Campus, London, UK; International Collaboration On Repair Discoveries, Blusson Spinal Cord Centre, Vancouver General Hospital, Vancouver, BC, Canada
| | - Matt S Ramer
- King's College London, Regeneration Group, Wolfson Centre for Age-Related Diseases, Guy's Campus, London, UK; International Collaboration On Repair Discoveries, Blusson Spinal Cord Centre, Vancouver General Hospital, Vancouver, BC, Canada; Department of Zoology, University of British Columbia, Vancouver, BC, Canada
| | - Elizabeth J Bradbury
- King's College London, Regeneration Group, Wolfson Centre for Age-Related Diseases, Guy's Campus, London, UK.
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25
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Granger N, Carwardine D. Acute spinal cord injury: tetraplegia and paraplegia in small animals. Vet Clin North Am Small Anim Pract 2014; 44:1131-56. [PMID: 25441629 DOI: 10.1016/j.cvsm.2014.07.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Spinal cord injury (SCI) is a common problem in animals for which definitive treatment is lacking, and information gained from its study has benefit for both companion animals and humans in developing new therapeutic approaches. This review provides an overview of the main concepts that are useful for clinicians in assessing companion animals with severe acute SCI. Current available advanced ancillary tests and those in development are reviewed. In addition, the current standard of care for companion animals following SCI and recent advances in the development of new therapies are presented, and new predictors of recovery discussed.
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Affiliation(s)
- Nicolas Granger
- The School of Veterinary Sciences, University of Bristol, Langford House, Langford, North Somerset BS40 5HU, UK.
| | - Darren Carwardine
- The School of Veterinary Sciences, University of Bristol, Langford House, Langford, North Somerset BS40 5HU, UK
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