Transneuronal cytokine delivery promotes functional recovery across spinal cord contusion severities via descending circuit plasticity.

Spinal cord injury (SCI) is a debilitating neurological condition that leads to physical dependence, substantial financial burden, and psychological stress. Current for SCI, such as stem cell therapy, pharmacological interventions, and neural implants offer limited functional recovery. Among emerging strategies, exosome-based therapies in nerve damage can reduce neuroinflammation and promote neural repair by angiogenesis and neurogenesis. MicroRNAs (miRNAs) are key modulators of inflammatory and regenerative pathways in SCI. Specifically, miR-19a-3p, miR-19b-3p, and miR-27b have been implicated in regulating neuroinflammatory responses, neuronal survival, and tissue remodeling. Dysregulation of these miRNAs following SCI can exacerbate inflammation and hinder recovery. In this study, exosomes were extracted and characterized using flowcytometry for surface markers CD81 and CD9, scanning electron microscopy (SEM), dynamic light scattering (DLS), and Zeta potential analysis. Thirty-two female rats were randomly assigned into four groups: laminectomy only, contusion, contusion + PBS, and contusion + exosomes. SCI were induced using contusion model and thirty minutes after the injury, the exosome-treated group received an intravenous injection of 100 μl of exosomes via the tail vein for 7 days. Motor and behavioral functions were assessed through the open-field test, Basso, Beattie, and Bresnahan (BBB) scale and narrow beam test (NBT). Eight weeks after the SCI, real time PCR, Western blotting was utilized to assess changes in inflammatory cytokines, while histological changes were observed using hematoxylin and eosin (H&E) staining and stereology. In vivo experiments showed that the administration of exosomes significantly enhanced functional recovery and behavioral test outcomes following SCI. The treatment also resulted in a significant reduction in inflammatory cytokine levels and a marked decrease in the size of the cavity in the group treated with exosomes. Molecular analysis revealed that exosome therapy modulated the expression of miR-19a-3p, miR-19b-3p, and miR-27b, which are key regulators of neuroinflammation and neural repair. These findings suggest that exosomes hold strong therapeutic potential for treating SCI by modulating inflammation and promoting neural repair. Collectively, these findings indicate a potential mechanism through which exosomes exert their neuroprotective effects, particularly by regulating inflammatory and regenerative pathways.

Vascular integrity and immune infiltration in SCI pain: Can exercise tip the balance?

Duration of intensive care unit admission to maintain mean arterial pressure goals following acute traumatic spinal cord injury.

The role of the gut-spinal axis in immune-metabolic coupling after spinal cord injury.

Depleting non-resolving neuroinflammation in chronic spinal cord injury attenuates thermal hypersensitivity.

Evolving role of biomarkers in spinal cord injury: From research to clinical translation.

Mesenchymal Stem Cell-Lysate Sustained-Release Nano-Hydrogel Alleviates Spinal Cord Injury by Inhibiting Ferroptosis and Mitochondrial Intrinsic Apoptosis.

An inflammation-targeted lipid nanoparticle inhibiting ferroptosis for spinal cord injury repair.

Spinal cord extracellular matrix hydrogel enhances organoid maturation and functional regeneration after spinal cord injury.

Spinal cord injury (SCI) is a severe neurological disorder that leads to significant complications, including loss of bladder/bowel control and increased infection risk. The current standard treatment involves methylprednisolone administration and surgical decompression, but finding an effective therapy with minimal side effects remains a major challenge. This study aimed to investigate the effects of an optimized conditioned medium derived from rat adipose-derived mesenchymal stem cells (AD-MSCs) and dihydroepiandrosterone (DHEA) on behavioral indices, oxidative stress, stereological parameters, and histopathological outcomes in rats with compressive spinal cord injury (SCI). In this study, 60 adult female rats were randomly divided into five groups: Sham group (laminectomy + intraperitoneal injection of 1 % dimethyl sulfoxide [DMSO], 200 µL for seven consecutive days), SCI-induced group (SCI induction + intraperitoneal injection of 1 % DMSO, 200 µL for seven consecutive days), Treatment group 1 (SCI induction + intraperitoneal injection of DHEA [30 mg/kg] dissolved in 1 % DMSO for seven consecutive days), Treatment group 2 (SCI induction + intraperitoneal injection of conditioned medium [200 µL] for seven consecutive days), Treatment group 3 (SCI induction + intraperitoneal injection of DHEA [30 mg/kg] dissolved in 1 % DMSO followed by conditioned medium [200 µL] for seven consecutive days). Behavioral assessments were performed using the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale and the rotarod test. Additionally, the levels of antioxidant enzymes-catalase, glutathione (GSH), superoxide dismutase (SOD), and the lipid peroxidation marker malondialdehyde (MDA)-were measured using respective assay kits. For stereological evaluation (to estimate neuronal and non-neuronal cell counts, gray and white matter volumes, spinal cord volume, and lesion area) and histopathological assessment (to evaluate inflammation, necrosis, and hemorrhage indices), tissue samples were stained with Cresyl Violet. The findings revealed that in the SCI-induced group, motor function, neuronal cell number in spinal gray matter, non-neuronal cell number in the spinal cord, white and gray matter volumes, total spinal cord volume, and levels of catalase, GSH, and SOD were significantly reduced compared to the sham group. Conversely, the spinal lesion volume and MDA levels were elevated. Treatment with DHEA, AD-MSC-conditioned medium, or their combination reversed these effects. Notably, the combined treatment group exhibited more pronounced therapeutic improvements compared to monotherapy groups. The administration of DHEA and AD-MSC-conditioned medium, particularly in combination, appears to enhance motor function, elevate antioxidant enzyme activity, reduce lipid peroxidation, improve spinal cord structural parameters (volume and cell counts), and ameliorate pathological markers in an animal model of compressive SCI.

Traumatic spinal cord injury (SCI) induces rapid and adverse changes in body composition, yet effective strategies to prevent excess fat accumulation are limited. This study aimed to evaluate the effect of an individualized dietitian-led nutrition intervention on change in fat mass and related markers of adiposity during the first year following SCI. In this single-center, open-label randomized controlled trial, adults with subacute traumatic SCI were randomized to an individualized dietitian-led intervention or usual care. The primary outcome was change in total fat mass (FM) over one year, assessed by multifrequency bioimpedance analysis. Secondary outcomes included fat mass index (FMI), visceral adipose tissue (VAT), waist circumference, fat-free mass, fat-free mass index, body weight, body mass index (BMI) and biomarkers (fasting glucose, 2-h oral glucose tolerance test, HbA1c, LDL, HDL and triglycerides). Intention-to-treat analyses used mixed-effects models adjusted for age, sex, and neurological severity. Sixty-two participants were randomized (32 intervention, 30 control). Participants were predominantly male (76%) with a mean age of 48 (SD 17) years. At 1 year, the adjusted between-group difference in FM change was -1.5 kg (95% CI -4.8 to 1.9; p = 0.39). Significant between-group differences were observed for VAT (-0.5 L; 95% CI -1.0 to -0.1; p = 0.02) and waist circumference (-4.0 cm; 95% CI -7.0 to -1.0; p = 0.01), with borderline significance for FMI (-1.6 kg/m2; 95% CI -3.2 to 0.0; p = 0.05). No significant between-group differences were observed for body weight, BMI, fat-free mass, or biomarkers. Sensitivity and per-protocol analyses yielded consistent results. Although the intervention did not significantly affect the primary endpoint of total fat mass, between-group differences were observed for VAT and waist circumference. These findings suggest that structured, individualized dietetic care initiated during SCI rehabilitation and continued post-discharge may attenuate accumulation of abdominal adiposity. Longer-term follow-up is needed to determine whether early attenuation of abdominal adiposity translates into reduced cardiometabolic risk and improved functional outcomes. NCT04109586.

Spinal cord injury (SCI), characterized by a sequential, spatiotemporally heterogeneous pathological progression encompassing primary injury, acute/subacute, intermediate and chronic phases, remains a devastating clinical challenge with limited effective therapies. Conventional hydrogel-based delivery system cannot dynamically match the spatiotemporally evolving pathological microenvironment of SCI, whereas self-adaptive hydrogels can recognize the dynamic pathological cues within the lesion microenvironment, and undergo programmable adjustments to their structural and functional properties, establishing a bidirectional adaptive interaction with the pathological microenvironment to achieve on-demand release and therapeutic regulation. In this review, we propose a pathology-driven analytical framework for the self-adaptive hydrogels in SCI repair, focusing on the intrinsic linkage between stage-specific SCI pathological characteristics, rational material design, and corresponding therapeutic outcomes. We first outline the full temporal pathological landscape of SCI and clarify the distinct therapeutic requirements of each injury phase, and then systematically classify and evaluate the self-adaptive hydrogel delivery systems in accordance with their suitability for different pathological stages, establishing a rigorous logical chain from pathological cue recognition, targeted adaptive material design to mechanism-based therapeutic validation. We further summarize the core design principles and multifunctional therapeutic roles of such adaptive systems, and finally discuss the key challenges in clinical translation and future development directions.

Development and internal validation of a risk prediction calculator for minor spinal cord injury in CT-negative blunt trauma.

Targeted biohybrid nanoplatform for spinal cord injury treatment: Restoring microglial mitophagy and alleviating oxidative stress.

Repurposing tumor-derived extracellular vesicles with an adhesive carboxymethyl chitosan-based hydrogel for spinal cord injury repair.

Spatiotemporal liposome-zwitterionic nano-hydrogel orchestrates immunomodulation and neurogenesis in spinal cord injury repair.

ROS-responsive hydrogels functionalized with Cu/Zn MOF targeting oxidative stress mitigation and inflammation modulation to promote spinal cord injury repair.

Chronic pain poses a significant challenge to quality of life throughout the USA. It is estimated that as much as 21% of the US population experiences chronic pain, and the incidence of new chronic pain cases is shockingly high, at 52.4 cases per 1000 persons per year. An intrathecal pump (ITP) consists of a small pump surgically implanted under the skin, along with a catheter inserted into the intrathecal space in the spine. Medication, usually in the form of opioids, local anesthetics, or muscle relaxants, is then delivered through the catheter into the spinal fluid, where it can act directly on nerves to provide pain relief or reduce spasticity. The use of intrathecal drug delivery has been established for decades and is used for various conditions, including chronic noncancer pain and cancer-related pain. ITPs are also employed for managing severe spasticity in conditions such as multiple sclerosis or spinal cord injury. Over the years, there has been a gradual increase in the use of ITPs, particularly as awareness of their benefits and technological advancements has increased. ITPs have been historically placed in the abdomen. However, more recently, some ITPs have begun to be placed in the lower back. Placing ITPs in the lower back has the potential to lower operative time and complication rates, but more research in this area is warranted. This study analyzes the outcomes of posterior ITP placement to evaluate their suitability and potential benefits. This study consisted of a retrospective review including data from 115 procedures completed between 2015 and 2025. Data collection included patient demographics, preoperative and postoperative pain scores, surgical time, needle and catheter locations, and adverse events. Pain scores were collected using the visual analog scale (VAS), and data were analyzed using SPSS 29. Two-tailed paired t-tests were used to determine the significance of the difference between preoperative and postoperative pain scores. A total of 115 procedures from 103 patients were included in the statistical analysis. The average preoperative pain was 6.54 (6.54 ± 2.00, n = 114), and the average postoperative pain score in the first year following the procedure was 4.45 (4.45 ± 2.30, n = 114), with a p value of < 0.001. The average surgical time for the procedure was 49.00 ± 19.53min (n = 113). In this study, ITPs implanted in the lower back were associated with greater pain relief, shorter surgical times, and fewer complications than those placed in the abdomen. These findings, while indirect, provide evidence for promoting ITP placement in the lower back as a safe and effective option for patients experiencing chronic pain.

Sex-related isokinetic profile of shoulder strength of a Brazilian amateur wheelchair basketball team.