Blood-spinal cord barrier in spinal cord injury: a scientific review based on own experimental trial

Abstract

Objective. To analyze the mechanisms of the blood-spinal cord barrier permeability violation after spinal cord injury and to assess its impact on the development of secondary injuries, including those in the areas significantly remote from the epicenter of injury.Material and Methods. The article is an analysis of 45 publications supplemented by our own experimental data. The search for articles was conducted in databases such as PubMed, Scopus and Web of Science on the topic under study. Experimental data were obtained using confocal microscopy and bioluminescence detection on a rat spinal cord contusion injury model.Results. The problem of barrier disintegration in a region remote from the injury epicenter is considered. It is shown that spinal cord injury significantly increases the permeability of the blood-spinal cord barrier, which promotes enhanced transmigration of immune cells and release of cytotoxic molecules. The results of our own studies on a model of dosed contusion injury in the thoracic spinal cord of a rat show that the permeability of the barrier increases not only in the injury epicenter, but also along the entire length of the organ. This circumstance is especially significant for the lumbar spinal cord, where neural networks that are critical for the maintenance and restoration of motor function are localized.Conclusion. Potential causes of remote barrier disruption have been discussed, including the possible influence of damage biomarker molecules that travel from the injury epicenter to remote regions of the spinal cord via the bloodstream or cerebrospinal fluid. The promising clinical application of effective experimental approaches to contain barrier disruption and restore the blood-spinal cord barrier and the lack of translational research in this direction are highlighted.