Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Spine (Phila Pa 1976). 2012 Dec 1;37(25):E1551-9. doi: 10.1097/BRS.0b013e31826ff7f1.
An experimental comparative study on moderate epidural hypothermia (MEH) versus moderate systemic hypothermia (MSH) after spinal cord injury (SCI).
To compare neuroprotective effects of hypothermia between MEH and MSH after SCI in rats.
Experimental MEH or MSH has been attempted for neuroprotection after ischemic or traumatic SCI. However, there is no comparative study on neuroprotective effect of MEH and MSH after SCI. If hypothermia is to be considered as 1 modality for treating SCI, further studies on the advantages and disadvantages of hypothermia will be mandatory.
A spinal cord contusion was produced in all 32 rats, and these rats were randomly divided into 4 groups-8 rats in each group: (1) the control group (spinal cord contusion only), (2) the methylprednisolone group, (3) the MEH group (28°C for 48 hr), and (4) the MSH group (32°C for 48 hr). The functional recovery was assessed using Basso, Beattie, Bresnahan scale and antiapoptotic and anti-inflammatory effects were assessed.
The Basso, Beattie, Bresnahan scale scores in both the hypothermia groups were significantly higher than that in the control group at 6 weeks. The numbers of terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells and OX-42 positive cells were significantly lower in both the MEH and MSH groups than that in the control group. The p38 mitogen-activated protein kinases expression of the treated groups was significantly lower than that of the control group. The expression of caspase-8 and caspase-9 significantly decreased in the treated groups compared with that of the control group. However, in terms of caspase-3, only the MSH group has shown to be significantly lower than that of the control group.
This study presented that both systemic and epidural hypothermia demonstrated neuroprotective effects after SCI. Systemic hypothermia showed more neuroprotective effect by antiapoptotic and anti-inflammatory effects.
一项关于脊髓损伤后中度硬膜外低温（MEH）与中度全身低温（MSH）的实验性对比研究。
比较大鼠脊髓损伤后 MEH 与 MSH 低温的神经保护作用。
在缺血性或创伤性 SCI 后，已经尝试过实验性 MEH 或 MSH 以实现神经保护。然而，目前尚无关于 SCI 后 MEH 和 MSH 神经保护效果的对比研究。如果低温被认为是治疗 SCI 的一种方式，那么必须进一步研究低温的优缺点。
所有 32 只大鼠均进行脊髓挫伤，然后将这些大鼠随机分为 4 组，每组 8 只：（1）对照组（仅脊髓挫伤）、（2）甲泼尼龙组、（3）MEH 组（28°C 48 小时）和（4）MSH 组（32°C 48 小时）。采用 Basso、Beattie、Bresnahan 量表评估功能恢复情况，并评估抗凋亡和抗炎作用。
在 6 周时，低温组的 Basso、Beattie、Bresnahan 量表评分均明显高于对照组。在 MEH 和 MSH 组中，末端脱氧核苷酸转移酶 dUTP 缺口末端标记阳性细胞和 OX-42 阳性细胞的数量均明显低于对照组。治疗组的 p38 丝裂原活化蛋白激酶表达明显低于对照组。与对照组相比，caspase-8 和 caspase-9 的表达在治疗组中显著降低。然而，在 caspase-3 方面，只有 MSH 组的表达明显低于对照组。
本研究表明，全身和硬膜外低温在脊髓损伤后均具有神经保护作用。全身低温通过抗凋亡和抗炎作用显示出更强的神经保护作用。
