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破伤风神经毒素在脊髓损伤中的治疗效果:4 例犬的病例系列研究。

Therapeutic effects of Tetanus neurotoxin in spinal cord injury: a case series on four dogs.

机构信息

Neurological Department, Medical Park Berlin Humboldtmühle, Berlin, Germany.

Department of Clinical Neurophysiology, University Medical Centre, Göttingen, Germany.

出版信息

Spinal Cord Ser Cases. 2020 Feb 17;6(1):9. doi: 10.1038/s41394-020-0258-9.

Abstract

STUDY DESIGN

Case series on four dogs.

OBJECTIVES

To determine the alleviation of motor symptoms in spinal cord injury (SCI) by tetanus neurotoxin (TeNT).

SETTING

Different Berlin veterinary clinics, Germany.

METHODS

We report on the effect of intramuscular injections of low-dose TeNT into paretic hind limb muscles 2-157 weeks after SCI due to lumbar disc herniation in a clinical case series on four dogs. All dogs underwent unsuccessful or incomplete surgical decompression prior to TeNT treatment. TeNT was injected on a compassionate basis. Stance, gait ability and the diameter of the rectus femoris muscle were assessed as parameters.

RESULTS

All four dogs improved their stance and three of these dogs improved in gait at 4 and 6 weeks after TeNT injections without evidence of side effects or spreading of TeNT effects. At the same time, the size of the rectus femoris muscle diameter increased considerably as compared with baseline (baseline: 100%; 4 weeks: 148.7% ± 10.9%; 6 weeks: 137.1% ± 7.9%).

CONCLUSIONS

Facilitation of α-motor neurons by TeNT injections into paretic hind limb muscles of four dogs improved standing and/or gait abilities and partly reversed muscle atrophy after SCI. The absence of generalized or painful muscle spasms supports the safety of low-dose TeNT. Therefore, TeNT might evolve as a promising therapeutic option for muscle paresis of central origin, e.g. in individuals with SCI, stroke or multiple sclerosis.

摘要

研究设计

4 只狗的病例系列。

目的

确定破伤风神经毒素 (TeNT) 对脊髓损伤 (SCI) 运动症状的缓解作用。

地点

德国不同的柏林兽医诊所。

方法

我们报告了在因腰椎间盘突出症导致 SCI 后 2-157 周,通过肌肉内注射低剂量 TeNT 到瘫痪的后肢肌肉,对 4 只狗的临床病例系列的影响。所有狗在接受 TeNT 治疗之前都经历了不成功或不完全的手术减压。TeNT 是基于同情原则进行注射的。姿势、步态能力和股直肌直径被评估为参数。

结果

所有 4 只狗的姿势都得到了改善,其中 3 只狗在 TeNT 注射后 4 周和 6 周时步态得到了改善,没有出现副作用或 TeNT 作用扩散的证据。与此同时,股直肌直径的大小与基线相比显著增加(基线:100%;4 周:148.7%±10.9%;6 周:137.1%±7.9%)。

结论

TeNT 注射到瘫痪的后肢肌肉中,促进了α运动神经元,改善了站立和/或步态能力,并部分逆转了 SCI 后的肌肉萎缩。没有出现全身性或疼痛性肌肉痉挛,支持低剂量 TeNT 的安全性。因此,TeNT 可能成为治疗中枢性肌肉瘫痪的有前途的治疗选择,例如在 SCI、中风或多发性硬化症患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcc9/7026047/075d0aca455d/41394_2020_258_Fig1_HTML.jpg

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