Pharmacological interventions targeting the microcirculation following traumatic spinal cord injury

Neural Regen Res, 2024 · DOI: https://doi.org/10.4103/1673-5374.375304 · Published: May 31, 2023

Spinal Cord Injury Cardiovascular Science Pharmacology

Simple Explanation

Traumatic spinal cord injury is a severe condition that impairs sensory, motor, and autonomic functions, greatly affecting daily life. The complex injury mechanism, limited nerve regeneration, and inhibitory environment worsen the outcomes. A key aspect of spinal cord injury is the disruption of microcirculation. Therapeutic agents that improve the injury environment, reduce secondary damage, and promote regeneration are being explored. Drug treatments aimed at the microcirculation can enhance the environment and improve recovery. These drugs target the structure and function of the spinal cord microcirculation, which are essential for the health of spinal neurons and glial cells.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Neurotrophic factors like diencephalon astrocyte derived neurotrophic factor and cerebrolysin can reduce abnormal permeability of the blood-spinal cord barrier and improve functional recovery.
2
Chemical synthetic drugs, such as melatonin and hydrogen sulfide, have demonstrated neuroprotective effects and the ability to protect endothelial cells and upregulate tight junction proteins.
3
Corticosteroids, particularly methylprednisolone, are commonly used to reduce neuroinflammation and tissue edema, thereby improving microcirculation and protecting neural tissue after spinal cord injury.

Research Summary

This review discusses the role of spinal cord microcirculation in spinal cord injury, including its structure and histopathological changes. It summarizes the progress of drug therapies targeting the spinal cord microcirculation after spinal cord injury. The review highlights that drugs targeting spinal cord microcirculation, such as neurotrophic factors, chemical synthetic drugs, and corticosteroids, show promising effects on functional recovery after SCI. The review concludes that drugs targeting spinal cord microcirculation may be an effective treatment following SCI by alleviating BSCB injury, enhancing intimal protection, and inducing vascular endothelial repair and regeneration.

Practical Implications

Drug Development

Focus on developing and refining drugs that target the microcirculation to improve the injury microenvironment and promote spinal cord tissue repair.

Combination Therapy

Explore combined therapeutic approaches that address multiple mechanisms of SCI, potentially involving both pharmacological interventions and stem cell engineering.

Clinical Application

Optimize drug delivery methods, dosage control, and timing for clinical application to overcome limitations and controversies associated with current treatments.

Study Limitations

1
Literature collection limited to the PubMed database.
2
Focus only on drugs targeting the structure and function of the spinal cord microcirculation.
3
Future studies can be done at the molecular or pathway level.

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