scholarly journals Level-Specific Differences in Systemic Expression of Pro- and Anti-Inflammatory Cytokines and Chemokines after Spinal Cord Injury

2018 ◽  
Vol 19 (8) ◽  
pp. 2167 ◽  
Author(s):  
James Hong ◽  
Alex Chang ◽  
Mohammad-Masoud Zavvarian ◽  
Jian Wang ◽  
Yang Liu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Vascular Supply ◽  
Thoracic Injury ◽  
Cervical Region ◽  
Cytokines And Chemokines ◽  
Markers Of Inflammation ◽  
Cord Injury ◽  
Anti Inflammatory ◽  
Splenic Atrophy

While over half of all spinal cord injuries (SCIs) occur in the cervical region, the majority of preclinical studies have focused on models of thoracic injury. However, these two levels are anatomically distinct—with the cervical region possessing a greater vascular supply, grey-white matter ratio and sympathetic outflow relative to the thoracic region. As such, there exists a significant knowledge gap in the secondary pathology at these levels following SCI. In this study, we characterized the systemic plasma markers of inflammation over time (1, 3, 7, 14, 56 days post-SCI) after moderate-severe, clip-compression cervical and thoracic SCI in a rat model. Using high-throughput ELISA panels, we observed a clear level-specific difference in plasma levels of VEGF, leptin, IP10, IL18, GCSF, and fractalkine. Overall, cervical SCI had reduced expression of both pro- and anti-inflammatory proteins relative to thoracic SCI, likely due to sympathetic dysregulation associated with higher level SCIs. However, contrary to the literature, we did not observe level-dependent splenic atrophy with our incomplete SCI model. This is the first study to compare the systemic plasma-level changes following cervical and thoracic SCI using level-matched and time-matched controls. The results of this study provide the first evidence in support of level-targeted intervention and also challenge the phenomenon of high SCI-induced splenic atrophy in incomplete SCI models.

scholarly journals Level-specific differences in systemic expression of pro- and anti-inflammatory cytokines and chemokines after spinal cord injury

2018 ◽  
Author(s):  
James Hong ◽  
Alex Chang ◽  
Mohammad Zavvarian ◽  
Jian Wang ◽  
Yang Liu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Vascular Supply ◽  
Thoracic Injury ◽  
Cervical Region ◽  
Cytokines And Chemokines ◽  
Markers Of Inflammation ◽  
Cord Injury ◽  
Anti Inflammatory ◽  
Splenic Atrophy

While over half of all spinal cord injuries (SCIs) occur in the cervical region, the majority of preclinical studies have focused on models of thoracic injury. However, these two levels are anatomically distinct—with the cervical region possessing a greater vascular supply, grey-white matter ratio and sympathetic outflow relative to the thoracic region. As such, there exists a significant knowledge gap in the secondary pathology at these levels following SCI. In this study, we characterized the systemic plasma markers of inflammation over time (1, 3, 7, 14, 56 days post-SCI) after moderate-severe, clip-compression cervical and thoracic SCI in the rat. Using high-throughput ELISA panels, we observed a clear level-specific difference in plasma levels of VEGF, leptin, IP10, IL18, GCSF, and fractalkine. Overall, cervical SCI had reduced expressions of both pro- and anti-inflammatory proteins relative to thoracic SCI, likely due to sympathetic dysregulation associated with higher level SCIs. However, contrary to the literature, we did not observe level-dependent splenic atrophy with our incomplete SCI model. This is the first study to compare the systemic plasma-level changes following cervical and thoracic SCI using level-matched and time-matched controls. The results of this study provide the first evidence in support of level-targeted intervention and also challenge the phenomenon of high SCI-induced splenic atrophy in incomplete SCI models.

scholarly journals Arrow-Shot Injury to Pediatric Spinal Cord

2021 ◽  
Author(s):  
Vijayveer Singh ◽  
Sharad Thanvi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Pediatric Population ◽  
Cervical Region ◽  
Cervical Cord ◽  
Cord Injury ◽  
Dural Suturing ◽  
Stab Injuries ◽  
Early Surgical Intervention

AbstractPenetrating spinal cord injuries (PSCI) in cervical region are extremely rare in pediatric population. Most injuries in pediatric population are accidental due to gunshot or a stab injury with a sharp or pointed object. Gun shots may result into a severe wound which is usually fatal and may result in death, quadriplegia, or serious long-term disability. Stab injuries are less severe and may result in neurological sequalae. In this paper, an unusual case of pediatric arrow shot partial cervical cord injury is reported which was managed by aggressive neurosurgical management. The arrow lodged in the cervical cord was very near to the vertebral artery leading to parapariesis which recovered well without any complications. Diagnostic imaging at admission included radiographs, computed tomography (CT), and CT angiography of the cervical region. The patient underwent early surgical intervention with removal of foreign body from the cord and subsequent dural suturing.

scholarly journals Nonsteroidal Anti-Inflammatory Drugs and Their Neuroprotective Role After an Acute Spinal Cord Injury: A Systematic Review of Animal Models

2020 ◽  
pp. 219256822090168
Author(s):  
Mark J. Lambrechts ◽  
James L. Cook
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Animal Models ◽  
Motor Function ◽  
Spinal Cord Injuries ◽  
Inclusion Criteria ◽  
Improve Motor Function ◽  
Cord Injury ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Study Design: Systematic review. Objective: Spinal cord injuries (SCIs) resulting in motor deficits can be devastating injuries resulting in millions of health care dollars spent per incident. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a potential class of drugs that could improve motor function after an SCI. This systematic review utilizes PRISMA guidelines to evaluate the effectiveness of NSAIDs for SCI. Methods: PubMed/MEDLINE, CINAHL, PsycINFO, Embase, and Scopus were reviewed linking the keywords of “ibuprofen,” “meloxicam,” “naproxen,” “ketorolac,” “indomethacin,” “celecoxib,” “ATB-346,” “NSAID,” and “nonsteroidal anti-inflammatory drug” with “spinal.” Results were reviewed for relevance and included if they met inclusion criteria. The SYRCLE checklist was used to assess sources of bias. Results: A total of 2960 studies were identified in the PubMed/MEDLINE database using the above-mentioned search criteria. A total of 461 abstracts were reviewed in Scopus, 340 in CINAHL, 179 in PsycINFO, and 7632 in Embase. A total of 15 articles met the inclusion criteria. Conclusions: NSAIDs’ effectiveness after SCI is largely determined by its ability to inhibit Rho-A. NSAIDs are a promising therapeutic option in acute SCI patients because they appear to decrease cord edema and inflammation, increase axonal sprouting, and improve motor function with minimal side effects. Studies are limited by heterogeneity, small sample size, and the use of animal models, which might not replicate the therapeutic effects in humans. There are no published human studies evaluating the safety and efficacy of these drugs after a traumatic cord injury. There is a need for well-designed prospective studies evaluating ibuprofen or indomethacin after adult spinal cord injuries.

scholarly journals Barriers and facilitators to adhering to an anti-inflammatory diet for individuals with spinal cord injuries

2018 ◽  
Vol 5 (2) ◽  
pp. 205510291879873 ◽  
Author(s):  
K Alysse Bailey ◽  
Katie Lenz ◽  
David J Allison ◽  
David S Ditor
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Health Benefits ◽  
Barriers And Facilitators ◽  
Social Events ◽  
Cord Injury ◽  
Diet Study ◽  
Anti Inflammatory ◽  
Support Autonomy ◽  
Age Range

The purpose of this study was to explore the barriers and facilitators of an anti-inflammatory diet in people with spinal cord injury. Six participants (age range of 23–68 years, three women and three men) who had previously completed an anti-inflammatory diet study were interviewed. Facilitators identified were family support, autonomy over meal choice, peer support, health benefits gained, and implementation of adherence strategies. The main barriers discussed were lack of motivation after study period ended, social events, diet expenses, and lack of knowledge about the diet. Several health benefits including reductions in pain, edema, and improvements in cognition and mobility were reported.

scholarly journals Spinal Cord Injuries in Dogs Part I: A Review of Basic Knowledge

2018 ◽  
Vol 62 (2) ◽  
pp. 35-44
Author(s):  
I. Šulla ◽  
V. Balik ◽  
S. Horňák ◽  
V. Ledecký
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Apoptotic Cell ◽  
Cauda Equina ◽  
Basic Knowledge ◽  
Cervical Region ◽  
Motor Deficit ◽  
High Morbidity ◽  
Science Literature ◽  
Cord Injury

Abstract Spinal cord injuries (SCI) in dogs are not frequent, but they are serious pathological conditions accompanied with high morbidity and mortality. The pathophysiology of SCI involves a primary insult, disrupting axons, blood vessels, and cell membranes by mechanical force, or causes tissue necrosis by ischemia and reperfusion. The primary injury is followed by a cascade of secondary events, involving vascular dysfunction, edema formation, continuing ischemia, excitotoxicity, electrolyte shifts, free radical production, inflammation, and delayed apoptotic cell death. The most frequent cause of SCI in dogs is an acute intervertebral disc extrusion, exogenous trauma or ischemia. Neurological symptomatology depends on the location, size and the type of spinal cord lesions. It is characterized by transient or permanent, incomplete or complete loss of motor, sensory, autonomic, and reflex functions caudal to the site of the lesion. In a case of partial spinal cord (SC) damage, one of the typical syndromes develops (e. g. Brown-Séquard syndrome, central SC syndrome, ventral SC syndrome, dorsal SC syndrome, conus medullaris syndrome, or traumatic cauda equina syndrome). The severe transversal spinal cord lesion in the cervical region causes paresis or plegia of all four extremities (tetraparesis, tetraplegia); in thoracic or lumbosacral region, paresis or plegia of the pelvic extremities (paraparesis, paraplegia), i. e. sensory-motor deficit, urinary and foecal incontinence and sexual incompetence. The central nervous system in mammals does not regenerate, so the neurological deficit in dogs following severe SCI persists for the rest of their lives and animals display an image of permanent suffering. The research strategy presented here involved a PubMed, Medline (Ovid) and ISI Web of Science literature search from Januray 2001 to December 2017 using the term “canine spinal cord injury” in the English language; also references from selected papers were scanned and relevant articles included.

scholarly journals Wild Bitter Melon Exerts Anti-Inflammatory Effects by Upregulating Injury-Attenuated CISD2 Expression following Spinal Cord Injury

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Woon-Man Kung ◽  
Chai-Ching Lin ◽  
Chan-Yen Kuo ◽  
Yu-Ching Juin ◽  
Po-Ching Wu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Signaling Pathway ◽  
Spinal Cord Injuries ◽  
Inflammatory Responses ◽  
Peroxisome Proliferator ◽  
Neural Cells ◽  
Bitter Melon ◽  
Cord Injury ◽  
Anti Inflammatory

Background. Spinal cord injuries (SCIs) induce secondary neuroinflammation through astrocyte reactivation, which adversely affects neuronal survival and eventually causes long-term disability. CDGSH iron sulfur domain 2 (CISD2), which has been reported to be involved in mediating the anti-inflammatory responses, can serve as a target in SCI therapy. Wild bitter melon (WBM; Momordica charantia Linn. var. abbreviata Ser.) contains an anti-inflammatory agent called alpha-eleostearic acid (α-ESA), a peroxisome proliferator-activated receptor-β (PPAR-β) ligand. Activated PPAR-β inhibits the nuclear factor κB (NF-κB) signaling pathway via the inhibition of IκB (inhibitor of NF-κB) degradation. The role of astrocyte deactivation and CISD2 in anti-inflammatory mechanisms of WBM in acute SCIs is unknown. Materials and Methods. A mouse model of SCI was generated via spinal cord hemisection. The SCI mice were administered WBM intraperitoneally (500 mg/kg bodyweight). Lipopolysaccharide- (LPS-) stimulated ALT cells (astrocytes) were used as an in vitro model for studying astrocyte-mediated inflammation post-SCI. The roles of CISD2 and PPAR-β in inflammatory signaling were examined using LPS-stimulated SH-SY5Y cells transfected with si-CISD2 or scramble RNA. Results. WBM mitigated the SCI-induced downregulation of CISD2, PPAR-β, and IκB and upregulation of glial fibrillary acidic protein (GFAP; marker of astrocyte reactivation) in the spinal cord of SCI mice. Additionally, WBM (1 μg/mL) mitigated LPS-induced CISD2 downregulation. Furthermore, SH-SY5Y neural cells with CISD2 knockdown exhibited decreased PPAR-β expression and augmented NF-κB signaling. Conclusion. To the best of our knowledge, this is the first study to report that CISD2 is an upstream modulator of the PPAR-β/NF-κB proinflammatory signaling pathway in neural cells, and that WBM can mitigate the injury-induced downregulation of CISD2 in SCI mice and LPS-stimulated ALT astrocytes.

scholarly journals Knowing to care: characterization of individuals with spinal cord injury treated at a rehabilitation center

2015 ◽  
Vol 28 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Soraia Dornelles Schoeller ◽  
Andréa Regina Schuch Grumann ◽  
Alessandra Cadete Martini ◽  
Stefânia Forner ◽  
Lívia Takano Sader ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Traffic Accidents ◽  
Spinal Cord Injuries ◽  
Cervical Region ◽  
Rehabilitation Center ◽  
Cross Sectional ◽  
Early Intervention Services ◽  
Cord Injury

Introduction Spinal cord injury (SCI) results in motor, sensory and autonomic dysfunction. The symptoms observed in patients with spinal cord injury will depend on the area affected by the injury. Nursing care is essential for better patient outcomes. Objective The aim of this study was to characterize patients with spinal cord injury treated at a state referral rehabilitation center for SCI. Methods We performed a quantitative cross-sectional descriptive study of 109 patients between the years 2000 and 2009. Results We found a predominance of spinal cord injury in men aged up to 30 years (48.5%). The main causes of spinal cord injuries were traffic accidents. The thoracic region was the most frequently affected site (39.7%), followed by the cervical region (25.6%). Most of the study subjects had been rated as ASIA A, according to the American Spinal Cord Injury Association scale. Discussion These findings corroborate previous studies observing that traffic accidents are the leading causes of spinal cord injury and that people affected by it usually do not seek proper care. Receiving early intervention services and counseling is essential for a better outcome and for achieving an improvement in the quality of life of these patients. Conclusion Despite the increasing incidence of spinal cord injuries nowadays, there is still a lack of data on the subject. The greatest limitation of this study is the incompleteness of medical records, which hindered the access to information.

scholarly journals Evaluation of spinal injuries by MRI

2019 ◽  
Vol 6 (2) ◽  
pp. 542
Author(s):  
Johny Prasad Bollipo ◽  
Pasupuleti Bhimeswara Rao
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Invasive Procedure ◽  
High Specificity ◽  
Neurological Status ◽  
Cervical Region ◽  
Correct Treatment ◽  
Specificity And Sensitivity ◽  
Cord Injury

Background: Radio-imaging is one of the most important tools in the diagnosis of spinal injury and helps to start a prompt and correct treatment to patients. Compared to CT, MRI allows better visualization of various tissues, including spinal cord and ligaments, not to mention discs and vessels. This study was done to evaluate the efficacy of low tesla MRI in acute spinal injuries.Methods: Site of injury, neurological status of the patient etc., were noted from 78 patients included in the study. The neurological status was evaluated according to the American Spinal Injury Association Impairment Scale. Within 2days of admission, MRI was done. In case of doubt, radiographs for superior and articular processes was done where necessary. CT was done in case edema was seen without a fracture line.Results: Most of the patients were males with the maximum of the patients being between the ages 21-50 years. Fall from height was the most common cause of injury and cervical region was the most common site. Osseous injury, ligament disruption and spinal cord injury were the most common MRI findings.Conclusions: Being non-invasive procedure with high specificity and sensitivity, MRI is a preferred diagnostic tool to assess the spinal cord injuries.

Impairment Rating and Spinal Cord Injuries: Revisiting the Guides

2010 ◽  
Vol 15 (3) ◽  
pp. 1-7
Author(s):  
Richard T. Katz
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Functional Independence ◽  
Outcome Data ◽  
Multiple Organ ◽  
Loss Of Function ◽  
Sixth Edition ◽  
Organ Systems ◽  
Cord Injury ◽  
Impairment Ratings

Abstract This article addresses some criticisms of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) by comparing previously published outcome data from a group of complete spinal cord injury (SCI) persons with impairment ratings for a corresponding level of injury calculated using the AMA Guides, Sixth Edition. Results of the comparison show that impairment ratings using the sixth edition scale poorly with the level of impairments of activities of daily living (ADL) in SCI patients as assessed by the Functional Independence Measure (FIM) motor scale and the extended FIM motor scale. Because of the combinations of multiple impairments, the AMA Guides potentially overrates the impairment of paraplegics compared with that of quadriplegics. The use and applicability of the Combined Values formula should be further investigated, and complete loss of function of two upper extremities seems consistent with levels of quadriplegia using the SCI model. Some aspects of the AMA Guides contain inconsistencies. The concept of diminishing impairment values is not easily translated between specific losses of function per organ system and “overall” loss of ADLs involving multiple organ systems, and the notion of “catastrophic thresholds” involving multiple organ systems may support the understanding that variations in rating may exist in higher rating cases such as those that involve an SCI.

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