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Gao X, Jin B, Zhou X, Bai J, Zhong H, Zhao K, Huang Z, Wang C, Zhu J, Qin Q. Recent advances in the application of gasotransmitters in spinal cord injury. J Nanobiotechnology 2024; 22:277. [PMID: 38783332 PMCID: PMC11112916 DOI: 10.1186/s12951-024-02523-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Abstract
Spinal Cord Injury (SCI) is a condition characterized by complete or incomplete motor and sensory impairment, as well as dysfunction of the autonomic nervous system, caused by factors such as trauma, tumors, or inflammation. Current treatment methods primarily include traditional approaches like spinal canal decompression and internal fixation surgery, steroid pulse therapy, as well as newer techniques such as stem cell transplantation and brain-spinal cord interfaces. However, the above methods have limited efficacy in promoting axonal and neuronal regeneration. The challenge in medical research today lies in promoting spinal cord neuron regeneration and regulating the disrupted microenvironment of the spinal cord. Studies have shown that gas molecular therapy is increasingly used in medical research, with gasotransmitters such as hydrogen sulfide, nitric oxide, carbon monoxide, oxygen, and hydrogen exhibiting neuroprotective effects in central nervous system diseases. The gas molecular protect against neuronal death and reshape the microenvironment of spinal cord injuries by regulating oxidative, inflammatory and apoptotic processes. At present, gas therapy mainly relies on inhalation for systemic administration, which cannot effectively enrich and release gas in the spinal cord injury area, making it difficult to achieve the expected effects. With the rapid development of nanotechnology, the use of nanocarriers to achieve targeted enrichment and precise control release of gas at Sites of injury has become one of the emerging research directions in SCI. It has shown promising therapeutic effects in preclinical studies and is expected to bring new hope and opportunities for the treatment of SCI. In this review, we will briefly outline the therapeutic effects and research progress of gasotransmitters and nanogas in the treatment of SCI.
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Affiliation(s)
- Xiang Gao
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China
| | - Bingrong Jin
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China
| | - Xiaozhong Zhou
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China
| | - Jinyu Bai
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China
| | - Hao Zhong
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China
| | - Kai Zhao
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China
| | - Zongrui Huang
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China
| | - Chao Wang
- Institute of Functional Nano & Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou, 215123, Jiangsu, China
| | - Jiang Zhu
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China.
| | - Qin Qin
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China.
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Xu X, Zhang CJ, Talifu Z, Liu WB, Li ZH, Wang XX, Du HY, Ke H, Yang DG, Gao F, Du LJ, Yu Y, Jing YL, Li JJ. The Effect of Glycine and N-Acetylcysteine on Oxidative Stress in the Spinal Cord and Skeletal Muscle After Spinal Cord Injury. Inflammation 2024; 47:557-571. [PMID: 37975960 DOI: 10.1007/s10753-023-01929-9] [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: 08/21/2023] [Revised: 09/24/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023]
Abstract
Oxidative stress is a frequently occurring pathophysiological feature of spinal cord injury (SCI) and can result in secondary injury to the spinal cord and skeletal muscle atrophy. Studies have reported that glycine and N-acetylcysteine (GlyNAC) have anti-aging and anti-oxidative stress properties; however, to date, no study has assessed the effect of GlyNAC in the treatment of SCI. In the present work, we established a rat model of SCI and then administered GlyNAC to the animals by gavage at a dose of 200 mg/kg for four consecutive weeks. The BBB scores of the rats were significantly elevated from the first to the eighth week after GlyNAC intervention, suggesting that GlyNAC promoted the recovery of motor function; it also promoted the significant recovery of body weight of the rats. Meanwhile, the 4-week heat pain results also suggested that GlyNAC intervention could promote the recovery of sensory function in rats to some extent. Additionally, after 4 weeks, the levels of glutathione and superoxide dismutase in spinal cord tissues were significantly elevated, whereas that of malondialdehyde was significantly decreased in GlyNAC-treated animals. The gastrocnemius wet weight ratio and total antioxidant capacity were also significantly increased. After 8 weeks, the malondialdehyde level had decreased significantly in spinal cord tissue, while reactive oxygen species accumulation in skeletal muscle had decreased. These findings suggested that GlyNAC can protect spinal cord tissue, delay skeletal muscle atrophy, and promote functional recovery in rats after SCI.
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Affiliation(s)
- Xin Xu
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, 100068, China
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China
| | - Chun-Jia Zhang
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, 100068, China
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China
| | - Zuliyaer Talifu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, 100730, China
| | - Wu-Bo Liu
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, 100068, China
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China
- Cheeloo College of Medicine, Shandong University, Jinan, 250100, Shandong Province, China
- Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, 250100, Shandong Province, China
| | - Ze-Hui Li
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, 100068, China
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China
| | - Xiao-Xin Wang
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, 100068, China
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China
- Cheeloo College of Medicine, Shandong University, Jinan, 250100, Shandong Province, China
| | - Hua-Yong Du
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, 100068, China
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China
| | - Han Ke
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, 100068, China
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China
- Cheeloo College of Medicine, Shandong University, Jinan, 250100, Shandong Province, China
- Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, 250100, Shandong Province, China
| | - De-Gang Yang
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, 100068, China
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China
| | - Feng Gao
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, 100068, China
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China
| | - Liang-Jie Du
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, 100068, China
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China
| | - Yan Yu
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China
| | - Ying-Li Jing
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China
| | - Jian-Jun Li
- School of Rehabilitation, Capital Medical University, Beijing, 100068, China.
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, 100068, China.
- Chinese Institute of Rehabilitation Science, Beijing, 100068, China.
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, 100068, China.
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, 100068, China.
- Cheeloo College of Medicine, Shandong University, Jinan, 250100, Shandong Province, China.
- School of Rehabilitation Sciences and Engineering, University of Health and Rehabilitation Sciences, Qingdao, 266000, Shandong Province, China.
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3
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Chiang MK, Lin TC, Lin KH, Chang YC, Hsieh-Li HM, Lai DM. Hyperbaric Oxygen Therapy Attenuated the Motor Coordination and Cognitive Impairment of Polyglutamine Spinocerebellar Ataxia SCA17 Mice. CEREBELLUM (LONDON, ENGLAND) 2024; 23:401-417. [PMID: 36943575 DOI: 10.1007/s12311-023-01548-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 03/23/2023]
Abstract
Spinocerebellar ataxias (SCAs) are a large and diverse group of autosomal-dominant neurodegenerative diseases. No drugs have been approved for these relentlessly progressive and fatal SCAs. Our previous studies indicate that oxidative stress, neuroinflammation, and neuronal apoptosis are elevated in the SCA17 mice, which are the main therapeutic targets of hyperbaric oxygen treatment (HBOT). HBOT is considered to be an alternative and less invasive therapy for SCAs. In this study, we evaluated the HBOT (2.2 ATA for 14 days) effect and the persistence for the management of SCA17 mice and their wild-type littermates. We found HBOT attenuated the motor coordination and cognitive impairment of SCA17 mice and which persisted for about 1 month after the treatment. The results of several biochemistry and liver/kidney hematoxylin and eosin staining show the HBOT condition has no obvious toxicity in the mice. Immunostaining analyses show that the neuroprotective effect of HBOT could be through the promotion of BDNF production and the amelioration of neuroinflammation. Surprisingly, HBOT executes different effects on the male and female SCA17 mice, including the reduction of neuroinflammation and activation of CaMKII and ERK. This study suggests HBOT is a potential alternative therapeutic treatment for SCA17. Accumulated findings have revealed the similarity in disease pathomechanisms and possible therapeutic strategies in polyQ diseases; therefore, HBOT could be an optional treatment as well as the other polyQ diseases.
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Affiliation(s)
- Meng-Ke Chiang
- Department of Life Science, National Taiwan Normal University, Taipei, Taiwan
| | - Ta-Chun Lin
- Department of Life Science, National Taiwan Normal University, Taipei, Taiwan
| | | | - Ya-Chin Chang
- Department of Life Science, National Taiwan Normal University, Taipei, Taiwan
| | - Hsiu Mei Hsieh-Li
- Department of Life Science, National Taiwan Normal University, Taipei, Taiwan.
| | - Dar-Ming Lai
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
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4
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Lin YT, Gonzalez-Rothi EJ, Lee KZ. Acute Hyperoxia Improves Spinal Cord Oxygenation and Circulatory Function Following Cervical Spinal Cord Injury in Rats. CHINESE J PHYSIOL 2024; 67:27-36. [PMID: 38780270 DOI: 10.4103/ejpi.ejpi-d-23-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/06/2023] [Indexed: 05/25/2024] Open
Abstract
Spinal cord injury is associated with spinal vascular disruptions that result in spinal ischemia and tissue hypoxia. This study evaluated the therapeutic efficacy of normobaric hyperoxia on spinal cord oxygenation and circulatory function at the acute stage of cervical spinal cord injury. Adult male Sprague Dawley rats underwent dorsal cervical laminectomy or cervical spinal cord contusion. At 1-2 days after spinal surgery, spinal cord oxygenation was monitored in anesthetized and spontaneously breathing rats through optical recording of oxygen sensor foils placed on the cervical spinal cord and pulse oximetry. The arterial blood pressure, heart rate, blood gases, and peripheral oxyhemoglobin saturation were also measured under hyperoxic (50% O2) and normoxic (21% O2) conditions. The results showed that contused animals had significantly lower spinal cord oxygenation levels than uninjured animals during normoxia. Peripheral oxyhemoglobin saturation, arterial oxygen partial pressure, and mean arterial blood pressure are significantly reduced following cervical spinal cord contusion. Notably, spinal oxygenation of contused rats could be improved to a level comparable to uninjured animals under hyperoxia. Furthermore, acute hyperoxia elevated blood pressure, arterial oxygen partial pressure, and peripheral oxyhemoglobin saturation. These results suggest that normobaric hyperoxia can significantly improve spinal cord oxygenation and circulatory function in the acute phase after cervical spinal cord injury. We propose that adjuvant normobaric hyperoxia combined with other hemodynamic optimization strategies may prevent secondary damage after spinal cord injury and improve functional recovery.
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Affiliation(s)
- Yen-Ting Lin
- Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Elisa J Gonzalez-Rothi
- Breathing Research and Therapeutics Center, Department of Physical Therapy, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Kun-Ze Lee
- Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan
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5
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Sunshine MD, Bindi VE, Nguyen BL, Doerr V, Boeno FP, Chandran V, Smuder AJ, Fuller DD. Oxygen therapy attenuates neuroinflammation after spinal cord injury. J Neuroinflammation 2023; 20:303. [PMID: 38110993 PMCID: PMC10729514 DOI: 10.1186/s12974-023-02985-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023] Open
Abstract
Acute hyperbaric O2 (HBO) therapy after spinal cord injury (SCI) can reduce inflammation and increase neuronal survival. To our knowledge, it is unknown if these benefits of HBO require hyperbaric vs. normobaric hyperoxia. We used a C4 lateralized contusion SCI in adult male and female rats to test the hypothesis that the combination of hyperbaria and 100% O2 (i.e. HBO) more effectively mitigates spinal inflammation and neuronal loss, and enhances respiratory recovery, as compared to normobaric 100% O2. Experimental groups included spinal intact, SCI no O2 therapy, and SCI + 100% O2 delivered at normobaric pressure (1 atmosphere, ATA), or at 2- or 3 ATA. O2 treatments lasted 1-h, commenced within 2-h of SCI, and were repeated for 10 days. The spinal inflammatory response was assessed with transcriptomics (RNAseq) and immunohistochemistry. Gene co-expression network analysis showed that the strong inflammatory response to SCI was dramatically diminished by both hyper- and normobaric O2 therapy. Similarly, both HBO and normobaric O2 treatments reduced the prevalence of immunohistological markers for astrocytes (glial fibrillary acidic protein) and microglia (ionized calcium binding adaptor molecule) in the injured spinal cord. However, HBO treatment also had unique impacts not detected in the normobaric group including upregulation of an anti-inflammatory cytokine (interleukin-4) in the plasma, and larger inspiratory tidal volumes at 10-days (whole body-plethysmography measurements). We conclude that normobaric O2 treatment can reduce the spinal inflammatory response after SCI, but pressured O2 (i.e., HBO) provides further benefit.
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Affiliation(s)
- Michael D Sunshine
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL, USA
| | - Victoria E Bindi
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL, USA
| | - Branden L Nguyen
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Vivian Doerr
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Franccesco P Boeno
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | | | - Ashley J Smuder
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL, USA
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - David D Fuller
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA.
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL, USA.
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
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6
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Wang X, Shen J, Xu C, Wan C, Yang H, Qiu Y, Xu M, Duo W, Sun T, Cui J, Chu L, Yang X. Proteomic profile of Trichinella spiralis infected mice with acute spinal cord injury: A 4D label-free quantitative analysis. Comp Immunol Microbiol Infect Dis 2023; 97:101994. [PMID: 37207504 DOI: 10.1016/j.cimid.2023.101994] [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: 03/04/2023] [Revised: 04/25/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023]
Abstract
Spinal cord injury (SCI) can cause severe loss of locomotor and sensory activities, with no ideal treatment. Emerging reports suggest that the helminth therapy is highly effective in relieving numerous inflammatory diseases. Proteomic profiling is often used to elucidate the underlying mechanism behind SCI. Herein, we systematically compared the protein expression profiles of murine SCI spinal cord and Trichinella spiralis treated murine SCI spinal cord, using a 4D label-free technique known for its elevated sensitivity. Relative to the SCI mice, the T. spiralis-treated mice exhibited marked alterations in 91 proteins (31 up- and 60 down-regulated). Based on our Gene Ontology (GO) functional analysis, the differentially expressed proteins (DEPs) were primarily enriched in the processes of metabolism, biological regulation, cellular process, antioxidant activity, and other cell functions. In addition, according to the Clusters of Orthologous Groups of protein/EuKaryotic Orthologous Groups (COG/KOG) functional stratification, proteins involved in signaling transduction mechanisms belonged to the largest category. Over-expressed DEPs were also enriched in the "NADPH oxidase complex", "superoxide anion generation", "other types of O-glycan biosynthesis", and "HIF-1 signaling pathway". Furthermore, the protein-protein interaction (PPI) network identified the leading 10 hub proteins. In conclusion, we highlighted the dynamic proteomic profiling of T. spiralis-treated SCI mice. Our findings provide significant insight into the molecular mechanism behind T. spiralis regulation of SCI.
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Affiliation(s)
- Xiaoli Wang
- Department of Microbiology and Parasitology, Bengbu Medical College, Bengbu, China; Anhui Key Laboratory of Infection and Immunology, Bengbu Medical College, Bengbu, China.
| | - Junhong Shen
- Department of Microbiology and Parasitology, Bengbu Medical College, Bengbu, China; Anhui Key Laboratory of Infection and Immunology, Bengbu Medical College, Bengbu, China.
| | - Changyan Xu
- Department of Microbiology and Parasitology, Bengbu Medical College, Bengbu, China; Anhui Key Laboratory of Infection and Immunology, Bengbu Medical College, Bengbu, China.
| | - Chen Wan
- Department of Microbiology and Parasitology, Bengbu Medical College, Bengbu, China; Anhui Key Laboratory of Infection and Immunology, Bengbu Medical College, Bengbu, China.
| | - Haoyu Yang
- Department of Microbiology and Parasitology, Bengbu Medical College, Bengbu, China; Anhui Key Laboratory of Infection and Immunology, Bengbu Medical College, Bengbu, China.
| | - Yu Qiu
- Department of Microbiology and Parasitology, Bengbu Medical College, Bengbu, China; Anhui Key Laboratory of Infection and Immunology, Bengbu Medical College, Bengbu, China.
| | - Mengmeng Xu
- Department of Microbiology and Parasitology, Bengbu Medical College, Bengbu, China; Anhui Key Laboratory of Infection and Immunology, Bengbu Medical College, Bengbu, China.
| | - Wenjuan Duo
- Department of Microbiology and Parasitology, Bengbu Medical College, Bengbu, China; Anhui Key Laboratory of Infection and Immunology, Bengbu Medical College, Bengbu, China.
| | - Tongjun Sun
- Department of Microbiology and Parasitology, Bengbu Medical College, Bengbu, China; Anhui Key Laboratory of Infection and Immunology, Bengbu Medical College, Bengbu, China.
| | - Jie Cui
- Department of Microbiology and Parasitology, Bengbu Medical College, Bengbu, China; Anhui Key Laboratory of Infection and Immunology, Bengbu Medical College, Bengbu, China.
| | - Liang Chu
- Second Affiliated Hospital of Bengbu Medical College, Bengbu, China.
| | - Xiaodi Yang
- Department of Microbiology and Parasitology, Bengbu Medical College, Bengbu, China; Anhui Key Laboratory of Infection and Immunology, Bengbu Medical College, Bengbu, China.
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7
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Rey F, Berardo C, Maghraby E, Mauri A, Messa L, Esposito L, Casili G, Ottolenghi S, Bonaventura E, Cuzzocrea S, Zuccotti G, Tonduti D, Esposito E, Paterniti I, Cereda C, Carelli S. Redox Imbalance in Neurological Disorders in Adults and Children. Antioxidants (Basel) 2023; 12:antiox12040965. [PMID: 37107340 PMCID: PMC10135575 DOI: 10.3390/antiox12040965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/03/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Oxygen is a central molecule for numerous metabolic and cytophysiological processes, and, indeed, its imbalance can lead to numerous pathological consequences. In the human body, the brain is an aerobic organ and for this reason, it is very sensitive to oxygen equilibrium. The consequences of oxygen imbalance are especially devastating when occurring in this organ. Indeed, oxygen imbalance can lead to hypoxia, hyperoxia, protein misfolding, mitochondria dysfunction, alterations in heme metabolism and neuroinflammation. Consequently, these dysfunctions can cause numerous neurological alterations, both in the pediatric life and in the adult ages. These disorders share numerous common pathways, most of which are consequent to redox imbalance. In this review, we will focus on the dysfunctions present in neurodegenerative disorders (specifically Alzheimer's disease, Parkinson's disease and amyotrophic lateral sclerosis) and pediatric neurological disorders (X-adrenoleukodystrophies, spinal muscular atrophy, mucopolysaccharidoses and Pelizaeus-Merzbacher Disease), highlighting their underlining dysfunction in redox and identifying potential therapeutic strategies.
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Affiliation(s)
- Federica Rey
- Pediatric Clinical Research Center "Romeo ed Enrica Invernizzi", Department of Biomedical and Clinical Sciences, University of Milano, 20157 Milano, Italy
- Center of Functional Genomics and Rare diseases, Department of Pediatrics, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Clarissa Berardo
- Pediatric Clinical Research Center "Romeo ed Enrica Invernizzi", Department of Biomedical and Clinical Sciences, University of Milano, 20157 Milano, Italy
- Center of Functional Genomics and Rare diseases, Department of Pediatrics, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Erika Maghraby
- Pediatric Clinical Research Center "Romeo ed Enrica Invernizzi", Department of Biomedical and Clinical Sciences, University of Milano, 20157 Milano, Italy
- Department of Biology and Biotechnology "L. Spallanzani", University of Pavia, 27100 Pavia, Italy
| | - Alessia Mauri
- Pediatric Clinical Research Center "Romeo ed Enrica Invernizzi", Department of Biomedical and Clinical Sciences, University of Milano, 20157 Milano, Italy
- Center of Functional Genomics and Rare diseases, Department of Pediatrics, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Letizia Messa
- Center of Functional Genomics and Rare diseases, Department of Pediatrics, Buzzi Children's Hospital, 20154 Milano, Italy
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, 20133 Milano, Italy
| | - Letizia Esposito
- Pediatric Clinical Research Center "Romeo ed Enrica Invernizzi", Department of Biomedical and Clinical Sciences, University of Milano, 20157 Milano, Italy
- Center of Functional Genomics and Rare diseases, Department of Pediatrics, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Giovanna Casili
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Sara Ottolenghi
- Department of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy
| | - Eleonora Bonaventura
- Child Neurology Unit, Buzzi Children's Hospital, 20154 Milano, Italy
- Center for Diagnosis and Treatment of Leukodystrophies and Genetic Leukoencephalopathies (COALA), Buzzi Children's Hospital, 20154 Milano, Italy
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Clinical Research Center "Romeo ed Enrica Invernizzi", Department of Biomedical and Clinical Sciences, University of Milano, 20157 Milano, Italy
- Department of Pediatrics, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Davide Tonduti
- Pediatric Clinical Research Center "Romeo ed Enrica Invernizzi", Department of Biomedical and Clinical Sciences, University of Milano, 20157 Milano, Italy
- Child Neurology Unit, Buzzi Children's Hospital, 20154 Milano, Italy
- Center for Diagnosis and Treatment of Leukodystrophies and Genetic Leukoencephalopathies (COALA), Buzzi Children's Hospital, 20154 Milano, Italy
| | - Emanuela Esposito
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Irene Paterniti
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Cristina Cereda
- Center of Functional Genomics and Rare diseases, Department of Pediatrics, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Stephana Carelli
- Pediatric Clinical Research Center "Romeo ed Enrica Invernizzi", Department of Biomedical and Clinical Sciences, University of Milano, 20157 Milano, Italy
- Center of Functional Genomics and Rare diseases, Department of Pediatrics, Buzzi Children's Hospital, 20154 Milano, Italy
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8
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Doerr V, Montalvo RN, Nguyen BL, Boeno FP, Sunshine MD, Bindi VE, Fuller DD, Smuder AJ. Effects of Hyperbaric Oxygen Preconditioning on Doxorubicin Cardiorespiratory Toxicity. Antioxidants (Basel) 2022; 11:antiox11102073. [PMID: 36290796 PMCID: PMC9598583 DOI: 10.3390/antiox11102073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/29/2022] Open
Abstract
Cardiorespiratory dysfunction resulting from doxorubicin (DOX) chemotherapy treatment is a debilitating condition affecting cancer patient outcomes and quality of life. DOX treatment promotes cardiac and respiratory muscle pathology due to enhanced reactive oxygen species (ROS) production, mitochondrial dysfunction and impaired muscle contractility. In contrast, hyperbaric oxygen (HBO) therapy is considered a controlled oxidative stress that can evoke a substantial and sustained increase in muscle antioxidant expression. This HBO-induced increase in antioxidant capacity has the potential to improve cardiac and respiratory (i.e., diaphragm) muscle redox balance, preserving mitochondrial function and preventing muscle dysfunction. Therefore, we determined whether HBO therapy prior to DOX treatment is sufficient to enhance muscle antioxidant expression and preserve muscle redox balance and cardiorespiratory muscle function. To test this, adult female Sprague Dawley rats received HBO therapy (2 or 3 atmospheres absolute (ATA), 100% O2, 1 h/day) for 5 consecutive days prior to acute DOX treatment (20 mg/kg i.p.). Our data demonstrate that 3 ATA HBO elicits a greater antioxidant response compared to 2 ATA HBO. However, these effects did not correspond with beneficial adaptations to cardiac systolic and diastolic function or diaphragm muscle force production in DOX treated rats. These findings suggest that modulating muscle antioxidant expression with HBO therapy is not sufficient to prevent DOX-induced cardiorespiratory dysfunction.
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Affiliation(s)
- Vivian Doerr
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | - Ryan N. Montalvo
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | - Branden L. Nguyen
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL 32610, USA
| | - Franccesco P. Boeno
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | - Michael D. Sunshine
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL 32610, USA
- Department of Physical Therapy, University of Florida, Gainesville, FL 32611, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA
| | - Victoria E. Bindi
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL 32610, USA
- Department of Physical Therapy, University of Florida, Gainesville, FL 32611, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA
| | - David D. Fuller
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL 32610, USA
- Department of Physical Therapy, University of Florida, Gainesville, FL 32611, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA
| | - Ashley J. Smuder
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL 32610, USA
- Correspondence:
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9
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Kostrominova TY. Skeletal Muscle Denervation: Past, Present and Future. Int J Mol Sci 2022; 23:ijms23147489. [PMID: 35886838 PMCID: PMC9316613 DOI: 10.3390/ijms23147489] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/28/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Tatiana Y Kostrominova
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Northwest, Gary, IN 46408, USA
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10
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Zafonte RD, Wang L, Arbelaez CA, Dennison R, Teng YD. Medical Gas Therapy for Tissue, Organ, and CNS Protection: A Systematic Review of Effects, Mechanisms, and Challenges. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2104136. [PMID: 35243825 PMCID: PMC9069381 DOI: 10.1002/advs.202104136] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/10/2022] [Indexed: 05/13/2023]
Abstract
Gaseous molecules have been increasingly explored for therapeutic development. Here, following an analytical background introduction, a systematic review of medical gas research is presented, focusing on tissue protections, mechanisms, data tangibility, and translational challenges. The pharmacological efficacies of carbon monoxide (CO) and xenon (Xe) are further examined with emphasis on intracellular messengers associated with cytoprotection and functional improvement for the CNS, heart, retina, liver, kidneys, lungs, etc. Overall, the outcome supports the hypothesis that readily deliverable "biological gas" (CO, H2 , H2 S, NO, O2 , O3 , and N2 O) or "noble gas" (He, Ar, and Xe) treatment may preserve cells against common pathologies by regulating oxidative, inflammatory, apoptotic, survival, and/or repair processes. Specifically, CO, in safe dosages, elicits neurorestoration via igniting sGC/cGMP/MAPK signaling and crosstalk between HO-CO, HIF-1α/VEGF, and NOS pathways. Xe rescues neurons through NMDA antagonism and PI3K/Akt/HIF-1α/ERK activation. Primary findings also reveal that the need to utilize cutting-edge molecular and genetic tactics to validate mechanistic targets and optimize outcome consistency remains urgent; the number of neurotherapeutic investigations is limited, without published results from large in vivo models. Lastly, the broad-spectrum, concurrent multimodal homeostatic actions of medical gases may represent a novel pharmaceutical approach to treating critical organ failure and neurotrauma.
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Affiliation(s)
- Ross D. Zafonte
- Department of Physical Medicine and RehabilitationHarvard Medical SchoolBostonMA02115USA
- Neurotrauma Recovery Research, Department of Physical Medicine and RehabilitationSpaulding Rehabilitation Hospital Network, Mass General Brigham, and Harvard Medical SchoolBostonMA02129USA
- Spaulding Research InstituteSpaulding Rehabilitation Hospital NetworkBostonMA02129USA
| | - Lei Wang
- Department of Physical Medicine and RehabilitationHarvard Medical SchoolBostonMA02115USA
- Laboratory of SCI, Stem Cell and Recovery Neurobiology Research, Department of Physical Medicine and RehabilitationSpaulding Rehabilitation Hospital Network, Mass General Brigham, and Harvard Medical SchoolBostonMA02129USA
| | - Christian A. Arbelaez
- Department of Physical Medicine and RehabilitationHarvard Medical SchoolBostonMA02115USA
- Laboratory of SCI, Stem Cell and Recovery Neurobiology Research, Department of Physical Medicine and RehabilitationSpaulding Rehabilitation Hospital Network, Mass General Brigham, and Harvard Medical SchoolBostonMA02129USA
| | - Rachel Dennison
- Department of Physical Medicine and RehabilitationHarvard Medical SchoolBostonMA02115USA
- Laboratory of SCI, Stem Cell and Recovery Neurobiology Research, Department of Physical Medicine and RehabilitationSpaulding Rehabilitation Hospital Network, Mass General Brigham, and Harvard Medical SchoolBostonMA02129USA
| | - Yang D. Teng
- Department of Physical Medicine and RehabilitationHarvard Medical SchoolBostonMA02115USA
- Neurotrauma Recovery Research, Department of Physical Medicine and RehabilitationSpaulding Rehabilitation Hospital Network, Mass General Brigham, and Harvard Medical SchoolBostonMA02129USA
- Spaulding Research InstituteSpaulding Rehabilitation Hospital NetworkBostonMA02129USA
- Laboratory of SCI, Stem Cell and Recovery Neurobiology Research, Department of Physical Medicine and RehabilitationSpaulding Rehabilitation Hospital Network, Mass General Brigham, and Harvard Medical SchoolBostonMA02129USA
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11
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Graham ZA, DeBerry JJ, Cardozo CP, Bamman MM. SS-31 does not prevent or reduce muscle atrophy 7 days after a 65 kdyne contusion spinal cord injury in young male mice. Physiol Rep 2022; 10:e15266. [PMID: 35611788 PMCID: PMC9131615 DOI: 10.14814/phy2.15266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 05/02/2023] Open
Abstract
Spinal cord injury (SCI) leads to major reductions in function, independent living, and quality of life. Disuse and paralysis from SCI leads to rapid muscle atrophy, with chronic muscle loss likely playing a role in the development of the secondary metabolic disorders often seen in those with SCI. Muscle disuse is associated with mitochondrial dysfunction. Previous evidence has suggested targeting the mitochondria with the tetrapeptide SS-31 is beneficial for muscle health in preclinical models that lead to mitochondrial dysfunction, such as cast immobilization or burn injury. We gave young male mice a sham (n = 8) or 65 kdyne thoracic contusion SCI with (n = 9) or without (n = 9) daily administration of 5.0 mg/kg SS-31. Hindlimb muscle mass and muscle bundle respiration were measured at 7 days post-SCI and molecular targets were investigated using immunoblotting, RT-qPCR, and metabolomics. SS-31 did not preserve body mass or hindlimb muscle mass 7 days post-SCI. SS-31 had no effect on soleus or plantaris muscle bundle respiration. SCI was associated with elevated levels of protein carbonylation, led to reduced protein expression of activated DRP1 and reductions in markers of mitochondrial fusion. SS-31 administration did result in reduced total DRP1 expression, as well as greater expression of inhibited DRP1. Gene expression of proinflammatory cytokines and their receptors were largely stable across groups, although SS-31 treatment led to greater mRNA expression of IL1B, TNF, and TNFRSF12A. In summation, SS-31 was not an efficacious treatment acutely after a moderate thoracic contusion SCI in young male mice.
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Affiliation(s)
- Zachary A. Graham
- Research ServiceBirmingham VA Medical CenterBirminghamAlabamaUSA
- Department of Cell, Developmental, and Integrative BiologyUABBirminghamAlabamaUSA
| | - Jennifer J. DeBerry
- Department of Anesthesiology and Perioperative MedicineUABBirminghamAlabamaUSA
| | - Christopher P. Cardozo
- Center for the Medical Consequences of Spinal Cord InjuryBronxNew YorkUSA
- Medical ServiceJames J. Peters VA Medical CenterBronxNew YorkUSA
- Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Marcas M. Bamman
- Research ServiceBirmingham VA Medical CenterBirminghamAlabamaUSA
- Department of Cell, Developmental, and Integrative BiologyUABBirminghamAlabamaUSA
- UAB Center for Exercise MedicineBirminghamAlabamaUSA
- Florida Institute for Human and Machine CognitionPensacolaFloridaUSA
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12
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Wang XR, Zhang Q, Ding WS, Zhang W, Zhou M, Wang HB. Comparison of clinical outcomes of tracheotomy in patients with acute cervical spinal cord injury at different timing. Clin Neurol Neurosurg 2021; 210:106947. [PMID: 34583275 DOI: 10.1016/j.clineuro.2021.106947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/08/2021] [Accepted: 09/12/2021] [Indexed: 11/16/2022]
Abstract
Respiratory failure is the leading cause of early death after acute CSCI. Tracheotomy is an effective approach to reduce mortality and improve the clinical outcomes. However, the optimal timing for tracheotomy remains controversial. Hence, the study aimed to compare the clinical outcomes of tracheotomy in patients with acute cervical spinal cord injury (CSCI) at different timing. A retrospectively review was performed of acute CSCI patients who underwent tracheotomy in the intensive care unit of Haian Hospital between January 2014 and June 2019. 124 CSCI patients were included and stratified into three groups based on the timing of tracheotomy: early group (≤4 days from initial intubation), medium group (4-10 days from initial intubation), and late group (≥10 days from initial intubation). The clinical outcomes and functional outcomes were analyzed. No significant intergroup differences in baseline characteristics were observed. The late group needed significantly longer duration of mechanical ventilation, longer ICU stay, and suffered higher ICU mortality, higher pneumonia after tracheotomy than the early and medium groups. More patients in the early and medium groups successfully weaned from mechanical ventilation. The early and medium groups achieved better improvement of JOA and NDI scores than the late group at one year after surgery and at the final follow-up. Early to medium term tracheotomy may lead to better clinical and functional outcomes in patients with acute CSCI who require prolonged mechanical ventilation.
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Affiliation(s)
- Xiao-Ran Wang
- Department of Intensive Care Unit, Affiliated Haian Hospital of Nantong University, Nantong 226001, China
| | - Qiang Zhang
- Department of Intensive Care Unit, Affiliated Haian Hospital of Nantong University, Nantong 226001, China
| | - Wen-Sen Ding
- Department of Intensive Care Unit, Affiliated Haian Hospital of Nantong University, Nantong 226001, China
| | - Wei Zhang
- Department of Intensive Care Unit, Affiliated Haian Hospital of Nantong University, Nantong 226001, China
| | - Min Zhou
- Department of Intensive Care Unit, Affiliated Haian Hospital of Nantong University, Nantong 226001, China
| | - Hai-Bo Wang
- Department of Intensive Care Unit, Affiliated Haian Hospital of Nantong University, Nantong 226001, China.
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13
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Effects of hyperbaric oxygen therapy on postoperative recovery after incomplete cervical spinal cord injury. Spinal Cord 2021; 60:129-134. [PMID: 34326463 DOI: 10.1038/s41393-021-00674-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 07/10/2021] [Accepted: 07/13/2021] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN A retrospective study of incomplete cervical spinal cord injury (SCI) treated with and without hyperbaric oxygen (HBO) therapy after operation. OBJECTIVE To investigate the effects of hyperbaric oxygen therapy on patients' postoperative recovery after incomplete cervical spinal cord injury. SETTING Shulan Hangzhou Hospital, Hangzhou, China. METHODS We analyzed the clinical data of 78 patients admitted in the Orthopedic Department of our hospital from June 2014 to June 2016, due to trauma-induced incomplete cervical spinal cord injury. All study subjects underwent nerve decompression and internal fixation procedures within 2 weeks of injury. The patients were divided into hyperbaric oxygen therapy (HBO) group (n = 40) and non-hyperbaric oxygen therapy (NHBO) group (n = 38) according to the chosen treatment option. The NHBO group only receive the conventional treatment regimen while the HBO group received a combination of conventional treatment and hyperbaric oxygen therapy. The subsequent changes in spinal functions and activities of daily living (ADL) were assessed by The American Spinal Injury Association (ASIA) scale and the Barthel Index at different time points (pretreatment, 1 month and 3 months of treatment, as well as 6 months, 1 year, 2 years, and 3 years after the surgical procedure). RESULTS There were no significant differences in age, gender, injury site, and disease condition between patients (p > 0.05). The results showed a significant difference in treatment total effectiveness rate between the HBO and NHBO groups (p < 0.05) (90% and 78.9%, respectively). Analyses of the ASIA scores and Barthel indices between the two groups indicated significant differences at 1 month and 3 months treatment time points, as well as 6 months and 1 year after the initial operation (p < 0.05). It showed that subjects in the HBO group had a better recovery than their NHBO counterparts, with the 1-month treatment time point being the most significant. In addition, the results indicated significant improvements in Barthel Index scores as well as ASIA sensory and motor function scores in both groups after a 1-month treatment, with the HBO group faring significantly better than the NHBO group (p < 0.01). CONCLUSIONS Our results not only showed that hyperbaric oxygen therapy is safe and effective for the treatment of incomplete cervical spinal cord injury but also indicated that the longer the treatment lasts (therapy initiation within 3 months after the surgical operation), the better the effects. In addition, a correct hyperbaric oxygen therapy leads to a peak in recovery within the first postoperative 3 months and can effectively promote spinal cord functions, reduce the disabilities, and improve patients' quality of life.
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