Casada, et al. (2001): Adenosine analogue reduces spinal cord reperfusion injury in a time- dependent fashion

[Wise Young]

• Cassada DC, Tribble CG, Kaza AK, Fiser SM, Long SM, Linden J, Rieger JM, Kron IL and Kern JA (2001). Adenosine analogue reduces spinal cord reperfusion injury in a time- dependent fashion. Surgery. 130 (2): 230-5. Summary: BACKGROUND: We hypothesized that inflammation during spinal cord reperfusion worsens ischemic injury. ATL-146e, an adenosine A(2A) agonist with known anti-inflammatory properties, was used to test this hypothesis at varied intervals to determine the time course of reperfusion injury. METHODS: Forty rabbits underwent cross-clamping of the infrarenal aorta for 45 minutes. One group (n = 14 animals) received 0.06 microg/kg/min systemic ATL-146e over 3 hours, beginning after 30 minutes of ischemic time. A second group (n = 6 animals) received ATL-146e over 1.5 hours. A third group (n = 3 animals) received ATL-146e over 1 hour, and a fourth group (n = 17 animals) received saline solution. All animals were assessed at 48 hours for hind limb motor function (Tarlov scale, 0-5). RESULTS: Animals that received ATL-146e for 3 hours (Tarlov score, 4.3 +/- 0.22; P <.001) or 1.5 hours [Tarlov score, 2.7 +/- 0.6; P <.05) had improved neurologic outcomes compared with rabbits that received saline solution [Tarlov score, 0.6 +/- 0.29). Animals that received ATL-146e for 1 hour [Tarlov score, 0.7 +/- 0.8) were not significantly different from those animals that received saline solution. CONCLUSIONS: Systemic ATL-146e, given during reperfusion, results in time-dependent improvement in spinal cord function after ischemia. This implies that the mechanism of spinal reperfusion injury includes leukocyte-mediated inflammation at a critical post-ischemic time interval. <http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11490354
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a115838&target=> Division of Thoracic and Cardiovascular Surgery, Department of Surgery, The University of Virginia Health System, Charlottesville, VA 22908, USA.

[This message was edited by Wise Young on September 23, 2001 at 10:34 PM.]

[Wise Young]

Adenosine was recently reported to stimulate regrowth in the spinal cord. As many of you know, inosine and adenosine are both purine nucleotide molecules and they have been reported to have neuroprotective and regenerative effects on the spinal cord. For that reason, when I came across this article, I decided to post it.

In this study, the authors used an adenosine analog (similar molecule) and found that it prevented damage that occurs to the spinal cord when you withhold blood from the spinal cord for a period of time and then let the blood flow back (called reperfusion injury). This, by the way, is what happens when people get into accidents and the aorta (the large vessel that carries blood from your heart to the lower body) gets damaged. When they repair the aort and restores blood flow, there may be damage to the spinal cord, over and above the damage that was due to the loss of blood flow.

In any case, this study suggests that an adenosime analog can protect against reperfusion injury.

wise.