Yacoub Adly, Hajec Marygrace C, Stanger Richard, Wan Wen, Young Harold, Mathern Bruce E
1 Department of Neurosurgery, Virginia Commonwealth University , Richmond, Virginia.
J Neurotrauma. 2014 Feb 1;31(3):256-67. doi: 10.1089/neu.2013.3037. Epub 2013 Nov 21.
Spinal cord injury (SCI) often results in irreversible and permanent neurological deficits and long-term disability. Vasospasm, hemorrhage, and loss of microvessels create an ischemic environment at the site of contusive or compressive SCI and initiate the secondary injury cascades leading to progressive tissue damage and severely decreased functional outcome. Although the initial mechanical destructive events cannot be reversed, secondary injury damage occurs over several hours to weeks, a time frame during which therapeutic intervention could be achieved. One essential component of secondary injury cascade is the reduction in spinal cord blood flow with resultant decrease in oxygen delivery. Our group has recently shown that administration of fluorocarbon (Oxycyte) significantly increased parenchymal tissue oxygen levels during the usual postinjury hypoxic phase, and fluorocarbon has been shown to be effective in stroke and head injury. In the current study, we assessed the beneficial effects of Oxycyte after a moderate-to-severe contusion SCI was simulated in adult Long-Evans hooded rats. Histopathology and immunohistochemical analysis showed that the administration of 5 mL/kg of Oxycyte perfluorocarbon (60% emulsion) after SCI dramatically reduced destruction of spinal cord anatomy and resulted in a marked decrease of lesion area, less cell death, and greater white matter sparing at 7 and 42 days postinjury. Terminal deoxynucleotidyl transferase dUTP nick end labeling staining showed a significant reduced number of apoptotic cells in Oxycyte-treated animals, compared to the saline group. Collectively, these results demonstrate the potential neuroprotective effect of Oxycyte treatment after SCI, and its beneficial effects may be, in part, a result of reducing apoptotic cell death and tissue sparing. Further studies to determine the most efficacious Oxycyte dose and its mechanisms of protection are warranted.
脊髓损伤(SCI)常导致不可逆的永久性神经功能缺损和长期残疾。血管痉挛、出血以及微血管丧失在挫伤性或压迫性脊髓损伤部位形成缺血环境,并引发继发性损伤级联反应,导致组织进行性损伤和功能结局严重下降。尽管初始的机械性破坏事件无法逆转,但继发性损伤在数小时至数周内发生,在此时间段内可以进行治疗干预。继发性损伤级联反应的一个重要组成部分是脊髓血流量减少,导致氧输送量下降。我们的研究小组最近发现,给予氟碳化合物(Oxycyte)可在伤后通常的缺氧阶段显著提高实质组织氧水平,并且氟碳化合物已被证明在中风和头部损伤中有效。在本研究中,我们评估了在成年Long-Evans有帽大鼠中模拟中度至重度挫伤性脊髓损伤后Oxycyte的有益作用。组织病理学和免疫组化分析表明,脊髓损伤后给予5 mL/kg的Oxycyte全氟碳化合物(60%乳剂)可显著减少脊髓解剖结构的破坏,并导致损伤面积明显减小、细胞死亡减少以及在伤后7天和42天白质保留更多。末端脱氧核苷酸转移酶dUTP缺口末端标记染色显示,与生理盐水组相比,Oxycyte治疗组动物的凋亡细胞数量显著减少。总体而言,这些结果证明了脊髓损伤后Oxycyte治疗具有潜在的神经保护作用,其有益效果可能部分是减少凋亡细胞死亡和组织保留的结果。有必要进一步研究以确定最有效的Oxycyte剂量及其保护机制。