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Pathophysiology of spinal cord injury

Sonia Kartha, Christine L Weisshaar, Blythe H Philips, Beth A Winkelstein
Painful neuropathic injuries are accompanied by robust inflammatory and oxidative stress responses that contribute to the development and maintenance of pain. After neural trauma the inflammatory enzyme cyclooxygenase-2 (COX-2) increases concurrent with pain onset. Although pre-treatment with the COX-2 inhibitor, meloxicam, before a painful nerve root compression prevents the development of pain, the pathophysiological mechanisms are unknown. This study evaluated if pre-treatment with meloxicam prior to painful root injury prevents pain by reducing spinal inflammation and peripheral oxidative stress...
August 4, 2018: Neuroscience
Anna Badner, Justin Hacker, James Hong, Mirriam Mikhail, Reaz Vawda, Michael G Fehlings
BACKGROUND: The spleen plays an important role in erythrocyte turnover, adaptive immunity, antibody production, and the mobilization of monocytes/macrophages (Mφ) following tissue injury. In response to trauma, the spleen initiates production of inflammatory cytokines, which in turn recruit immune cells to the inflamed tissue, exacerbating damage. Our previous work has shown that intravenous mesenchymal stromal cell (MSC) infusion has potent immunomodulatory effects following spinal cord injury (SCI), associated with the transplanted cells homing to and persisting within the spleen...
August 3, 2018: Journal of Neuroinflammation
Longfei Ma, Hongmei Liu, Guowu Chen, Mingtai Chen, Lina Wang, Xu Zhang, Daiqiang Liu, Chunyang Meng
Neuropathic pain is a severe and chronic neurological disease caused by injury or disease of the somatosensory system. Currently, there are no effective treatments for neuropathic pain. Neuroinflammation, characterized by activation of spinal glial cells and increased production of pro-inflammatory cytokines (for example, IL-1β, TNF-α and IL-6), is a pathophysiological process closely related to neuropathic pain. The anti-inflammatory drug sulfasalazine (SFZ) is approved for inflammatory bowel disease and rheumatoid arthritis...
July 31, 2018: Neuroscience Letters
Steve Casha, Tiffany Rice, David P Stirling, Claudia Silva, Sharmilee Gnanapavan, Gavin Giovannoni, R John Hurlbert, V Wee Yong
Inflammatory changes after spinal cord injury (SCI) have been reported in animal models, but human studies are relatively limited. We examined cerebrospinal fluid (CSF) collected from subjects enrolled in a phase II placebo-controlled trial of minocycline for evidence of inflammatory and structural changes after acute human SCI. CSF was collected from 29 subjects every 6 h for 7 days and investigated for eight molecules. CSF from 6 normal subjects (lumbar microdiscectomy patients without central nervous system pathology) was also examined for comparison...
August 15, 2018: Journal of Neurotrauma
Y-D Fan, M-L Zhu, D Geng, K Zhou, G-J Du, Z-L Wang
OBJECTIVE: We aimed at investigating the pathological mechanism changing of injury during reperfusion injury, reperfusion time correlation and compliance, finding the blood supply and improving the secondary damage. MATERIALS AND METHODS: A total of 180 patients who underwent a surgical procedure and that received normal saline intraperitoneally immediately after the patients' aortic occlusions were investigated. Patients were divided in three groups. Experimental conditions and programs were designed for various approaches...
July 2018: European Review for Medical and Pharmacological Sciences
Angie Rantell, Yutao Lu, Marcio A Averbeck, Jasmin K Badawi, Kevin Rademakers, Tufan Tarcan, Linda Cardozo, Jens C Djurhuus, David Castro-Diaz
AIMS: This article focuses on how, and if, urodynamics can help to identify which kidneys are in danger of deteriorating in function and also gives recommendations for future research. METHODS: At the International Consultation on Incontinence-Research Society (ICI-RS) in 2017, a multi-disciplinary group presented a literature search of what is known about the utility of Urodynamics, including ambulatory, and 24 h monitoring, in predicting upper urinary tract damage in neuro-urological patients and other lower urinary tract dysfunctions...
July 19, 2018: Neurourology and Urodynamics
Jie Qu, Hengli Zhao, Qiang Li, Pengyu Pan, Kang Ma, Xin Liu, Hua Feng, Yujie Chen
Background: Mammalian sterile 20-like kinase 1 (MST1), the key component of the Hippo-YAP pathway, exhibits an important role in the pathophysiological process of various neurological disorders, including ischemic stroke and spinal cord injury. However, during subarachnoid hemorrhage, the involvement of MST1 in the pathophysiology of early brain injury remains unknown. Methods: We employed intravascular filament perforation to establish the subarachnoid hemorrhage (SAH) mouse model...
2018: Behavioural Neurology
Syed A Quadri, Mudassir Farooqui, Asad Ikram, Atif Zafar, Muhammad Adnan Khan, Sajid S Suriya, Chad F Claus, Brian Fiani, Mohammed Rahman, Anirudh Ramachandran, Ian I T Armstrong, Muhammad A Taqi, Martin M Mortazavi
Spinal cord injury (SCI) is a life-shattering neurological condition that affects between 250,000 and 500,000 individuals each year with an estimated two to three million people worldwide living with an SCI-related disability. The incidence in the USA and Canada is more than that in other countries with motor vehicle accidents being the most common cause, while violence being most common in the developing nations. Its incidence is two- to fivefold higher in males, with a peak in younger adults. Apart from the economic burden associated with medical care costs, SCI predominantly affects a younger adult population...
July 11, 2018: Neurosurgical Review
Michael D Staudt, Alexander John Clark, Allan S Gordon, Mary E Lynch, Pat K Morley-Forster, Howard Nathan, Catherine Smyth, Larry W Stitt, Cory Toth, Mark A Ware, Dwight E Moulin
BACKGROUND: Central neuropathic pain syndromes are a result of central nervous system injury, most commonly related to stroke, traumatic spinal cord injury, or multiple sclerosis. These syndromes are distinctly less common than peripheral neuropathic pain, and less is known regarding the underlying pathophysiology, appropriate pharmacotherapy, and long-term outcomes. The objective of this study was to determine the long-term clinical effectiveness of the management of central neuropathic pain relative to peripheral neuropathic pain at tertiary pain centers...
July 12, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Leung-Wah Yick, Oscar Ka-Fai Ma, Roy Chun-Laam Ng, Jason Shing-Cheong Kwan, Koon-Ho Chan
Neuromyelitis optica spectrum disorders (NMOSD) are central nervous system inflammatory disorders causing significant morbidities and mortality. The majority of NMOSD patients have autoimmunity against aquaporin-4 (AQP4), evidenced by seropositivity for autoantibodies against aquaporin-4 (AQP4-IgG). AQP4-IgG is pathogenic with neuroinflammation initiated upon binding of AQP4-IgG to astrocytic AQP4. Complement activation contributes to astrocytic cytotoxicity, neuroinflammation, and tissue necrosis in NMOSD, but the role of complement-independent mechanisms is uncertain...
2018: Frontiers in Immunology
Joseph Piatt
OBJECTIVE Penetrating injury of the spine in childhood commonly causes profound and life-long disability, but it has been the object of very little study. The goal of the current report is to document temporal trends in the nationwide incidence of this condition and to highlight the differences between penetrating injuries and closed injuries. METHODS The Kids' Inpatient Database was queried for spinal injuries in 1997, 2000, 2003, 2006, 2009, and 2012. Penetrating mechanism was determined by diagnostic coding for open injuries and by mechanistic codes for projectiles and knives...
July 6, 2018: Journal of Neurosurgery. Pediatrics
Harun Najib Noristani, Laetitia They, Florence Evelyne Perrin
Spinal cord injuries (SCI) are neuropathologies causing enormous physical and emotional anguish as well as irreversibly disabilities with great socio/economic burdens to our society. The availability of multiple mouse strains is important for studying the underlying pathophysiological response after SCI. Although strain differences have been shown to directly affect spontaneous functional recovery following incomplete SCI, its influence after complete lesion of the spinal cord is unclear. To study the influence of mouse strain on recovery after severe SCI, we first carried out behavioral analyses up to 6 weeks following complete transection of the spinal cord in mice with two different genetic backgrounds namely, C57BL/6 and Swiss Webster...
2018: Frontiers in Cellular Neuroscience
Francesco Roselli, Akila Chandrasekar, Maria C Morganti-Kossmann
This review article provides a general perspective of the experimental and clinical work surrounding the role of type-I, type-II, and type-III interferons (IFNs) in the pathophysiology of brain and spinal cord injury. Since IFNs are themselves well-known therapeutic targets (as well as pharmacological agents), and anti-IFNs monoclonal antibodies are being tested in clinical trials, it is timely to review the basis for the repurposing of these agents for the treatment of brain and spinal cord traumatic injury...
2018: Frontiers in Neurology
Arcangelo Barbonetti, Settimio D'Andrea, Alessio Martorella, Giorgio Felzani, Sandro Francavilla, Felice Francavilla
A lower risk of prostate cancer has been reported in men with spinal cord injury (SCI) as compared to that observed in able-bodied subjects. As injury-related consequences can have opposite effects on prostate pathophysiology, this meta-analysis aimed to (1) establish the existence/quantify the extent of decreased prostate cancer risk following SCI and (2) find out if there is any statistically significant difference in prostate-specific antigen (PSA) levels between SCI and able-bodied subjects. MEDLINE, Cochrane Library, Scopus, CINAHL, and ScienceDirect databases were used...
June 26, 2018: Asian Journal of Andrology
Lennart Riemann, Alexander Younsi, Moritz Scherer, Guoli Zheng, Thomas Skutella, Andreas W Unterberg, Klaus Zweckberger
Inflammation after traumatic spinal cord injury (SCI) is non-resolving and thus still present in chronic injury stages. It plays a key role in the pathophysiology of SCI and has been associated with further neurodegeneration and development of neuropathic pain. Neural precursor cells (NPCs) have been shown to reduce the acute and sub-acute inflammatory response after SCI. In the present study, we examined effects of NPC transplantation on the immune environment in chronic stages of SCI. SCI was induced in rats by clip-compression of the cervical spinal cord at the level C6-C7...
2018: Frontiers in Neurology
A Dinh, F Bouchand, B Davido, C Duran, P Denys, A Lortat-Jacob, M Rottman, J Salomon, L Bernard
OBJECTIVES: Pressure ulcers are frequently observed in spinal cord injury (SCI) patients. They can be life-threatening and are a major medico-economic burden. Despite their frequency, their pathophysiology and optimal management are still poorly understood. Most available data comes from non-comparative studies, especially in terms of antimicrobial use. METHODS: We performed a critical review of the literature and opinions of infectious disease specialists based in a French expert center for this disease...
June 21, 2018: Médecine et Maladies Infectieuses
Tiege Chen, Yuexiu Dang, Ming Wang, Dongliang Zhang, Yongqiang Guo, Haihong Zhang
Spinal edema is a very important pathophysiological basis for secondary spinal cord injury, which affects the repair and prognosis of spinal cord injury. Aquaporin-4 is widely distributed in various organs of the body, and is highly expressed in the brain and spinal cord. Inward rectifying potassium channel 4.1 is a protein found in astrocytes of central nervous system. It interacts with aquaporins in function. Aquaporin-4 and inward rectifying potassium channel 4.1 play an important role in the formation and elimination of spinal cord edema, inhibition of glial scar formation and promotion of excitotoxic agents exclusion...
May 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Harun Najib Noristani, Guillaume Patrick Saint-Martin, Maida Cardoso, Rahima Sidiboulenouar, Mathias Catteau, Christophe Coillot, Christophe Goze-Bac, Florence Evelyne Perrin
Spinal cord injuries (SCI) are disastrous neuropathologies causing permanent disabilities. The availability of different strains of mice is valuable for studying the pathophysiological mechanisms involved in SCI. However, strain differences have a profound effect on spontaneous functional recovery after SCI. CX3CR1+/eGFP and Aldh1l1-EGFP mice that express green fluorescent protein in microglia/monocytes and astrocytes respectively are particularly useful to study glial reactivity. Whereas CX3CR1+/eGFP mice have C57BL/6 background, Aldh1l1-EGFP are in Swiss Webster background...
June 7, 2018: Journal of Neurotrauma
Simon Gelman
The Pathophysiology of Aortic Cross-clamping and Unclamping. By Gelman S. ANESTHESIOLOGY 1995; 82:1026-60. Reprinted with permission.Aortic cross-clamping (AoX) and unclamping are associated with severe hemodynamic disturbances in virtually all organs and systems. The main hemodynamic changes induced by AoX result from an increase in impedance to aortic flow, an increase in systemic vascular resistance and afterload, blood volume redistribution caused by collapse and constriction of venous vasculature distal to the aortic clamp, and a subsequent increase in preload...
August 2018: Anesthesiology
Ashley L de Padua, Kimberly Strickland, Mary Patrick, John F Ditunno
Introduction: Women with spinal cord injury (SCI) and who develop breast cancer are a vulnerable and potentially overlooked population. They experience risk factors owing to decreased mobility and are at risk for unique complications from their oncologic treatment. Case presentation: A 54-year-old woman who suffered a T6 AIS A traumatic SCI in 1981, who was diagnosed 32 years later with estrogen receptor and progesterone receptor positive and human epidermal growth factor receptor 2-negative invasive ductal carcinoma...
2018: Spinal Cord Series and Cases
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