This study was designed to elucidate the potential neuroprotective effects of Reg-2 (regeneration gene protein 2) in a rodent model of spinal cord transection injury at the ninth thoracic level. Reg-2 at 100 and 500 lg, recombinant rat ciliary neurotrophic factor, or vehicle were delivered intrathecally using Alzet miniosmotic pumps. We found that Reg-2 treatment significantly reduced neuronal death in the spinal cord. There was also an attenuation of inflammation at the injury site and an increase in white matter sparing and retained myelination. Retrograde tracing revealed that Reg-2 protected axons of long descending pathways at 6 weeks post-SCI, and the number of FluoroGold-labeled neurons in spinal and supraspinal regions was also significantly increased. Immunofluorescent staining confirmed that the spared white matter contained neurofilament-positive axons. Moreover, behavioral improvements were revealed by Basso Beattie Bresnahan locomotor rating scores and grid-walk analysis. These results suggest that Reg-2 might promote functional recovery by increasing axonal growth, inhibiting neuronal apoptosis, and attenuating spinal cord secondary injury after SCI. Anat Rec, 294:24-45, 2011. V V C 2010 Wiley-Liss, Inc.Key words: Reg-2; spinal cord injury; neuroprotective effects; white matter sparing; axonal growth; functional recoveryReg-2 is a 16-KDa secreted protein belonging to a family of proteins structurally related to c-type lectins, which are upregulated in pancreatitis and have been shown to possess antiapoptotic actions on pancreatic cell lines (Iovanna et al., 1991;Orelle et al., 1992;Ortiz et al., 1998). Reg-2 normally is not expressed in the adult rat central (CNS) or peripheral nervous system (PNS), but it is expressed in a cytokine-dependent manner in both sensory and motor neurons during development (Livesey et al., 1997). Interestingly, Reg-2 is strongly upregulated in the PNS after nerve axotomy or crushing in adult rats, and it is also reexpressed in the CNS during Alzheimer's disease, spinal cord injury (SCI), or inflammation of peripheral motor and sensory nerves (De la Monte et al., 1990;Nishimune et al., 2000;Averill et al., 2002Averill et al., , 2008Fang et al., 2010). The expression of Reg-2 is driven by cytokines including the interleukin-6 family, ciliary neurotrophic factor (CNTF), Additional Supporting Information may be found in the online version of this article. leukemia inhibitory factor, and cardiotrophin (CT-1; Livesey et al., 1997). Previous studies demonstrated that expression of Reg-2 is also required for the survival-promoting actions of CNTF on motoneurons (Livesey et al., 1997;Nishimune et al., 2000). Indeed, blocking Reg-2 expression specifically abrogated the survival effect of CNTF, suggesting that it could be an important intermediate involved in the survival signaling pathway of CNTF-related cytokines (Nishimune et al., 2000).The rapid increase in expression of CNTF after CNS injury has been hypothesized to play an intimate role in neuronal survival and funct...