Abstract
Root lesions may affect both dorsal and ventral roots. However, due to the possibility of generating further inflammation and neuropathic pain, surgical procedures do not prioritize the repair of the afferent component. The loss of such sensorial input directly disturbs the spinal circuits thus affecting the functionality of the injuried limb. The present study evaluated the motor and sensory improvement following dorsal root reimplantation with fibrin sealant (FS) plus bone marrow mononuclear cells (MC) after dorsal rhizotomy. MC were used to enhance the repair process. We also analyzed changes in the glial response and synaptic circuits within the spinal cord. Female Lewis rats (6–8 weeks old) were divided in three groups: rhizotomy (RZ group), rhizotomy repaired with FS (RZ+FS group) and rhizotomy repaired with FS and MC (RZ+FS+MC group). The behavioral tests electronic von-Frey and Walking track test were carried out. For immunohistochemistry we used markers to detect different synapse profiles as well as glial reaction. The behavioral results showed a significant decrease in sensory and motor function after lesion. The reimplantation decreased glial reaction and improved synaptic plasticity of afferent inputs. Cell therapy further enhanced the rewiring process. In addition, both reimplanted groups presented twice as much motor control compared to the non-treated group. In conclusion, the reimplantation with FS and MC is efficient and may be considered an approach to improve sensory-motor recovery following dorsal rhizotomy.
Highlights
Motor coordination is dependent on delicate sensory-motor integration, which is evident in the spinal cord
The animals were subjected to unilateral rhizotomy of the L4–L6 dorsal roots and divided into 3 groups: (1) RZ without reimplantation (RZ, n = 22); (2) RZ followed by root reimplantation with fibrin sealant (FS) (RZ+FS, n = 23); and (3) RZ followed by root reimplantation with FS plus mononuclear cells (MC) (RZ+FS+MC, n = 20)
The MC expressed low CD3 (1.52%) and a significant percentage of cells were positive to CD11b (13.2%), CD45 (92.2%), and CD34 (20.8%) (Figure S1)
Summary
Motor coordination is dependent on delicate sensory-motor integration, which is evident in the spinal cord In this sense, primary afferent inputs enter the dorsal horn and make synapses at different laminae, according to the nature of the information (Brodal and Rexed, 1953; Rexed, 1954). Spinal root injury has become a relatively common occurrence following vehicle accidents and is related to complicated child-births (Carlstedt, 2009; Barbizan et al, 2013; Kachramanoglou et al, 2013; Spejo et al, 2013; Wu et al, 2013) It generally occurs in the brachial plexus, leading to loss of sensibility and paralysis of the limb ipsilateral to the injury. Such lesion may result in neuropathic pain, indicating that pathological circuitry rearrangements may take place (Carlstedt, 2009)
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