Research led by Ohio State University’s Wexner Medical Center and the School of Medicine found that gabapentin, a widely prescribed pain relief drug, can prevent damaging structural changes in the injured spinal cord of mice and also block cardiovascular changes and immunosuppression caused by spinal cord injury.
“Gabapentin is often prescribed as a treatment for pain, but if it is given soon after wounds– before symptoms develop – it can also limit structural changes in nerve cells. We show that these benefits remain up to one month after the interruption gabapentin treatment in rats with spinal cord injury. We believe that gabapentin can be reused as a prophylactic therapy that can prevent autonomic dysfunction in people affected by spinal cord injuries, “said Phillip Popovich, senior author and chairman of the Ohio State Department of Neuroscience.
The results of the study are published online in the journal Cell reports.
“This is the first time that a treatment has been shown to prevent the development of autonomic dysfunction, instead of controlling the symptoms caused by autonomic dysfunction. In response to stress or danger, autonomic nerve cells in the spinal cord, it triggers a “fight or flight” response. This is a normal and useful answer that increases blood pressure and releases hormones like adrenaline and cortisol, “said author Faith Brennan, a researcher in the Ohio State Department of Neuroscience.
But after traumatic spinal cord injury, massive structural changes occur in the autonomic spinal nerve centers that control the fight or flight response, and these changes cause uncontrolled autonomic reflexes.
For example, normally harmless stimuli, such as bladder filling, will trigger the fight or flight response. But, because of the spinal cord injury, the response is uncontrolled and can cause several health problems, including severe hypertension, slow heart rate and long-term immune suppression.
“Autonomic dysfunction is a major problem for people living with a spinal cord injury. Cardiovascular complications can lead to serious morbidities, such as heart attack and stroke, while long-term immune suppression can lead to serious recurrent infections, such as pneumonia, “said Popovich.
Currently, these symptoms can only be controlled (regular bowel / bladder regimens, for example), but there is no treatment.
“The possibility of redirecting gabapentin as a prophylactic therapy to prevent the development of autonomic dysfunction can significantly improve the quality of life of individuals living with spinal cord injuries, including greater independence in society, reduced dependence on caregivers, reduced susceptibility to infections and increased life expectancy, “Brennan said. “Gabapentin is approved by the FDA and is already widely used to control neuropathic pain caused by spinal cord injuries. If patients are treated soon after their injuries, gabapentin can prevent the damaging structural changes that are inevitable in the most severe cases. serious spinal cord injuries. “
This study builds on previous research from the state of Ohio, showing that autonomic dysfunction It directly boosts immune suppression, said Popovich, who is also a researcher at the Ohio State Neurological Institute and the Belford Spinal Cord Injury Center.
“We do not know how long the treatment can be postponed after the injury and still maintain the beneficial effects. Studies underway at the Belford Center are optimizing this window for starting treatment. We also do not know whether gabapentin targets other cells / organs in the body. , so let’s investigate the effects of this therapy on tissues other than the spinal cord, “said Popovich.
Faith H. Brennan et al, Post-acute blockade of α2δ-1 calcium channel subunits prevents pathological autonomic plasticity after spinal cord injury, Cell reports (2021). DOI: 10.1016 / j.celrep.2020.108667
Ohio State University Medical Center
Study in mice: gabapentin prevents harmful structural changes in the spinal cord (2021, 26 January)
recovered on January 27, 2021
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