Pretreatment with erythropoietin attenuates the neurological injury after spinal cord ischemia

Abstract

Experimental study. To investigate the effect of erythropoietin (EPO) pretreatment on spinal cord ischemic injury. Experimental Research Center at Seoul National University Bundang Hospital, Korea. Rats were treated with either 1000 IU kg(-1) of EPO (EPO group, n=8) or saline (control group, n=8) 24 h before ischemia. Spinal cord ischemia was induced using a balloon-tipped catheter placed on the proximal descending aorta in the control group and the EPO group, but not in the sham group (n=8). Neurological function was assessed using the motor deficit index (MDI; 0=normal, 6=complete paralysis) until 7 days after reperfusion, and histological examination of spinal cord was performed. At the first day after reperfusion, the EPO group demonstrated a significantly lower MDI compared with the control group (2.0 (0.3-2.0) vs 4.0 (3.0-4.8), median (interquartile range); EPO group vs control group, respectively; P=0.002). This trend was sustained until 7 days after reperfusion (1.0 (1.0-1.8) vs 4.5 (3.3-5.0); EPO group vs control group, respectively; P=0.001), and more normal motor neurons (29.9±3.1 vs 21.4±3.4, mean±s.d.; EPO group vs control group, respectively; P<0.001) were observed. However, compared with the sham group, the EPO group displayed a significantly higher MDI (0.0, sham group) and fewer intact motor neurons (37.8±5.5, sham group; P<0.001, sham vs control group). Pretreatment with EPO significantly attenuates neurological injury following spinal cord ischemia, although it cannot completely abolish the ischemic injury.