Ditor David S, Bao Feng, Chen Yuhua, Dekaban Gregory A, Weaver Lynne C
Spinal Cord Injury Team, BioTherapeutics Research Group, Robarts Research Institute, London, Ontario, Canada.
J Neurosurg Spine. 2006 Oct;5(4):343-52. doi: 10.3171/spi.2006.5.4.343.
The purpose of this study was to investigate the therapeutic time window for antiinflammatory treatment within the first 24 hours of spinal cord injury (SCI). The authors have shown that an anti-CD11d antibody treatment attenuates leukocyte infiltration and improves neurological function when administered beginning 2 hours after SCI. A more clinically relevant time for the initiation of treatment after SCI, however, is 6 or more hours postinjury.
In Study 1, the T-4 vertebrae in four groups of rats were injured by a 50-g clip-induced compression method, and the anti-CD11d antibody (1 mg/kg) was intravenously administered starting 2, 6, 12, or 24 hours postinjury. All groups received subsequent doses at 24 and 48 hours, and animals were killed at 72 hours. The anti-CD11d antibody treatment starting at 6 hours postinjury caused significant attenuation of leukocyte infiltration, reactive oxygen species-associated enzymes, and secondary tissue damage. Based on these findings, Study 2 included two groups of rats receiving the aforementioned injury and treatment beginning at 6 hours postinjury (with subsequent treatments at 24 and 48 hours) with the anti-CD11d or a control antibody (1B7); these rats were then observed for 5 weeks. Basso-Beattie-Bresnahan (BBB) scores were significantly higher in anti-CD11d-treated rats (mean BBB score 8.9 +/- 0.1) than controls (mean BBB score 7.7 +/- 0.1) 5 weeks postinjury. Increases in mean arterial pressure during colon distension were smaller in anti-CD11d-treated rats (19.5 +/- 3.7 mm Hg) than in controls (37.4 +/- 4.7 mm Hg).
These findings suggest that antiinflammatory treatments that reduce secondary tissue damage after SCI may be delayed until 6 hours postinjury and still be effective.
本研究旨在探讨脊髓损伤(SCI)后24小时内抗炎治疗的治疗时间窗。作者已表明,抗CD11d抗体治疗在SCI后2小时开始给药时可减轻白细胞浸润并改善神经功能。然而,SCI后开始治疗的更具临床相关性的时间是损伤后6小时或更长时间。
在研究1中,通过50 g夹压诱导的压迫方法损伤四组大鼠的T-4椎骨,并在损伤后2、6、12或24小时开始静脉注射抗CD11d抗体(1 mg/kg)。所有组在24和48小时接受后续剂量,动物在72小时处死。损伤后6小时开始的抗CD11d抗体治疗可显著减轻白细胞浸润、活性氧相关酶和继发性组织损伤。基于这些发现,研究2包括两组大鼠,在损伤后6小时接受上述损伤和治疗(随后在24和48小时进行治疗),使用抗CD11d或对照抗体(1B7);然后对这些大鼠进行5周观察。损伤后5周,抗CD11d治疗的大鼠(平均BBB评分8.9±0.1)的Basso-Beattie-Bresnahan(BBB)评分显著高于对照组(平均BBB评分7.7±0.1)。抗CD11d治疗的大鼠在结肠扩张期间平均动脉压的升高(19.5±3.7 mmHg)小于对照组(37.4±4.7 mmHg)。
这些发现表明,减轻SCI后继发性组织损伤的抗炎治疗可能延迟至损伤后6小时,且仍然有效。