Nowacka Agnieszka, Śniegocki Maciej, Ziółkowska Ewa
Department of Neurosurgery, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, ul. Curie Skłodowskiej 9, 85-094 Bydgoszcz, Poland.
Department of Pediatrics, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA.
Antioxidants (Basel). 2025 Sep 3;14(9):1081. doi: 10.3390/antiox14091081.
Spinal cord injury (SCI) is a debilitating neurological condition marked by primary mechanical damage followed by a complex secondary injury cascade, in which oxidative stress plays a central role. Mitochondrial dysfunction, ionic imbalance, and inflammatory responses drive excessive generation of reactive oxygen and nitrogen species, leading to lipid peroxidation, protein and DNA damage, apoptosis, and progressive neurological impairment. Antioxidant-based therapies have emerged as promising neuroprotective strategies, with compounds such as A91 peptide, curcumin, edaravone, ginsenosides, and glutathione demonstrating preclinical efficacy in reducing oxidative damage, restoring redox balance, modulating signaling pathways (e.g., Nrf2, NF-κB, MAPK, PI3K/Akt), and enhancing neuronal survival. While therapeutic outcomes depend on injury severity, timing, and combinatorial approaches, translating these findings into clinical practice and integrating antioxidants with cell-based therapies, biomaterials, and rehabilitation offers a critical avenue for improving functional recovery in SCI.
脊髓损伤（SCI）是一种使人衰弱的神经疾病，其特征是原发性机械损伤，随后是复杂的继发性损伤级联反应，其中氧化应激起着核心作用。线粒体功能障碍、离子失衡和炎症反应促使活性氧和氮物种过度生成，导致脂质过氧化、蛋白质和DNA损伤、细胞凋亡以及进行性神经功能损害。基于抗氧化剂的疗法已成为有前景的神经保护策略，诸如A91肽、姜黄素、依达拉奉、人参皂苷和谷胱甘肽等化合物在减少氧化损伤、恢复氧化还原平衡、调节信号通路（如Nrf2、NF-κB、MAPK、PI3K/Akt）以及提高神经元存活率方面已显示出临床前疗效。虽然治疗结果取决于损伤严重程度、时机和联合治疗方法，但将这些研究结果转化为临床实践，并将抗氧化剂与基于细胞的疗法、生物材料和康复相结合，为改善脊髓损伤后的功能恢复提供了一条关键途径。
