Wang Li, Li Sen, Liu Yuan, Feng Dong-Liang, Jiang Long, Long Zai-Yun, Wu Ya-Min
State Key Laboratory of Trauma, Burns and Combined Injury, 3rd Department of Research Institute of Surgery, Daping Hospital, Third Military Medical UniversityChongqing 400042, China.
Am J Transl Res. 2017 Jul 15;9(7):3411-3421. eCollection 2017.
Spinal cord ischemia and reperfusion (SCIR) injury is the major cause of a wide range of complications, including neural degeneration and devastating paraplegia. Decrease of inhibitory neurotransmitters and increase of excitory neurotransmitters are the major cause for the excitotoxicity of neurons. However, no study has reported the temporal loss of motor neuron in the ventral horn of spinal cord area following SCIR-induced spastic paralysis, not even the mechanism under it. In the present study, we found that the rabbits were mainly spastic paralyzed after spinal cord ischemia-reperfusion injury. And the ischemia 60 min group is the optimal treating condition, because of the higher rate of spastic paralysis and lower mortality. Motor neurons in the ventral horn of spinal cord were significant degeneration at 3 h following spastic paralysis and only 12.5% motor neurons were observed at 72 h post-operation, compared with control group. ELISA results indicated that Glycine and GABA were both downregulated following spastic paralysis. But Glycine immediately decreased at 10 min post-operation and lasted for the whole process (at least 72 h). Meanwhile GABA only significantly decreased at 72 h. Furthermore, Glutamic expression was significant upregulation at 3 hours post-operation, and the upregulation back to the base level at 72 h post-operation. Glutamic receptor-(NR1) and Glycine α1 receptor upregulated accordingly, whereas GABBR2 didn't upregulate significantly until at 72 h post-operation. Abundant extracellular Ca influxed into cytoplasm in neurons following spastic paralysis. The type of paraplegia is mainly spastic paraplegia after SCIR (ischemia 60 min treatment). Following spastic paraplegia, motor neuron in the ventral horn of spinal cord area was significant degeneration at early stage and last for the whole process. It may contribute to the decrease of Glycine at early stage and followed exitotoxicity, which caused intracellular calcium overload to make neurons dead. It would lay the foundation for better understanding the motor neuron degeneration and mechanism following spastic paralysis. And it would supply a novel and effective target for spastic paralysis prevention and therapy.
脊髓缺血再灌注(SCIR)损伤是包括神经变性和严重截瘫在内的多种并发症的主要原因。抑制性神经递质减少和兴奋性神经递质增加是神经元兴奋性毒性的主要原因。然而,尚无研究报道脊髓缺血再灌注诱导的痉挛性瘫痪后脊髓腹角运动神经元的时间性丧失,甚至其机制也未见报道。在本研究中,我们发现兔在脊髓缺血再灌注损伤后主要表现为痉挛性瘫痪。缺血60分钟组是最佳治疗条件,因为痉挛性瘫痪发生率较高且死亡率较低。与对照组相比,痉挛性瘫痪后3小时脊髓腹角运动神经元明显变性,术后72小时仅观察到12.5%的运动神经元。ELISA结果表明,痉挛性瘫痪后甘氨酸和GABA均下调。但甘氨酸在术后10分钟立即下降,并持续整个过程(至少72小时)。同时,GABA仅在72小时时显著下降。此外,谷氨酸表达在术后3小时显著上调,术后72小时上调回到基线水平。谷氨酸受体(NR1)和甘氨酸α1受体相应上调,而GABBR2直到术后72小时才显著上调。痉挛性瘫痪后大量细胞外钙流入神经元细胞质。截瘫类型主要为脊髓缺血再灌注(缺血60分钟治疗)后的痉挛性截瘫。痉挛性截瘫后,脊髓腹角运动神经元在早期明显变性并持续整个过程。这可能导致早期甘氨酸减少并随后出现兴奋性毒性,导致细胞内钙超载使神经元死亡。这将为更好地理解痉挛性瘫痪后运动神经元变性及其机制奠定基础。并为痉挛性瘫痪的预防和治疗提供新的有效靶点。