Kentucky Spinal Cord Injury Research Center and Departments of University of Louisville School of Medicine, Louisville, Kentucky, USA.
Neurological Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA.
J Neurotrauma. 2021 Feb;38(3):365-372. doi: 10.1089/neu.2020.7258. Epub 2020 Nov 10.
One of the difficulties in identifying novel therapeutic strategies to manage central nervous system (CNS) trauma is the need for behavioral assays to assess chronic functional recovery. assays and/or acute behavioral assessments cannot accurately predict long-term functional outcome. Using data from 13 independent T9 moderate contusive spinal cord injury (SCI) studies, we asked whether the ratio of acute (24-72 h post-injury) changes in the levels of neuron-, oligodendrocyte-, astrocyte-specific and/or endoplasmic reticulum stress response (ERSR) messenger ribonucleic acids (mRNAs) could predict the extent of chronic functional recovery. Increased levels of neuron, oligodendrocyte, and astrocyte mRNAs all correlated with enhanced Basso Mouse Scale (BMS) scores. Reduced levels of the ERSR mRNAs and correlate with improved chronic locomotor function. Neither neural or ERSR mRNAs were predictive for chronic recovery across all behavioral changes. The ratio of oligodendrocyte/ERSR mRNAs, however, did predict "improved," "no change," or "worse" functional recovery. Neuronal/ERSR mRNA ratios predicted functional improvement, but could not distinguish between worse or no change outcomes. Astrocyte/ERSR mRNA ratios were not predictive. This approach can be used to confirm biological action of injected drugs and to optimize dose and therapeutic window. It may prove useful in cervical and lumbar SCI and in other traumatic CNS injuries such as traumatic brain injury and stroke, where prevention of neuronal loss is paramount to functional recovery. Although the current analysis was directed toward ERSR whose activity was targeted in all but one study, acute mRNA markers for other pathophysiological cascades may be as predictive of chronic recovery when those cascades are targeted for neuroprotection.
确定治疗中枢神经系统 (CNS) 创伤的新策略的困难之一是需要行为测定来评估慢性功能恢复。测定和/或急性行为评估不能准确预测长期功能结果。我们利用来自 13 项独立的 T9 中度挫伤性脊髓损伤 (SCI) 研究的数据,询问急性 (损伤后 24-72 小时) 神经元、少突胶质细胞、星形胶质细胞特异性和/或内质网应激反应 (ERSR) 信使核糖核酸 (mRNA) 水平变化的比值是否可以预测慢性功能恢复的程度。神经元、少突胶质细胞和星形胶质细胞 mRNA 水平的升高均与 Basso Mouse Scale (BMS) 评分的提高相关。ERSR mRNA 水平的降低与慢性运动功能的改善相关。无论是神经还是 ERSR mRNA 均不能预测所有行为变化的慢性恢复。然而,少突胶质细胞/ERSR mRNA 的比值可预测“改善”、“无变化”或“恶化”的功能恢复。神经元/ERSR mRNA 比值可预测功能改善,但不能区分恶化或无变化的结果。星形胶质细胞/ERSR mRNA 比值无预测作用。这种方法可用于确认注射药物的生物学作用,并优化剂量和治疗窗口。它可能对颈段和胸段 SCI 以及其他创伤性 CNS 损伤(如创伤性脑损伤和中风)有用,在这些损伤中,预防神经元丢失对于功能恢复至关重要。尽管目前的分析针对的是除一项研究之外的所有研究均靶向的 ERSR,但当针对神经保护靶向其他病理生理级联反应时,急性 mRNA 标志物可能与慢性恢复一样具有预测作用。