Trends in Neuroprotective Strategies after Spinal Cord Injury: State of the Art

Abstract

Spinal cord injury (SCI) is an important pathology leading to possibly fatal consequences. The most common repercussions are those affecting motor and sensitivity skills. SCI-damage occurs in its first phase-as a result of the lesion mechanism (contusion, compression, transection, and primary lesion). After this primary damage, there is a second phase with further deleterious effects on neural degeneration and tissue restoration. At the moment, several investigation groups are working on developing therapeutic strategies to induce neuroprotection. This chapter pretends to introduce the reader to a wide range of these therapies, particularly those with promising results and tested in preclinical and clinical studies. In the first section, physiopathology of SCI will be addressed. Afterwards, the chapter will review neuroprotective strategies such as cyclooxygenase, calpain, and apoptosis inhibitors. Finally, the effect of immunophilin ligands, neural-derived peptides, antioxidants, hypoglycemic agent, gonadal hormones, Na channel blockers, and transplant of cultured cells will also be reviewed.

Spinal Cord Injury: Pathophysiology, Multimolecular Interactions, and Underlying Recovery Mechanisms

“…N-, P-, Q-and R-type VGCCs can be blocked by several snails and spider toxins [67]. T-type VGCCs can be blocked by mibefradil with 10-30 times higher potency than nimodipine [67]. Some Na + and Ca 2+ channel blockers possessing neuroprotective activity [66][67][68][69][70][71][72] are listed in Table 3.…”

“…The voltage-gated calcium channel blockers (VGCCs) play a vital role in calcium load regulation during SCI. VGCCs have six subtypes, i.e., L-, N-, P-, Q-, R- and T-type channels [ 67 ]. T-type calcium channels are present on neuron surface and their blockage results in long-term neuroprotection and maintenance of homeostasis by improving neuronal microcirculation [ 66 ].…”

“…L-type VGCCs include dihydropyridines such as nimodipine. N-, P-, Q- and R-type VGCCs can be blocked by several snails and spider toxins [ 67 ]. T-type VGCCs can be blocked by mibefradil with 10–30 times higher potency than nimodipine [ 67 ].…”

The Role of Vitamins in Spinal Cord Injury: Mechanisms and Benefits

“…Various treatments are available to manage symptoms and enhance the overall quality of for individuals living with SCI. One promising treatment approach involves the use of vitamins with antioxidant, anti-inflammatory, and neuroprotective properties [ 5 , 6 ]. Vitamins are naturally occurring substances that play a crucial role in maintaining optimal human body functions.…”