Early microvascular reactions and blood–spinal cord barrier disruption are instrumental in pathophysiology of spinal cord injury and repair: novel therapeutic strategies including nanowired drug delivery to enhance neuroprotection

• Published in: Journal of Neural Transmission Vol. 118; no. 1; pp. 155 - 176
• Main Author: Sharma, Hari Shanker
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.01.2011; Springer Nature B.V
• Subjects: Animals; Antibodies therapy; Basic Neurosciences; Blood-spinal cord barrier; Drug Delivery Systems; Edema - etiology; Edema - pathology; Edema formation; Electrophysiological Phenomena; Electrophysiology; Endothelial cells; Genetics and Immunology - Review article; Glial cells; Humans; Matrix Metalloproteinases - physiology; MEDICIN; MEDICINE; Medicine & Public Health; Microcirculation - drug effects; Microvascular reactions; Motoneurons; Nanowired drug delivery; Nanowires; Neurology; Neurons - pathology; Neuroprotective Agents - administration & dosage; Neuroprotective Agents - therapeutic use; Neurosciences; Psychiatry; Regional Blood Flow - physiology; Spinal Cord - blood supply; Spinal Cord - drug effects; Spinal Cord Injuries - drug therapy; Spinal Cord Injuries - physiopathology; Spinal cord injury; Spinal cord pathology; Treatment; Edema formation; Motoneurons; Microvascular reactions; Treatment; Blood–spinal cord barrier; Electrophysiology; Nanowired drug delivery; Spinal cord pathology; Glial cells; Spinal cord injury; Endothelial cells; Antibodies therapy
• ISSN: 0300-9564; 1435-1463; 1435-1463
• DOI: 10.1007/s00702-010-0514-4

Spinal cord injury (SCI) is a devastating disease that leads to permanent disability of victims for which no suitable therapeutic intervention has been achieved so far. Thus, exploration of novel therapeutic agents and nano-drug delivery to enhance neuroprotection after SCI is the need of the hour. Previous research on SCI is largely focused to improve neurological manifestations of the disease while ignoring spinal cord pathological changes. Recent studies from our laboratory have shown that pathological recovery of SCI appears to be well correlated with the improvement of sensory motor functions. Thus, efforts should be made to reduce or minimize spinal cord cell pathology to achieve functional and cellular recovery to enhance the quality of lives of the victims. While treating spinal cord disease, recovery of both neuronal and non-neuronal cells, e.g., endothelia and glial cells are also necessary to maintain a healthy spinal cord function after trauma. This review focuses effects of novel therapeutic strategies on the role of spinal cord microvascular reactions and endothelia cell functions, i.e., blood–spinal cord barrier (BSCB) in SCI and repair mechanisms. Thus, new therapeutic approach to minimize spinal cord pathology after trauma using antibodies to various neurotransmitters and/or drug delivery to the cord directly by topical application to maintain strong localized effects on the injured cells are discussed. In addition, the use of nanowired drugs to affect remote areas of the cord after their application on the injured spinal cord in thwarting the injury process rapidly and to enhance the neuroprotective effects of the parent compounds are also described in the light of current knowledge and our own investigations. It appears that local treatment with new therapeutic agents and nanowired drugs after SCI are needed to enhance neurorepair leading to improved spinal cord cellular functions and the sensory motor performances.