Abstract
OBJECTIVES:To evaluate the effects of combined treatment with granulocyte colony-stimulating factor (G-CSF) and methylprednisolone in rats subjected to experimental spinal cord injury.METHODS:Forty Wistar rats received a moderate spinal cord injury and were divided into four groups: control (no treatment); G-CSF (G-CSF at the time of injury and daily over the next five days); methylprednisolone (methylprednisolone for 24 h); and G-CSF/Methylprednisolone (methylprednisolone for 24 h and G-CSF at the time of injury and daily over the next five days). Functional evaluation was performed using the Basso, Beattie and Bresnahan score on days 2, 7, 14, 21, 28, 35 and 42 following injury. Motor-evoked potentials were evaluated. Histological examination of the spinal cord lesion was performed immediately after euthanasia on day 42.RESULTS:Eight animals were excluded (2 from each group) due to infection, a normal Basso, Beattie and Bresnahan score at their first evaluation, or autophagy, and 32 were evaluated. The combination of methylprednisolone and G-CSF promoted greater functional improvement than methylprednisolone or G-CSF alone (p<0.001). This combination also exhibited a synergistic effect, with improvements in hyperemia and cellular infiltration at the injury site (p<0.001). The groups displayed no neurophysiological differences (latency p=0.85; amplitude p=0.75).CONCLUSION:Methylprednisolone plus G-CSF promotes functional and histological improvements superior to those achieved by either of these drugs alone when treating spinal cord contusion injuries in rats. Combining the two drugs did have a synergistic effect.
Highlights
Researchers worldwide struggle to find evidence of substances or procedures that can reduce the devastating consequences of spinal cord injuries, which affect up to 80 per million people worldwide, with 500,000 new cases per year [1]
In the Control Group (CG), one rat was excluded due to failure of the experimental lesion, and the second was excluded for autophagy on the 22nd postoperative day
One of the reasons why traumatic spinal cord injury is such a devastating condition is that it leads to chronic impairment and disability: it impairs the function of young accident victims in the productive phase of their lives, and with the aging of the population, it is increasingly affecting the elderly [1,34]
Summary
Researchers worldwide struggle to find evidence of substances or procedures that can reduce the devastating consequences of spinal cord injuries, which affect up to 80 per million people worldwide, with 500,000 new cases per year [1]. Methylprednisolone has proven clinically effective [9,10]; its use as a first-line treatment has recently been questioned due to the high incidence of complications and adverse events, especially when higher doses are used [11]. The use of methylprednisolone has been reevaluated [12] but is still widely accepted [13]. Stem-cell transplantation [14,15] has been investigated
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