Study design: Experimental study. Objective: To evaluate the treatment of spinal cord injury with glial cell-derived neurotrophic factor (GDNF) delivered using an adenoviral vector (AdV-GDNF group) in comparison with treatment performed using human umbilical cord blood mononuclear cells (UCB-MCs)-transduced with an adenoviral vector carrying the GDNF gene (UCB-MCs+AdV-GDNF group) in rat. Setting: Kazan, Russian Federation. Methods: We examined the efficacy of AdV-GDNF and UCB-MCs+AdV-GDNF therapy by conducting behavioral tests on the animals and morphometric studies on the spinal cord, performing immunofluorescence analyses on glial cells, investigating the survival and migration potential of UCB-MCs, and evaluating the expression of the recombinant GDNF gene. Results: At the 30th postoperative day, equal positive locomotor recovery was observed after both direct and cell-based GDNF therapy. However, after UCB-MCs-mediated GDNF therapy, the area of preserved tissue and the number of spared myelinated fibers were higher than those measured after direct GDNF gene therapy. Moreover, we observed distinct changes in the populations of glial cells; expression patterns of the specific markers for astrocytes (GFAP, S100B and AQP4), oligodendrocytes (PDGFαR and Cx47) and Schwann cells (P0) differed in various areas of the spinal cord of rats treated with AdV-GDNF and UCB-MCs+AdV-GDNF. Conclusion: The differences detected in the AdV-GDNF and UCB-MCs+AdV-GDNF groups could be partially explained by the action of UCB-MCs. We discuss the insufficiency and the advantages of these two methods of GDNF gene delivery into the spinal cord after traumatic injury.
INTRODUCTIONSpinal cord injury (SCI) leads to complex pathological changes that include the death of neurons and glial cells and the demyelination and degeneration of nerve fibers. The limited growth capacity of mature central nervous system (CNS) neurons and the non-permissive environment of the CNS for axon regrowth are the main factors responsible for the little or no regeneration toward targets displayed by injured axons and for the permanent functional deficit observed after SCI. One promising approach for preventing neurodegeneration involves locally treating the site of injury in order to increase the expression of neurotrophic factors. Exploiting the stimulatory effects of neurotrophic factors on neuroregeneration appears to also be useful for SCI treatment, and one neurotrophic factor that is particularly suitable for SCI treatment is glial cell-derived neurotrophic factor (GDNF). GDNF is a member of the TGF-β superfamily that binds to the receptor GFRα1 and upregulates several signaling pathways; these pathways include those involving intracellular RAS/extracellular signalregulated kinase, phosphatidylinositol 3-kinase/AKT, p38 mitogen-