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Advances in Research on Spinal Cord Injury

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: closed (20 October 2021) | Viewed by 26417

Special Issue Editors


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Guest Editor
Departments of Neurosurgery and Neurology, Medical University of South Carolina, Charleston, SC, USA
Interests: Calpain; inflammation; demyelination; neurodegeneration; multiple sclerosis; optic neuritis; Parkinsonson’s disease; spinal cord injury

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Guest Editor
Department of Microbiology and Immunology, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC 29425, USA
Interests: inflammation; immunity; autophagy; calpain; enolase; spinal cord injury; Parkinson’s disease; neurodegeneration

Special Issue Information

Dear Colleagues,

 

Spinal cord injury (SCI) is one of the most devastating of all traumatic events, resulting in a loss or impairment of function causing reduced mobility or sensation. While the primary injury results from external mechanical forces at the injury site leading to irreversible necrotic cell death and tissue destruction, devastating secondary injury processes continue to cause damage to tissue below the lesion. The secondary injury involves multiple cellular and molecular events such as ischemia, edema, excitotoxicity, inflammation, electrolyte imbalance, free radical damage, increased proteinases and lipases, and apoptosis. Blood vessel disruption due to the initial primary injury may also lead to edema and ischemia, triggering a secondary injury cascade that causes further damage to axons and contributes to neuronal death, which may be preventable with early intervention. Interestingly, recent discoveries have shown some promising results on the induction of neuroprotection and recovery of function in animal models of SCI that may be targeted for novel therapies. Neurological deficits in SCI are visible following neuronal and myelinated axonal degeneration in people with SCI, who often experience loss of bladder function, motor impairment, and paralysis. Thus, it is apparent that the neuroplasticity of spinal circuitry underlies some functional recovery which represents a therapeutic target to improve locomotor function after SCI. However, the cellular and molecular mechanisms mediating neuroplasticity below the lesion level are not clearly understood, although some studies have focused on the mechanisms causing paralysis after SCI. Among the treatment possibilities discussed are cell transplantation strategies, including the use of fetal spinal cord tissue, remyelination in SCI models, and high-dose steroid therapy immediately after SCI. However, no single effective pharmacotherapeutic agent has been available to attenuate these destructive processes to improve function. Although advances have been made toward understanding the complex molecular mechanisms involved in SCI, a number of agents (methylprednisolone, gacyclidine, etc.) used off-label have been found ineffective for the treatment of SCI. Many therapeutic strategies have also been proposed to overcome neurodegenerative events and attenuate secondary neuronal damage. Despite the recent advances made in SCI research, much remains to be learned to ameliorate dysfunction and disability caused by SCI. This Special Issue is focused on “Advances in Research on Spinal Cord Injury”, with the goal of evaluating the role of cellular and molecular bases in the pathophysiology of spinal cord injury. The scope of this Issue also includes molecular mechanisms of neuroprotection in SCI and summarizes recent findings on the therapeutic and translational potential of pharmacological agents in SCI.

Prof. Dr. Naren L. Banik
Dr. Azizul Haque
Guest Editors

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Keywords

  • spinal cord injury
  • gliosis
  • neurodegeneration
  • axonal damage
  • paralysis
  • regeneration
  • neuroprotection
  • locomotor function

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Published Papers (6 papers)

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Research

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18 pages, 4727 KiB  
Article
Premarin Reduces Neurodegeneration and Promotes Improvement of Function in an Animal Model of Spinal Cord Injury
by Azizul Haque, Arabinda Das, Supriti Samantaray, Denise Matzelle, Mollie Capone, Gerald Wallace, Aarti N. Husarik, Saied Taheri, Russel J. Reiter, Abhay Varma, Swapan K. Ray and Naren L. Banik
Int. J. Mol. Sci. 2022, 23(4), 2384; https://doi.org/10.3390/ijms23042384 - 21 Feb 2022
Cited by 8 | Viewed by 2709
Abstract
Spinal cord injury (SCI) causes significant mortality and morbidity. Currently, no FDA-approved pharmacotherapy is available for treating SCI. Previously, low doses of estrogen (17β-estradiol, E2) were shown to improve the post-injury outcome in a rat SCI model. However, the range of associated side [...] Read more.
Spinal cord injury (SCI) causes significant mortality and morbidity. Currently, no FDA-approved pharmacotherapy is available for treating SCI. Previously, low doses of estrogen (17β-estradiol, E2) were shown to improve the post-injury outcome in a rat SCI model. However, the range of associated side effects makes advocating its therapeutic use difficult. Therefore, this study aimed at investigating the therapeutic efficacy of Premarin (PRM) in SCI. PRM is an FDA-approved E2 (10%) formulation, which is used for hormone replacement therapy with minimal risk of serious side effects. The effects of PRM on SCI were examined by magnetic resonance imaging, immunofluorescent staining, and western blot analysis in a rat model. SCI animals treated with vehicle alone, PRM, E2 receptor antagonist (ICI), or PRM + ICI were graded in a blinded way for locomotor function by using the Basso–Beattie–Bresnahan (BBB) locomotor scale. PRM treatment for 7 days decreased post-SCI lesion volume and attenuated neuronal cell death, inflammation, and axonal damage. PRM also altered the balance of pro- and anti-apoptotic proteins in favor of cell survival and improved angiogenesis and microvascular growth. Increased expression of estrogen receptors (ERs) ERα and ERβ following PRM treatment and their inhibition by ER inhibitor indicated that the neuroprotection associated with PRM treatment might be E2-receptor mediated. The attenuation of glial activation with decreased inflammation and cell death, and increased angiogenesis by PRM led to improved functional outcome as determined by the BBB locomotor scale. These results suggest that PRM treatment has significant therapeutic implications for the improvement of post-SCI outcome. Full article
(This article belongs to the Special Issue Advances in Research on Spinal Cord Injury)
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18 pages, 3028 KiB  
Article
Inhibition of Bruton Tyrosine Kinase Reduces Neuroimmune Cascade and Promotes Recovery after Spinal Cord Injury
by Chen Guang Yu, Vimala Bondada, Hina Iqbal, Kate L. Moore, John C. Gensel, Subbarao Bondada and James W. Geddes
Int. J. Mol. Sci. 2022, 23(1), 355; https://doi.org/10.3390/ijms23010355 - 29 Dec 2021
Cited by 12 | Viewed by 4086
Abstract
Microglia/astrocyte and B cell neuroimmune responses are major contributors to the neurological deficits after traumatic spinal cord injury (SCI). Bruton tyrosine kinase (BTK) activation mechanistically links these neuroimmune mechanisms. Our objective is to use Ibrutinib, an FDA-approved BTK inhibitor, to inhibit the neuroimmune [...] Read more.
Microglia/astrocyte and B cell neuroimmune responses are major contributors to the neurological deficits after traumatic spinal cord injury (SCI). Bruton tyrosine kinase (BTK) activation mechanistically links these neuroimmune mechanisms. Our objective is to use Ibrutinib, an FDA-approved BTK inhibitor, to inhibit the neuroimmune cascade thereby improving locomotor recovery after SCI. Rat models of contusive SCI, Western blot, immunofluorescence staining imaging, flow cytometry analysis, histological staining, and behavioral assessment were used to evaluate BTK activity, neuroimmune cascades, and functional outcomes. Both BTK expression and phosphorylation were increased at the lesion site at 2, 7, 14, and 28 days after SCI. Ibrutinib treatment (6 mg/kg/day, IP, starting 3 h post-injury for 7 or 14 days) reduced BTK activation and total BTK levels, attenuated the injury-induced elevations in Iba1, GFAP, CD138, and IgG at 7 or 14 days post-injury without reduction in CD45RA B cells, improved locomotor function (BBB scores), and resulted in a significant reduction in lesion volume and significant improvement in tissue-sparing 11 weeks post-injury. These results indicate that Ibrutinib exhibits neuroprotective effects by blocking excessive neuroimmune responses through BTK-mediated microglia/astroglial activation and B cell/antibody response in rat models of SCI. These data identify BTK as a potential therapeutic target for SCI. Full article
(This article belongs to the Special Issue Advances in Research on Spinal Cord Injury)
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19 pages, 5483 KiB  
Article
Sodium Benzoate, a Metabolite of Cinnamon and a Food Additive, Improves Cognitive Functions in Mice after Controlled Cortical Impact Injury
by Suresh B. Rangasamy, Sumita Raha, Sridevi Dasarathy and Kalipada Pahan
Int. J. Mol. Sci. 2022, 23(1), 192; https://doi.org/10.3390/ijms23010192 - 24 Dec 2021
Cited by 10 | Viewed by 3834
Abstract
Traumatic brain injury (TBI) is a major health concern, sometimes leading to long-term neurological disability, especially in children, young adults and war veterans. Although research investigators and clinicians have applied different treatment strategies or neurosurgical procedures to solve this health issue, we are [...] Read more.
Traumatic brain injury (TBI) is a major health concern, sometimes leading to long-term neurological disability, especially in children, young adults and war veterans. Although research investigators and clinicians have applied different treatment strategies or neurosurgical procedures to solve this health issue, we are still in need of an effective therapy to halt the pathogenesis of brain injury. Earlier, we reported that sodium benzoate (NaB), a metabolite of cinnamon and a Food and Drug Administration-approved drug against urea cycle disorders and glycine encephalopathy, protects neurons in animal models of Parkinson’s disease and Alzheimer’s disease. This study was undertaken to examine the therapeutic efficacy of NaB in a controlled cortical impact (CCI)-induced preclinical mouse model of TBI. Oral treatment with NaB, but not sodium formate (NaFO), was found to decrease the activation of microglia and astrocytes and to inhibit the expression of inducible nitric oxide synthase (iNOS) in the hippocampus and cortex of CCI-insulted mice. Further, administration of NaB also reduced the vascular damage and decreased the size of the lesion cavity in the brain of CCI-induced mice. Importantly, NaB-treated mice showed significant improvements in memory and locomotor functions as well as displaying a substantial reduction in depression-like behaviors. These results delineate a novel neuroprotective property of NaB, highlighting its possible therapeutic importance in TBI. Full article
(This article belongs to the Special Issue Advances in Research on Spinal Cord Injury)
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15 pages, 3010 KiB  
Article
Exerting the Appropriate Application of Methylprednisolone in Acute Spinal Cord Injury Based on Time Course Transcriptomics Analysis
by Liang-Yo Yang, Meng-Yu Tsai, Shu-Hui Juan, Shwu-Fen Chang, Chang-Tze Ricky Yu, Jung-Chun Lin, Kory R. Johnson, Hendrick Gao-Min Lim, Yang C. Fann and Yuan-Chii Gladys Lee
Int. J. Mol. Sci. 2021, 22(23), 13024; https://doi.org/10.3390/ijms222313024 - 1 Dec 2021
Cited by 7 | Viewed by 2734
Abstract
Methylprednisolone (MP) is an anti-inflammatory drug approved for the treatment of acute spinal cord injuries (SCIs). However, MP administration for SCIs has become a controversial issue while the molecular effects of MP remain unexplored to date. Therefore, delineating the benefits and side effects [...] Read more.
Methylprednisolone (MP) is an anti-inflammatory drug approved for the treatment of acute spinal cord injuries (SCIs). However, MP administration for SCIs has become a controversial issue while the molecular effects of MP remain unexplored to date. Therefore, delineating the benefits and side effects of MP and determining what MP cannot cure in SCIs at the molecular level are urgent issues. Here, genomic profiles of the spinal cord in rats with and without injury insults, and those with and without MP treatment, were generated at 0, 2, 4, 6, 8, 12, 24, and 48 h post-injury. A comprehensive analysis was applied to obtain three distinct classes: side effect of MP (SEMP), competence of MP (CPMP), and incapability of MP (ICMP). Functional analysis using these genes suggested that MP exerts its greatest effect at 8~12 h, and the CPMP was reflected in the immune response, while SEMP suggested aspects of metabolism, such as glycolysis, and ICMP was on neurological system processes in acute SCIs. For the first time, we are able to precisely reveal responsive functions of MP in SCIs at the molecular level and provide useful solutions to avoid complications of MP in SCIs before better therapeutic drugs are available. Full article
(This article belongs to the Special Issue Advances in Research on Spinal Cord Injury)
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12 pages, 2810 KiB  
Article
The Application of an Omentum Graft or Flap in Spinal Cord Injury
by Li-Yu Fay, Yan-Ru Lin, Dann-Ying Liou, Chuan-Wen Chiu, Mei-Yin Yeh, Wen-Cheng Huang, Jau-Ching Wu, May-Jywan Tsai and Henrich Cheng
Int. J. Mol. Sci. 2021, 22(15), 7930; https://doi.org/10.3390/ijms22157930 - 25 Jul 2021
Cited by 9 | Viewed by 2754
Abstract
Background: Spinal cord injury (SCI) causes a primary injury at the lesion site and triggers a secondary injury and prolonged inflammation. There has been no definitive treatment till now. Promoting angiogenesis is one of the most important strategies for functional recovery after SCI. [...] Read more.
Background: Spinal cord injury (SCI) causes a primary injury at the lesion site and triggers a secondary injury and prolonged inflammation. There has been no definitive treatment till now. Promoting angiogenesis is one of the most important strategies for functional recovery after SCI. The omentum, abundant in blood and lymph vessels, possesses the potent ability of tissue regeneration. Methods: The present work examines the efficacy of autologous omentum, either as a flap (with vascular connection intact) or graft (severed vascular connection), on spinal nerve regeneration. After contusive SCI in rats, a thin sheath of omentum was grafted to the injured spinal cord. Results: Omental graft improved behavior scores significantly from the 3rd to 6th week after injury (6th week, 5.5 ± 0.5 vs. 8.6 ± 1.3, p < 0.05). Furthermore, the reduction in cavity and the preservation of class III β-tubulin-positive nerve fibers in the injury area was noted. Next, the free omental flap was transposed to a completely transected SCI in rats through a pre-implanted tunnel. The flap remained vascularized and survived well several weeks after the operation. At 16 weeks post-treatment, SCI rats with omentum flap treatment displayed the preservation of significantly more nerve fibers (p < 0.05) and a reduced injured cavity, though locomotor scores were similar. Conclusions: Taken together, the findings of this study indicate that treatment with an omental graft or transposition of an omental flap on an injured spinal cord has a positive effect on nerve protection and tissue preservation in SCI rats. The current data highlight the importance of omentum in clinical applications. Full article
(This article belongs to the Special Issue Advances in Research on Spinal Cord Injury)
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Review

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42 pages, 1480 KiB  
Review
The Effects of Exercise and Activity-Based Physical Therapy on Bone after Spinal Cord Injury
by Tommy W. Sutor, Jayachandra Kura, Alex J. Mattingly, Dana M. Otzel and Joshua F. Yarrow
Int. J. Mol. Sci. 2022, 23(2), 608; https://doi.org/10.3390/ijms23020608 - 6 Jan 2022
Cited by 28 | Viewed by 9154
Abstract
Spinal cord injury (SCI) produces paralysis and a unique form of neurogenic disuse osteoporosis that dramatically increases fracture risk at the distal femur and proximal tibia. This bone loss is driven by heightened bone resorption and near-absent bone formation during the acute post-SCI [...] Read more.
Spinal cord injury (SCI) produces paralysis and a unique form of neurogenic disuse osteoporosis that dramatically increases fracture risk at the distal femur and proximal tibia. This bone loss is driven by heightened bone resorption and near-absent bone formation during the acute post-SCI recovery phase and by a more traditional high-turnover osteopenia that emerges more chronically, which is likely influenced by the continual neural impairment and musculoskeletal unloading. These observations have stimulated interest in specialized exercise or activity-based physical therapy (ABPT) modalities (e.g., neuromuscular or functional electrical stimulation cycling, rowing, or resistance training, as well as other standing, walking, or partial weight-bearing interventions) that reload the paralyzed limbs and promote muscle recovery and use-dependent neuroplasticity. However, only sparse and relatively inconsistent evidence supports the ability of these physical rehabilitation regimens to influence bone metabolism or to increase bone mineral density (BMD) at the most fracture-prone sites in persons with severe SCI. This review discusses the pathophysiology and cellular/molecular mechanisms that influence bone loss after SCI, describes studies evaluating bone turnover and BMD responses to ABPTs during acute versus chronic SCI, identifies factors that may impact the bone responses to ABPT, and provides recommendations to optimize ABPTs for bone recovery. Full article
(This article belongs to the Special Issue Advances in Research on Spinal Cord Injury)
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