Effects of traumatic injury on dynorphin immunoreactivity in spinal cord

Traumatic spinal cord injury in rats resulted in a significant eleation of dynorphin A immunoreactivity in spinal cord tissue at the level of, and below, the site of injury. [Leu5]enkephalin levels in the same tissue samples were not significantly altered following severe injury. Dynorphin A immunoreactivity was found in the fraction relatively enriched in synaptosomes after subcellular fractionation of spinal cord tissue. The dynorphin A content of this fraction was not significantly changed following injury, suggesting that dynorphin containing nerve terminals and axons are not severely damaged as a result of the injury.     

Depression following traumatic spinal cord injury

OBJECTIVES: To describe the epidemiology of depression following traumatic spinal cord injury (SCI) and identify risk factors associated with depression. METHODS: This population-based cohort study followed individuals from date of SCI to 6 years after injury. Administrative data from a Canadian province with a universal publicly funded health care system and centralized databases were used. A Cox proportional hazards model was developed to identify risk factors. RESULTS: Of 201 patients with SCI, 58 (28.9%) were treated for depression. Individuals at highest risk were those with a pre-injury history of depression [hazard rate ratio (HRR) 1.6; 95% CI: 1.1-2.3], a history of substance abuse (HRR 1.6; 95% CI: 1.2-2.3) or permanent neurological deficit (HRR 1.6; 95% CI: 1.2-2.1). CONCLUSION: Depression occurs commonly and early in persons who sustain an SCI. Both patient and injury factors are associated with the development of depression. These should be used to target patients for mental health assessment and services during initial hospitalization and following discharge into the community.     

Suicide following acute traumatic spinal cord injury.

The rate of suicide following spinal cord injury has not been extensively studied but appears to be greater than in the general population. Six patients who died by suicide, from a total of 342 patients who were treated for acute spinal cord injury over a 5 year period are described. Clinical features shared by this group of patients included being male; having schizoid, depressive or narcissistic personality traits; alcohol or drug abuse; family or significant others favouring death as a preferred option; and the development of significant depression.     

Endogenous opioid immunoreactivity in rat spinal cord following traumatic injury

It has been postulated that endogenous opioids play a pathophysiological role in spinal cord injury, based on the therapeutic effects of the opiate receptor antagonist naloxone in certain experimental models. The high doses of naloxone required to exert a therapeutic action suggest that naloxone's effects may be mediated by non-mu opiate receptors, such as the kappa receptor. This notion is supported by recent pharmacological studies demonstrating that an opiate antagonist more active at kappa sites is effective and far more potent than naloxone in improving outcome after spinal cord injury. Moreover, dynorphin--postulated to be the endogenous ligand for the kappa receptor--is unique among opioids in producing hindlimb paralysis following intrathecal administration in the rat. In the present studies we have examined changes in endogenous opioid immunoreactivity following traumatic spinal cord injury in the rat. Dynorphin A was found to increase progressively with graded injury; changes were restricted to the injury segment and adjacent areas and were time dependent. Dynorphin A-(1-8) showed no marked changes. Methionine and leucine enkephalin were either unaltered or reduced at the injury site; changes were not well localized and were not clearly related to the injury variables. These findings provide further support for a potential pathophysiological role of prodynorphin-derived peptides in spinal cord injury.     

Induced hypothermia in experimental traumatic spinal cord injury: an update

The use of induced hypothermia in the treatment of traumatic spinal cord injury (SCI) has been studied extensively between the 1960s and 1970s. Although the treatment showed some promise, it became less popular by the 1980s, mainly because of its adverse effects. However, a revival of hypothermia in the treatment of traumatic brain injury (TBI) in the last decade has encouraged neuroscientists to conduct experiments to reevaluate the potential benefits of hypothermia in traumatic SCI. All laboratory investigations studying the mechanisms of action and/or the efficacy of induced hypothermia in treating experimental traumatic SCI published in the last decade were reviewed. Although efficacy of hypothermia in improving functional outcome of mild to moderate traumatic SCI has been demonstrated, hypothermia may not be protective against severe traumatic SCI. At present, induced hypothermia has yet to be recognized or approved as a potential treatment having therapeutic value for traumatic SCI in humans. The continued search for a possible synergistic effect of induced hypothermia and pharmacological therapy may yield some promise. It has also been deduced from these laboratory studies that hyperthermia is deleterious and rigorous measures to prevent hyperthermia should be taken to minimize the propagation of secondary neuronal damage after traumatic SCI.     

Current therapeutic strategies for inflammation following traumatic spinal cord injury

Damage from spinal cord injury occurs in two phases-the trauma of the initial mechanical insult and a secondary injury to nervous tissue spared by the primary insult.Apart from damage sustained as a result of direct trauma to the spinal cord,the post-traumatic inflammatory response contributes significantly to functional motor deficits exacerbated by the secondary injury.Attenuating the detrimental aspects of the inflammatory response is a promising strategy to potentially ameliorate the secondary injury,and promote significant functional recovery.This review details how the inflammatory component of secondary injury to the spinal cord can be treated currently and in the foreseeable future.     

A method for estimating edema in experimental traumatic spinal cord injury

In this experiment a method was developed to estimate spinal cord edema following experimental trauma. After the intravenous administration of Evans Blue solution and 100 μc of iodinated I-131 serum albumin, the spinal cords of rhesus monkeys were traumatized with a 600 g cm injury. Edema at the injury site was evaluated at 6 hr after injury and compared to a section of uninjured spinal cord from each animal. The I-131 serum albumin acted as an excellent marker to estimate the extravasation of serum proteins into the neural extracellular spaces. In the future this method will be used to test the effect of various drugs on post-traumatic edema formation.     

Riluzole improves measures of oxidative stress following traumatic spinal cord injury

Rats received a contusion injury to the spinal cord followed by treatment with riluzole (a glutamate release inhibitor, 8 mg/kg), methylprednisolone (MP 30 mg/kg) or both. At 4 h following injury, spinal cords were removed and synaptosomes prepared and examined using five measures of oxidative stress. Riluzole treatment was found to improve mitochondrial function, and enhance glutamate and glucose uptake. As expected, MP treatment was found to reduce lipid peroxidation, but also improved glutamate and glucose uptake. Interestingly, the combination treatment was found to be effective in improving all five measures of oxidative stress. The results of this study clearly demonstrate the potential beneficial effects of a combination approach in the treatment of oxidative stress events in traumatic spinal cord injury.     

Increase of interleukin-1β mRNA and protein in the spinal cord following experimental traumatic injury in the rat

Interleukin-1 beta (IL-1β) is a major mediator of inflammation and a growth promoter for many cell types that could play an important role in the consequences of traumatic spinal cord injury (SCI). In the present study, the expression of IL-1β and its mRNA was determined in the rat spinal cord following a standardized contusion injury. IL-1β mRNA, measured with quantitative RT-PCR, was significantly increased in the lesion site by 1 h after SCI (35.2±5.9 vs. 9.1±2.1 pg/mg RNA, n=3, P<0.05) and remained significantly higher than in the normal spinal cord for at least 72 h post-injury (p.i.). IL-1β mRNA levels in tissue immediately caudal to the lesion site did not change after the injury. IL-1β protein levels, measured by an ELISA, were determined at the lesion site and in cerebrospinal fluid (CSF) and serum samples. IL-1β levels in the CSF and serum were much lower than in the spinal cord. At the lesion site, IL-1β was increased significantly by 1 h p.i., peaked at 8 h (32.3±0.1 vs. 7.6±1.9, ng/g tissue, n=5, P<0.05) and remained significantly higher than normal through at least 7 days p.i. These results suggest that the increased IL-1β mRNA and protein levels are an early and local response at the lesion site that could trigger other, later, responses to traumatic SCI.     

C-fos expression in the spinal cord of rats exhibiting allodynia following contusive spinal cord injury

Contusive spinal cord injury (SCI) may result in central neuropathic pain marked by allodynia-like features in the dermatomes close to the level of injury. The aim of this study was to compare the laminar distribution of activated neurons (as determined by c-fos immediate early gene expression) in the spinal cord immediately above the level of a SCI in rats with or without allodynia-like features. Non-noxious mechanical stimulation was applied to half the animals in the dermatomes corresponding to the level of injury prior to perfusion. Stimulation resulted in a significant increase in c-fos labelling in all laminae of the spinal dorsal horn in the segment immediately above the level of injury only in allodynia animals. Animals that had allodynia also demonstrated a significant increase in the level of c-fos labelling in lamina III, IV and V of the dorsal horn without stimulation. Thus, allodynia following SCI is associated with significant increases in basal and evoked c-fos expression ("neuronal activity") in response to non-noxious mechanical stimulation. The data also suggest that allodynia-like behaviour following SCI cannot be accounted for solely by changes occurring at a spinal level.     

Production of tumor necrosis factor in spinal cord following traumatic injury in rats

Production of tumor necrosis factor (TNF) in the spinal cord following traumatic injury has been studied. In these experiments, the level of TNF was examined in the homogenate of the spinal cord, cerebrospinal fluid (CSF) and serum (n = 56). TNF could be detected in the injured spinal cord but not in the normal spinal cord. The TNF level increased in the spinal cord after the injury. At the lesion site, a maximal TNF concentration was observed 1 h after the injury, and the TNF concentration remained at this level until 8 h after the injury. Thereafter, it decreased gradually. However, TNF still could be detected 72 h after the injury. No TNF could be detected in the CSF and serum, collected from rats both with and without spinal cord injury (SCI). This study thus suggests that TNF is produced locally in the spinal cord following traumatic injury, and this TNF production is caused by the injury. The present results also demonstrate that TNF production is an acute and rapid reaction in the spinal cord following traumatic injury.     

Changes in metabotropic glutamate receptor expression following spinal cord injury

Spinal cord injury (SCI) initiates biochemical events that lead to an increase in extracellular excitatory amino acid concentrations, resulting in glutamate receptor-mediated excitotoxic events. These receptors include the three groups of metabotropic glutamate receptors (mGluRs). Group I mGluR activation can initiate a number of intracellular pathways that increase neuronal excitability. Group II and III mGluRs may function as autoreceptors to modulate neurotransmission. Thus, all three groups may contribute to the mechanisms of central sensitization and chronic central pain. To begin evaluating mGluRs in SCI, we quantified the changes in mGluR expression after SCI in control (naive), sham, and impact injured adult male Sprague-Dawley rats (200-250 g). SCI was produced at spinal segment T10 with a New York University impactor (12.5-mm drop, 10-g rod of 2-mm diameter). Expression levels were determined by Western blot and immunohistochemistry analyses at the epicenter of injury, as well as segments rostral and caudal. The group I subtype mGluR1 was increased over control levels in segments rostral and caudal by postsurgical day (PSD) 7 and remained elevated through PSD 60. The group I subtype mGluR5 was unchanged in all segments rostral and caudal to the injury at every time point measured. Group II mGluRs were decreased compared to control levels from PSD 7 through PSD 60 in all segments. These results suggest that different subtypes of mGluRs have different spatial and temporal expression patterns following SCI. The expression changes in mGluRs parallel the development of mechanical allodynia and thermal hyperalgesia following SCI; therefore, understanding the expression of mGluRs after SCI may give insight into mechanisms underlying the development of chronic central pain.     

Reduction in expression of the astrocyte glutamate transporter, GLT1, worsens functional and histological outcomes following traumatic spinal cord injury

The astrocyte glutamate transporter, GLT1, is responsible for the vast majority of glutamate uptake in the adult central nervous system (CNS), thereby regulating extracellular glutamate homeostasis and preventing excitotoxicity. Glutamate dysregulation plays a central role in outcome following traumatic spinal cord injury (SCI). To determine the role of GLT1 in secondary cell loss following SCI, mice heterozygous for the GLT1 astrocyte glutamate transporter (GLT1^+/?) and wild‐type mice received thoracic crush SCI. Compared with wild‐type controls, GLT1^+/? mice had an attenuated recovery in hindlimb motor function, increased lesion size, and decreased tissue sparing. GLT1^+/? mice showed a decrease in intraspinal GLT1 protein and functional glutamate uptake compared with wild‐type mice, accompanied by increased apoptosis and neuronal loss following crush injury. These results suggest that astrocyte GLT1 plays a role in limiting secondary cell death following SCI, and also show that compromise of key astrocyte functions has significant effects on outcome following traumatic CNS injury. These findings also suggest that increasing intraspinal GLT1 expression may represent a therapeutically relevant target for SCI treatment. © 2011 Wiley‐Liss, Inc.     

Nitric oxide via macrophage iNOS induces apoptosis following traumatic spinal cord injury

To investigate the pathophysiological mechanisms involved in post-traumatic impairment of the spinal cord, we analyzed expression patterns of the inducible nitric oxide synthase (iNOS) gene following acute injury of rat spinal cord using a weight drop technique. PCR analysis revealed that iNOS mRNA appeared at 3-12 h after injury and declined thereafter. Immunohistochemical analysis showed that iNOS-positive cells invaded the lesioned area through the perivascular space at 6 h after injury. The population of these cells peaked at 24 h and then declined to disappear 3 days after injury. The iNOS-positive cells were also stained with ED-2 but not with ED-1 or OX-42, indicating that these cells were macrophages and/or perivascular cells. In parallel with the appearance of iNOS-positive cells, other cells emerged that were positively stained by the terminal deoxynucleotidyl-transferase-mediated dUDP-biotin nick end-labeling (TUNEL) assay. TUNEL-positive cells were scattered in the lesioned area 1 day after injury, but some in the surrounding area close to iNOS-positive cells. Administration of L-Ng-nitro-arginine methylester, a competitive inhibitor of NOS, resulted in a reduction of TUNEL-positive cells in the lesioned area. These results suggest that nitric oxide generated by iNOS of macrophages and/or perivascular cells plays a significant role in eliminating damaged cells from the lesioned area by apoptosis.