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神经修复辅助治疗完全性脊髓损伤的神经功能恢复:病例报告。

Facilitation of neurological recovery in a complete spinal cord injury with NeuroAiD: case report.

机构信息

Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Teknologi MARA, 47000, Sungai Buloh, Selangor, Malaysia.

Department of Rehabilitation Medicine, Queen Elizabeth Hospital, 88200, Kota Kinabalu, Sabah, Malaysia.

出版信息

Spinal Cord Ser Cases. 2024 Apr 3;10(1):16. doi: 10.1038/s41394-024-00632-7.

Abstract

INTRODUCTION

NeuroAiD (MLC601 & MLC901)'s neuroprotective capabilities include limiting exaggerated calcium influx, decreasing excitotoxicity, reducing oxidative stress, and preventing glutamate-induced cell death. It has also been shown to facilitate synaptogenesis, neurogenesis, and neuroplasticity. However, its clinical efficacy has primarily been studied in the context of brain injuries, particularly stroke. NeuroAiD's potential application in SCI remains largely untapped.

CASE PRESENTATION

A 34-year-old male presented with C4 complete tetraplegia. Following surgical decompression and initial inpatient rehabilitation, he started consuming MLC901 two capsules three times daily at month 4 post injury for 6 months. He regained considerable neurological recovery following the supplementation. Apart from the improvement in the neurological level of injury, the patient exhibited motor recovery beyond the initial zone of partial preservation up to 24 months post injury.

DISCUSSION

Our findings align with a recent animal study demonstrating MLC901's potential to downregulate Vascular Endothelial Growth Factor (VEGF), a molecule known to increase vascular permeability and exacerbate tissue edema and infarction. In another animal study involving stroke-affected mice, MLC901 demonstrates the ability to promote neurological recovery by regulating the expression of proteins mediating angiogenesis, such as hypoxic inducible factor 1α, erythropoietin, angiopoietins 1 and 2, as well as VEGF. The anecdotal findings from this case report offer preliminary insights into NeuroAiD's potential in facilitating recovery during post-acute and chronic phases of severe SCI, necessitating further exploration.

摘要

简介

NeuroAiD(MLC601 和 MLC901)具有神经保护作用,包括限制过度的钙离子内流、减少兴奋性毒性、降低氧化应激和防止谷氨酸诱导的细胞死亡。它还可以促进突触发生、神经发生和神经可塑性。然而,其临床疗效主要在脑损伤,特别是中风的背景下进行了研究。NeuroAiD 在 SCI 中的潜在应用在很大程度上尚未得到开发。

病例介绍

一名 34 岁男性,表现为 C4 完全性四肢瘫痪。在接受手术减压和初始住院康复后,他在受伤后第 4 个月开始每天服用 MLC901 胶囊 3 次,每次 2 粒,持续 6 个月。在补充后,他恢复了相当大的神经功能。除了损伤神经水平的改善外,患者在受伤后 24 个月表现出了运动功能的恢复,超出了最初的部分保留区。

讨论

我们的发现与最近一项动物研究一致,该研究表明 MLC901 具有下调血管内皮生长因子(VEGF)的潜力,VEGF 是一种已知增加血管通透性并加重组织水肿和梗死的分子。在另一项涉及中风影响的小鼠的动物研究中,MLC901 通过调节介导血管生成的蛋白质的表达来促进神经恢复,如缺氧诱导因子 1α、促红细胞生成素、血管生成素 1 和 2 以及 VEGF。这个病例报告的偶然发现为 NeuroAiD 在促进严重 SCI 的急性后期和慢性期恢复方面的潜力提供了初步的见解,需要进一步探索。

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