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Methods to Quantify Pharmacologically Induced Alterations in Motor Function in Human Incomplete SCI
Published on: April 18, 2011
Recent advances in the pharmacologic treatment of spinal cord injury
April Cox1, Abhay Varma, Naren Banik
1Department of Neurosciences, Medical University of South Carolina, 96 Jonathan Lucas ST. MSC606, Charleston, SC, 29425, USA, coxaa@musc.edu.
Abstract:
A need exists for the effective treatment of individuals suffering from spinal cord injury (SCI). Recent advances in the understanding of the pathophysiological mechanisms occurring in SCI have resulted in an expansion of new therapeutic targets. This review summarizes both preclinical and clinical findings investigating the mechanisms and cognate pharmacologic therapeutics targeted to modulate hypoxia, ischemia, excitotoxicity, inflammation, apoptosis, epigenetic alterations, myelin regeneration and scar remodeling. Successful modulation of these targets has been demonstrated in both preclinical and clinical studies with agents such as Oxycyte, Minocycline, Riluzole, Premarin, Cethrin, and ATI-355. The translation of these agents into clinical studies highlights the progress the field has made in the past decade. SCI proves to be a complex condition; the numerous pathophysiological mechanisms occurring at varying time points suggests that a single agent approach to the treatment of SCI may not be optimal. As the field continues to mature, the hope is that the knowledge gained from these studies will be applied to the development of an effective multi-pronged treatment strategy for SCI.
Insights
Effective spinal cord injury (SCI) treatment requires addressing multiple targets. Research shows promise in modulating hypoxia, inflammation, and other mechanisms with various agents, suggesting a multi-pronged approach is optimal for SCI recovery.
Area of Science:
- Neuroscience and Regenerative Medicine
- Pharmacology and Therapeutics
Background:
- Spinal cord injury (SCI) presents a significant unmet medical need.
- Understanding SCI pathophysiology has revealed numerous therapeutic targets.
- Existing treatments are limited, necessitating novel therapeutic strategies.
Purpose of the Study:
- To review preclinical and clinical findings on SCI therapeutic targets.
- To summarize pharmacologic agents targeting key SCI mechanisms.
- To assess the progress and future directions in SCI treatment.
Main Methods:
- Comprehensive literature review of preclinical and clinical studies.
- Analysis of therapeutic agents targeting hypoxia, ischemia, excitotoxicity, inflammation, apoptosis, epigenetic alterations, myelin regeneration, and scar remodeling.
- Evaluation of agents including Oxycyte, Minocycline, Riluzole, Premarin, Cethrin, and ATI-355.
Main Results:
- Successful modulation of SCI targets demonstrated in both preclinical and clinical settings.
- Specific agents show efficacy in addressing various pathophysiological mechanisms.
- Translation of several agents into clinical trials indicates significant progress.
Conclusions:
- SCI is a complex condition with multiple, time-dependent pathophysiological processes.
- A single-agent therapeutic strategy may be insufficient for optimal SCI treatment.
- Future research should focus on developing effective, multi-pronged treatment strategies for spinal cord injury.
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