Hand and Microsurgery Center, the second Affiliated Hospital of Harbin Medical University, Harbin, China.
State-Province Key Laboratories of Biomedicine-Pharmaceutics, Harbin Medical University, Harbin, China.
CNS Neurosci Ther. 2017 Aug;23(8):680-685. doi: 10.1111/cns.12713. Epub 2017 Jun 14.
Despite more than a century of research, spinal paralysis remains untreatable via biological means. A new understanding of spinal cord physiology and the introduction of membrane fusogens have provided new hope that a biological cure may soon become available. However, proof is needed from adequately powered animal studies.
Two groups of rats (n=9, study group, n=6 controls) were submitted to complete transection of the dorsal cord at T10. The animals were randomized to receive either saline or polyethylene glycol (PEG) in situ. After 4 weeks, the treated group had recovered ambulation vs none in the control group (BBB scores; P=.0145). One control died. All animals were studied with somatosensory-evoked potentials (SSEP) and diffusion tensor imaging (DTI). SSEP recovered postoperatively only in PEG-treated rats. At study end, DTI showed disappearance of the transection gap in the treated animals vs an enduring gap in controls (fractional anisotropy/FA at level: P=.0008).
We show for the first time in an adequately powered study that the paralysis attendant to a complete transection of the spinal cord can be reversed. This opens the path to a severance-reapposition cure of spinal paralysis, in which the injured segment is excised and the two stumps approximated after vertebrectomy/diskectomies.
尽管经过了一个多世纪的研究,脊髓瘫痪仍然无法通过生物手段治疗。对脊髓生理学的新认识和膜融合剂的引入,为生物治疗可能很快成为现实提供了新的希望。然而,需要通过充分有力的动物研究来证明。
两组大鼠(n=9,研究组,n=6 对照组)接受 T10 处脊髓完全横断。动物随机接受生理盐水或聚乙二醇(PEG)原位治疗。4 周后,治疗组与对照组相比(BBB 评分;P=.0145)恢复了步行能力。对照组有 1 只动物死亡。所有动物均进行体感诱发电位(SSEP)和弥散张量成像(DTI)研究。只有接受 PEG 治疗的大鼠术后 SSEP 恢复。研究结束时,DTI 显示治疗组的横断间隙消失,而对照组的间隙持续存在(治疗组与对照组在水平的各向异性分数/FA:P=.0008)。
我们首次在一项充分有力的研究中表明,完全横断脊髓引起的瘫痪是可以逆转的。这为脊髓瘫痪的切断-再连接治疗开辟了道路,在这种治疗中,受伤的节段被切除,椎板切除术/椎间盘切除术切除后,两断端重新连接。