Abstract
Background: Spinal cord injuries (SCI) often lead to devastating loss of neurological functions. Among other therapeutic methods, acupuncture is applied to support recovery. In former studies with healthy volunteers, we demonstrated an acupuncture-induced mobilization of potential neuroprogenitors. We hypothesized that this might also occur in patients with SCI and thereby improve regeneration. Methods: Four patients with SCI were acupunctured 15 times over a period of eight weeks. Before and after each acupuncture, CD133<sup>+</sup>34<sup>–</sup> cells were determined as potential neuroprogenitors by flow cytometry. By means of Elisa, we measured matrix metalloproteinase 9 (MMP-9), which is suggested to be involved in the mobilization of progenitor cells, and brain-derived neurotrophic factor (BDNF), a neurotrophin regulating neurogenesis. Patients’ motor and sensory functions were determined by American Spinal Injury Association Impairment Scale (AIS), and the quality of life was assessed using short form (SF)-36. Results: We observed that the number of potential neuroprogenitors increased gradually in peripheral blood over the eight weeks’ course of acupuncture treatment with a concomitant increase of MMP-9 and decrease in BDNF (p<0.05). Patients felt an improved sensory function and showed a positive perception of acupuncture treatment, while no clear changes in motor function were documented. Conclusion: Our results suggest that acupuncture induces the mobilization of potential neuroprogenitors in SCI patients, improvement of subjective sensory function and a better quality of life. Whether and to what extent acupuncture supports regeneration needs to be verified in future studies. Study registration: ISRCTN, ISRCTN71857369, retrospectively registered 18 February 2019, http://www.isrctn.com/ISRCTN71857369).
Highlights
Spinal cord injury (SCI) causes damage of neurological structures leading to loss of sensory and motor functions, with most patients experiencing para- or tetraplegia and multiple comorbidities [1]
New therapeutic approaches included the autograft of cultured neural cells from the olfactory nerve or bone marrow cells, which influenced the motor and sensory function in SCI patients after one to three months without adverse events [4, 5]
We previously reported that CD133+CD34- cells were mobilized, while brain-derived neurotrophic factor (BDNF) and matrix metalloproteinase (MMP)-9 concentrations decreased 48 hours following acupuncture of healthy volunteers [9]
Summary
Spinal cord injury (SCI) causes damage of neurological structures leading to loss of sensory and motor functions, with most patients experiencing para- or tetraplegia and multiple comorbidities [1]. In former studies with healthy volunteers, we demonstrated an acupuncture-induced mobilization of potential neuroprogenitors. We hypothesized that this might occur in patients with SCI and thereby improve regeneration. Patients’ motor and sensory functions were determined by American Spinal Injury Association Impairment Scale (AIS), and the quality of life was assessed using short form (SF)-36. Conclusion: Our results suggest that acupuncture induces the mobilization of potential neuroprogenitors in SCI patients, improvement of subjective sensory function and a better quality of life. Study registration: ISRCTN, ISRCTN71857369, retrospectively registered 18 February 2019, http://www.isrctn.com/ISRCTN71857369)
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