Immunomodulatory effect of the purine nucleoside inosine following spinal cord contusion injury in rat

STUDY DESIGN: In vivo study using a moderate spinal cord contusion injury (SCI) model in adult rat. OBJECTIVE: To assess the immunomodulatory effects of the purine nucleoside inosine on macrophage/microglia activation at and near the lesion site and in white matter areas remote from the injury epicenter. SETTING: Department of Cell and Developmental Biology, SUNY Upstate Medical University, Syracuse, NY, USA. METHODS: Animals (N=56) were injured using a moderate SCI at T9-T10 spinal level and were divided into three groups, depending on treatment paradigm. Rats received either intraperitoneal or subcutaneous injections of inosine (N=28) or vehicle (N=28). Spinal cord tissue was processed for ED-1 immunoreactivity and the volume fraction of ED-1(+) profiles was calculated using the Cavalieri method and unbiased stereology. RESULTS: The volume fraction of ED-1(+) profiles within gray and lateral white matter regions at and around the lesion site was significantly reduced only following a twice daily-6 week treatment course, compared with vehicle controls, and white matter areas remote from the lesion were unaffected by all inosine treatment paradigms. CONCLUSIONS: Continued subcutaneous delivery of inosine, beginning 15-min post-SCI and persisting throughout the survival period of 6 weeks exerted immunomodulatory effects at and around the lesion site.     

大鼠脊髓损伤过程中细胞周期蛋白H的表达变化

目的 观察细胞周期蛋白H(Cyclin H)在急性脊髓损伤后的表达变化及定位情况,探讨其在脊髓损伤与修复过程中的生物学功能.方法 取56只成年SD大鼠,随机分8组:正常对照组、T9撞击伤6 h、12 h、1 d、3 d、5 d、7 d、14 d 7组,每组7只.采用Western blot测定损伤后各时间段Cyclin H蛋白水平在脊髓中的表达变化,采用免疫组织化学方法检测Cyclin H在正常及损伤后脊髓中的分布和定位,在此基础上探讨Cyclin H在脊髓损伤后的病理生理意义.结果 Western blot结果表明创伤性脊髓损伤后脊髓中Cyclin H表达呈现逐渐升高再下降的趋势,3 d达到高峰.免疫组织化学表明Cyclin H在正常脊髓中表达,损伤后3 d,Cyclin H在脊髓白质中的表达明显增强,在灰质中的表达也有一定程度的增强.免疫荧光双标记表明Cyclin H与神经元标记物NeuN、小胶质细胞标记物CD11b有明显共定位,与星形胶质细胞标记物GFAP有少量共定位.结论 脊髓损伤后Cyclin H蛋白水平有明显时相改变,且与神经元、小胶质细胞和星形胶质细胞有共定位,提示Cyclin H在脊髓损伤后可能发挥了作用.     

Chlorpromazine protects rat spinal cord against contusion injury

The protective effect of chlorpromazine on rat spinal cord injury was investigated using a dynamic impact model. A 10 g weight was dropped 5 cm on an impounder placed on the exposed spinal cord at the T-11 level. Changes in potassium concentration on the epidural surface of the injured spinal cord were measured using a combined impounder-K+ electrode assembly. Recovery of motor performance was estimated using the modified Tarlov score. In the injury control (no treatment) group, the recovery was slow. Animals were still paralyzed 4 weeks after injury and none of them could walk; the Tarlov score was 1.88 +/- 0.78 (S.D.). In contrast, the chlorpromazine-treated group (20 mg/kg i.p. 30 min prior to injury) recovered significantly in 4 weeks. Animals could either support body weight or walk with some deficit; the Tarlov score was 4.0 +/- 0.35. Chlorpromazine inhibited potassium efflux from the spinal cord after contusion. Possible mechanisms of protection of neural cells by chlorpromazine are discussed.     

Neuroprotective effects of basic fibroblast growth factor following spinal cord contusion injury in the rat.

Cytokines and neurotrophic factors have been implicated in the pathophysiology of injury to the central nervous system. While some cytokines are considered pro-inflammatory, other factors promote neuronal growth and survival. The present study investigated the neuroprotective effects of interleukins 1 (IL-1), 4 (IL-4), and 6 (IL-6), nerve growth factor (NGF), ciliary neurotrophic factor (CNTF), and basic fibroblast growth factor (bFGF) in a contusion model of spinal cord injury. Female Sprague-Dawley rats (n = 55) sustained a 10-g weight-drop injury to the lower thoracic spinal cord (T10) from a height of 12.5 mm using the NYU impactor. A micro-infusion system (Alzet minipump) was used to continuously deliver drugs or vehicle directly into the epicenter of the contused spinal cord starting 1 or three h postinjury. At the end of 7 days, animals were perfused and the cords removed for histopathological analysis. Longitudinal serial sections were cut on a freezing microtome and stained with cresyl violet. Areas of central necrosis, partial preservation, and total zone of tissue injury were identified and traced by an independent reviewer using a computer based imaging system. The mean total zone of injury in five animals receiving vehicle infusion was 18.04+/-4.20 mm3. The mean zone of partial preservation in these animals was 16.46+/-3.32 mm. Basic fibroblast growth factor reduced the total zone of injury by 33% [p<0.01, least significant difference (LSD) of Fisher] in five animals and the zone of partial preservation by 32% (p<0.01, LSD of Fisher) when compared to controls. There were trends toward reduction in total zone of injury and zone of partial preservation in rats treated with IL-4, CNTF, and NGF versus vehicle; however, none of these reached statistical significance. No significant differences were observed between animals receiving vehicle versus bFGF treatment commencing 3 h after injury. These data demonstrate that the continuous intramedullary infusion of bFGF initiated one hour after moderate contusion injury of the spinal cord significantly reduces the total zone of injury and the zone of partial preservation. These results support the further investigation and possible future clinical application of bFGF in the treatment of acute spinal cord contusion injury.     

Chondroitinase ABCI improves locomotion and bladder function following contusion injury of the rat spinal cord

Chondroitin sulfate proteoglycans are synthesized and deposited in the spinal cord following injury. These proteoglycans may restrict regeneration and plasticity and contribute to the limited recovery seen after an injury. Chondroitinase, a bacterial enzyme that catalyzes the hydrolysis of the chondroitin chains on proteoglycans, has been shown to improve motor and sensory function following partial transection lesions of the spinal cord. To assess the effects of chondroitinase in a clinically relevant model of spinal cord injury, 128 female Long-Evans rats received either a severe, moderate, or mild contusion injury at the vertebral level T9/T10 with a forceps model and were treated for 2 weeks with chondroitinase ABCI at 0.06 Units per dose, penicillinase, or vehicle control via an intrathecal catheter placed near the injury. Motor behavior was measured by open-field testing of locomotion and bladder function monitored by measuring daily residual urine volumes. Animals treated with chondroitinase showed significant improvements in open-field locomotor activity as measured by the Basso, Beattie and Bresnahan scoring system after both severe and moderate SCI (p<0.05 and 0.01, respectively). No significant locomotor differences were observed in the mild injury group. In the moderate injury group, residual urine volumes were reduced with chondroitinase treatment by 2 weeks after injury (p<0.05) and in the severe injury group, by 6 weeks after injury (NS). These results demonstrate that chondroitinase is effective at promoting both somatic and autonomic motor recovery following a clinically relevant contusion spinal cord injury and is a candidate as a therapeutic for human spinal cord injury.     

环氧化酶在大鼠急性打击损伤脊髓中的表达

目的观察正常和急性打击损伤大鼠脊髓组织中环氧化酶（COX）的表达。方法48只Sprague-Dawley大鼠，随机平均分为正常组，手术对照组，脊髓损伤后2、4、8、16、24、48h组。采用改良Allen’s打击脊髓损伤动物模型。应用免疫组织化学染色的方法观察两种COX蛋白的表达变化。结果COX-1蛋白在正常胸椎脊髓组织中有基础性表达，主要分布在脊髓灰质后角和白质后索的神经纤维网中；COX-2蛋白在正常胸椎脊髓组织中也存在基础性表达，主要分布于脊髓灰质神经元细胞；急性打击脊髓损伤后COX—1蛋白的表达没有明显变化；急性打击脊髓损伤后4h，COX-2蛋白的表达开始增高，损伤后24h染色程度达到高峰，并维持至损伤后48h，表达增高主要出现在脊髓灰质的神经元细胞中。结论与环氧化酶在外周组织中的表达特点不同，正常胸段脊髓组织中同时存在COX-1和COX-2蛋白的基础性表达。急性机械打击脊髓损伤后，参与继发损伤的主要环氧化酶亚型是COX-2。     

Quantification of locomotor recovery following spinal cord contusion in adult rats

Injury to the spinal cord not only disrupts the functioning of spinal circuits at the site of the impact, but also limits sensorimotor function caudal to the level of the lesion. Ratings of gross locomotor skill are generally used to quantify locomotor recovery following spinal cord injury (SCI). The purpose of this study was to assess behavioral recovery following SCI with three tasks: (1) BBB ratings, (2) walking on a horizontal ladder, and (3) footprint analyses. Behavioral testing was conducted for 6 postoperative weeks, and then the spinal cords were processed for the amount of white matter spared. As expected, BBB ratings dramatically decreased and then improved during recovery. The number of hindlimb foot-faults on the horizontal ladder increased after injury and remained elevated during the recovery period. Footprint analyses revealed that sham-control rats used several different gaits to cross the runway. In contrast, the locomotor function of rats with a SCI was impaired throughout the postoperative period. Some locomotor parameters of the injured rats improved slightly (velocity, stride length, stride duration, stance duration), some did not change (interlimb coordination, swing duration, forelimb base of support, hindpaw angle), and others declined (hindlimb base of support) during the recovery period. Together, these results show that gross locomotor skill improved after SCI, while recovery of fine locomotor function was more limited. Multiple tests should be included in future experiments in order to assess gross and fine changes in sensorimotor function following SCI.     

Bcl-xL expression after contusion to the rat spinal cord.

After contusion-derived spinal cord injury, (SCI) there is localized tissue disruption and energy failure that results in early necrosis and delayed apoptosis, events that contribute to chronic central pain in a majority of patients. We assessed the extent of contusion-induced apoptosis of neurons in a known central pain-signaling pathway, the spinothalamic tract (STT), which may be a contributor to SCI-induced pain. We observed the loss of STT cells and localized increase of DNA fragmentation and cytoplasmic histone-DNA complexes, which suggested potential apoptotic changes among STT neurons after SCI. We also showed SCI-associated changes in the expression of the antiapoptotic protein Bcl-xL, especially among STT cells, consistent with the hypothesis that Bcl-xL regulates the extent of apoptosis after SCI. Apoptosis in the injured spinal cord correlated well with prompt decreases in Bcl-xL protein levels and Bcl-xL/Bax protein ratios at the contusion site. We interpret these results as evidence that regulation of Bcl-xL may play a role in neural sparing after spinal injury and pain-signaling function.     

Functional consequences of lumbar spinal cord contusion injuries in the adult rat

Our understanding of the substrates of locomotion, and hence our understanding of the causes of deficits following spinal cord injury, is still incomplete. While severe locomotor deficits can be induced by either contusion or laceration injuries or demyelination of thoracic spinal cord ventral and ventrolateral white matter, loss of mid-thoracic gray matter (intraspinal kainic acid injection) has no impact on locomotion. In contrast, loss of gray matter from the rostral lumbar segments induces severe locomotor deficits. This study examines the histological and locomotor outcomes following contusion injuries involving the rostral segments of the lumbar enlargement in the adult rat. Adult Sprague-Dawley rats received contusion injuries centered on the T13/L1, L2, or L3/4 spinal cord segments. Moderately severe injuries centered on the T13/L1 and L2 spinal cord segments induced more severe locomotor deficits than those centered on the L3/4 segments, despite a significantly smaller total gray matter volume loss (1.7 vs. 2.7 mm3). Moderately-severe injuries at T13/L1, L2, and L3/4 showed 21%, 31%, and 39% white matter sparing, respectively, with 6-week BBB scores of 10, 10, and 15.7, respectively. These data suggest that moderately-severe contusion injuries centered on the rostral segments of the lumbar enlargement induce more severe locomotor deficits than would be predicted by the histological outcome (spared white matter), suggesting that gray matter loss may play a role in functional deficits following some lumbar contusion injuries.     

Valproic acid preserves motoneurons following contusion in organotypic spinal cord slice culture

Objective: Spinal cord injury (SCI) is a devastating condition causing neuronal loss. A key challenge in treatment of SCI is how to retain neurons after injury. Valproic acid (VPA) is a drug recently has been appreciated for its neuroprotective and neurotrophic properties in various SCI models. In this study the role of VPA was assessed in organotypic spinal cord slice culture following the contusion.

Design: The lumbar enlargement of adult rat was cut transversely and slices were cultured. Seven days after culturing, injury was induced by dropping a 0.5 gram weight from 3?cm height on the slice surface. One hour after injury, the VPA was administered at 1, 5 and 10?µM concentrations. Afterward, at day 1 and 3 post injury (DPI: 1 and 3) propidium iodide (PI) and immunohistochemistry staining were performed to evaluate the cell death, NeuN and β-Tubulin expression, respectively.

Results: The PI staining of slices at DPI: 1 and 3 following treatment with VPA revealed significant decreases in the cell death in all three concentrations comparing to the non-treated group. Also immunostaining showed VPA only at 5?µM concentration considerably rescued ventral horn’ MNs from death and protected the neuronal integrity.

Conclusion: The results of this study indicate applying VPA one hour after injury can prevent the death of a majority of cells, importantly MNs and preserve the neuronal integrity. Since the first 24 hours after SCI is a critical period for employing any treatment, VPA can be considered as an option for further evaluation.     

Three-dimensional computer-assisted analysis of graded contusion lesions in the spinal cord of the rat

Histological analysis of spinal cord injury in experimental animals has focused primarily on the microanatomy of damaged tissue. The current study presents an analysis of the three-dimensional structure of lesion sites in the spinal cord of rats contused with an injury device which produces consistent lesions. Three levels of injury were produced by systematically varying the cord displacement and the duration of the displacement during impact. The resulting groups of subjects exhibited mild, moderate, and severe neurological deficits. Comparisons of equivalent mild impacts made at thoracic versus lumbar spinal cord levels were also made. The results indicate that the overall shape of the lesions is generally biconical, with extensions in the base of the dorsal funiculus, irrespective of the degree of damage or the spinal level of the injury. Lower displacement injuries yielded shorter lesions rostrocaudally with less spread into the white matter. Similar impacts in the lumbar versus thoracic spinal cord produced shorter, more truncated lesion sites at lumbar levels with less involvement of the white matter than in the thoracic lesions. Three-dimensional analyses can can provide additional information about the lesion beyond that available from conventional histopathological measures. Such information could be useful in assessing the results of posttraumatic manipulations which are directed at reducing tissue damage or tissue replacement via transplantation.     

热休克蛋白70在大鼠急性打击损伤脊髓中的表达

目的观察急性打击损伤大鼠脊髓组织中热休克蛋白70（heat shock protein70，HSP 70）的表达。方法65只大鼠随机分为3组：正常对照组5只、手术对照组和脊髓损伤组各30只，采用改良Allen法建立脊髓损伤动物模型。手术对照组和脊髓损伤组分别于处置后的2h、6h、12h、24h、48h、72h这6个时间点各采集5只大鼠的脊髓。应用免疫组织化学染色方法观察不同时点各组脊髓中热休克蛋白的表达变化。结果在大鼠正常胸段脊髓中没有基础性HSP70的表达。打击造成急性脊髓损伤后2h，脊髓组织内出现HSP70的表达，损伤后24～48h脊髓组织中HSP70染色达到高峰，并维持至损伤后72h。结论在遭遇损伤性刺激后，脊髓组织在随后的2～72h内HSP70的表达明显增加；HSP70可能在阻止脊髓的继发性损伤方面发挥一定的作用。     

Locomotor deficits and adaptive mechanisms after thoracic spinal cord contusion in the adult rat

The rat is widely used for modeling human spinal cord injury (SCI) and paraplegia. However, quadruped animals adapt trunk, forelimb and hindlimb movements to compensate for deficits, improving their behavioral scores and complicating the interpretation of spontaneous and treatment-induced function recovery. The kinematics of locomotion was studied in rats, both normal and after SCI (T9 contusion), and variables indicative of hindlimb function were related to brain-spinal cord connections (BSCC) spared during lesioning. Normal animals showed forward velocities characteristic of fast walking. The hind paw was placed approximately three centimeters in front of the hip at the initial contact. Hip height decreased during the first third of hindlimb stance and increased later. Mild and moderate spinal cord contusions destroyed the gray matter and adjacent axons but spared the ventrolateral tracts to various degrees. Injured animals placed the hindpaw in a more caudal position than normal and showed reduced forward velocity and hip height. Knee extension was also impaired, and both hindlimb and forelimb steps were adapted to compensate for the deficits. BSCC was estimated by averaging the transverse area of white matter at the lesion epicenter and the percentage of brain neurons labeled after peroxidase injection into L2 and L3. Recovery of hindlimb motor function was proportional to the amount of BSCC. On average, injured animals retained 18% of BSSC and recovered 23% of hindlimb function. These findings show that kinematic analysis is a reliable tool for assessing locomotor deficits and compensations and suggest limited spontaneous motor plasticity after SCI.     

Motoneuron loss associated with chronic locomotion impairments after spinal cord contusion in the rat

Information on the nature of deficits and adaptive mechanisms occurring after spinal cord injury is essential to the design of strategies for promoting functional recovery. Motor impairments and compensations were quantified by three-dimensional kinematic analysis in freely walking rats, 6 months after mild cervical (C7) or moderate lumbar (L2) spinal cord contusion. After C7 contusion, the animals showed reduced elbow extension and wrist movement, whereas reduced knee extension was the main impairment after L2 contusion. In both cases, the duration of the walking cycle increased and forward velocity was reduced due to a longer stance phase. Histology revealed reproducible lesions extending approximately to one spinal cord segment. In the transverse plane, the lesion involved the central gray matter and adjacent axons, including the dorsal corticospinal tract, but partially spared the ventrolateral tracts. Retrograde motoneuron tracing by nerve exposure to HRP or intramuscular injection of aminostilbamidine demonstrated that C7 contusion caused the loss of approximately 40% of triceps brachii motoneurons, whereas approximately 30% of quadriceps femoris motoneurons were lost after L2 contusion. These results demonstrate permanent deficits after incomplete lesions at the spinal cord enlargements and suggest that motoneuron loss contributes to their production.     

The extent of myelin pathology differs following contusion and transection spinal cord injury

Demyelination is a prominent feature of spinal cord injury (SCI) and is followed by incomplete remyelination, which may contribute to physiological impairment. Demyelination has been documented in several species including humans, but the extent of demyelination and its functional consequence remain unknown. In this report, we document and compare the extent of tissue pathology, white matter apoptosis, demyelination, and remyelination 2 months following injury in rat contusion and transection models of SCI. Moreover, we document and compare the macrophage response 3 and 14 days post contusion and transection SCI. Contusion injury resulted in widespread tissue pathology, white matter apoptosis, demyelination, incomplete remyelination, and robust macrophage response extending several millimeters cranial and caudal to the epicenter of injury. In contrast, transection injury resulted in focal tissue pathology with white matter apoptosis, demyelination, incomplete remyelination, and robust macrophage response at the epicenter of injury, and little pathologic features at a distance from the epicenter of injury, as indicated by the lack of apoptosis and demyelination. These data indicate for the first time that myelin pathology differs substantially following contusion and transection SCI.     

Intermittent fasting improves functional recovery after rat thoracic contusion spinal cord injury

Spinal cord injury (SCI) often results in a loss of motor and sensory function. Currently there are no validated effective clinical treatments. Previously we found in rats that dietary restriction, in the form of every-other-day fasting (EODF), started prior to (pre-EODF), or after (post-EODF) an incomplete cervical SCI was neuroprotective, increased plasticity, and promoted motor recovery. Here we examined if EODF initiated prior to, or after, a T10 thoracic contusion injury would similarly lead to enhanced functional recovery compared to ad libitum feeding. Additionally, we tested if a group fed every day (pair-fed), but with the same degree of restriction as the EODF animals (～25% calorie restricted), would also promote functional recovery, to examine if EODF's effect is due to overall calorie restriction, or is specific to alternating sequences of 24-h fasts and ad libitum eating periods. Behaviorally, both pre- and post-EODF groups exhibited better functional recovery in the regularity indexed BBB ambulatory assessment, along with several parameters of their walking pattern measured with the CatWalk device, compared to both the ad-libitium-fed group as well as the pair-fed group. Several histological parameters (intensity and symmetry of serotonin immunostaining caudal to the injury and gray matter sparing) correlated with functional outcome; however, no group differences were observed. Thus besides the beneficial effects of EODF after a partial cervical SCI, we now report that alternating periods of fasting (but not pair-fed) also promotes improved hindlimb locomotion after thoracic spinal cord contusion, demonstrating its robust effect in two different injury models.     

F-wave amplitudes indicate evolving spinal autonomy during spontaneous recovery of hindlimb function in rat spinal cord contusion

STUDY DESIGN: Experimental rat model of spinal cord contusion. OBJECTIVES: To reveal the extent of spinal autonomy contributing to recovery of hindlimb function. SETTING: Experimental laboratory of a neurosurgical university department. METHODS: F-wave amplitudes as a probe for spinal cord excitability were recorded from both sciatic nerves (lumbar segments L2-L5) before and after an experimental spinal cord contusion performed in the lower thoracic spinal cord. Additionally, transcranial electrically motor evoked potentials from the hindlimbs and cerebral somatosensory potentials evoked by sciatic nerve stimulation were recorded. Clinical evaluation of hindlimb function was done regularly for survival periods of 3 and 50 days, respectively. Electrophysiological testing was performed immediately prior and after lesioning of the cord and at the endpoint of survival periods. RESULTS: Hindlimb function recovered from a mean Basso-Beattie-Bresnahan score of 5.6 on day 1 to 9.2 on day 3 (3-day-survivors) and from 7.7 to 17.2 on day 50 (50-day-survivors). This was accompanied by a significant increase of F-wave amplitudes on day 50 compared to baseline values, whereas amplitudes of somatosensory and motor-evoked potentials remained significantly depressed. CONCLUSION: Recovery of hindlimb function may at least in part be attributed to evolving spinal autonomy, which can be assessed by F-wave amplitudes.     

Persistent phosphorylation of NKCC1 and WNK1 in the epicenter of the spinal cord following contusion injury

Background contextNKCC1 regulates neuronal homeostasis of chloride ions and mediates GABAergic activities in nociceptive processing. WNK1 is an upstream regulator of NKCC1 and acts via SPAK (STE20/SPS1-related proline/alanine-rich kinase) and oxidative stress-responsive kinase 1. NKCC1 activity has been shown to be important in edema formation and nociception following spinal cord injury (SCI).PurposeTo determine the role of NKCC1 and WNK1 in spinal cord tissues in the acute and chronic phases following contusional SCI.Study designAn experimental study investigating the phosphorylation profile of an important Cl-regulatory protein Na+-K+-Cl? cotransporter 1 (NKCC1) and its regulatory-kinase WNK1 (kinase with-no-lysine).MethodsSprague-Dawley rats underwent a contusive SCI at T9. The epicenter spinal cord tissues were harvested at Days 1, 3, and 7 for acute phase of injury or Days 35 and 42 in the chronic phase of injury. Western blot was used to compare phosphorylated levels of both NKCC1 and WNK1 in injured tissues compared with those of sham.ResultsA sustained increase in phosphorylation of NKCC1 and WNK1 was detected in the lesion epicenter in spinal cord during both acute and chronic phases following SCI.ConclusionsThese results suggest that persistent activation of NKCC1 and WNK1 may play an important role in SCI.