angel7
05-08-2002, 12:04 PM
NEW YORK (Reuters Health) Apr 26 - New findings from a rat study fuel growing uncertainty about the efficacy of methylprednisolone sodium succinate (MPSS) for patients with acute traumatic spinal cord injury.
Writing in the April 1st issue of the Journal of Neuroscience Research, Dr. Alexander G. Rabchevsky and colleagues note that MPSS is currently the only accepted therapeutic intervention for these patients, although the mechanism of action of its reported benefits is not entirely clear.
As the University of Kentucky team points out, emerging clinical and experimental evidence suggests that the beneficial effects of MPSS are moderate at best. In fact, a critical review of case reports from the last four decades failed to show any neurological benefit of high-dose MPSS for acute spinal cord injury and hinted that this treatment may be harmful.
Dr. Rabchevsky's team stereologically assessed the impact of this therapy on lesion volume, tissue sparing, and long-term behavioral recovery in adult rats with spinal cord injury. Rats received either MPSS or saline for 24 hours starting 5 minutes after injury.
Compared with controls, MPSS "marginally reduced lesion volumes across time," they report. But the "actual volume of tissue sparing as well as the percentages of spared gray matter and white matter were indistinguishable between the saline- versus MPSS-treated groups over time." MPSS failed to improve functional recovery in the hind limbs.
These findings, coupled with other reports, suggest that MPSS, "as a standard therapy or a positive control, may not be justified," the authors write. However, before the potential efficacy of MPSS treatment is dismissed, they recommend establishment of a dose-response curve and development of combination therapies for spinal cord injury.
For instance, Dr. Rabchevsky's group has evidence that basic fibroblast growth factor may act synergistically with MPSS to improve functional recovery in injured rats.
J Neurosci Res 2002;68:7-18.
[This message was edited by Wise Young on May 08, 2002 at 10:22 PM.]
Writing in the April 1st issue of the Journal of Neuroscience Research, Dr. Alexander G. Rabchevsky and colleagues note that MPSS is currently the only accepted therapeutic intervention for these patients, although the mechanism of action of its reported benefits is not entirely clear.
As the University of Kentucky team points out, emerging clinical and experimental evidence suggests that the beneficial effects of MPSS are moderate at best. In fact, a critical review of case reports from the last four decades failed to show any neurological benefit of high-dose MPSS for acute spinal cord injury and hinted that this treatment may be harmful.
Dr. Rabchevsky's team stereologically assessed the impact of this therapy on lesion volume, tissue sparing, and long-term behavioral recovery in adult rats with spinal cord injury. Rats received either MPSS or saline for 24 hours starting 5 minutes after injury.
Compared with controls, MPSS "marginally reduced lesion volumes across time," they report. But the "actual volume of tissue sparing as well as the percentages of spared gray matter and white matter were indistinguishable between the saline- versus MPSS-treated groups over time." MPSS failed to improve functional recovery in the hind limbs.
These findings, coupled with other reports, suggest that MPSS, "as a standard therapy or a positive control, may not be justified," the authors write. However, before the potential efficacy of MPSS treatment is dismissed, they recommend establishment of a dose-response curve and development of combination therapies for spinal cord injury.
For instance, Dr. Rabchevsky's group has evidence that basic fibroblast growth factor may act synergistically with MPSS to improve functional recovery in injured rats.
J Neurosci Res 2002;68:7-18.
[This message was edited by Wise Young on May 08, 2002 at 10:22 PM.]