Adenosine A2A analogue improves neurologic outcome after spinal cord trauma in the rabbit.
BACKGROUND
ATL-146e, an adenosine A2A agonist, reduces paralysis after spinal cord ischemia-reperfusion. We hypothesized that systemic ATL-146e could improve neurologic outcome after blunt spinal cord trauma.


METHODS
Twenty rabbits survived a thoracic spinal cord impact of 30 g-cm. One group received 0.06 microg/kg/min ATL-146e for the first 3 hours after impact (A2A group), whereas a second group received saline carrier (T/C group). Neurologic outcome was measured using the Tarlov scale (0-5). Histologic sections from the A2A and T/C groups were compared for neuronal viability.


RESULTS
There was significant improvement in Tarlov scores of A2A animals compared with T/C animals at 12 hours (p = 0.007), with a trend toward improvement at 36 (p = 0.08) and 48 (p = 0.09) hours after injury. There was decreased neuronal attrition in A2A animals (p = 0.06).


CONCLUSIONS
Systemic ATL-146e given after spinal cord trauma results in improved neurologic outcome. Adenosine A2A agonists may hold promise as a rapidly acting alternative to steroids in the early treatment of the spinal cord injured patient.
Cassada
David C
DC
Division of Vascular Surgery, University of Tennessee Medical Center at Knoxville, USA.
Tribble
Curtis G
CG
Young
Jeffrey S
JS
Gangemi
James J
JJ
Gohari
A Reza
AR
Butler
Paris D
PD
Rieger
Jayson M
JM
Kron
Irving L
IL
Linden
Joel
J
Kern
John A
JA
D000818:Animals; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010243:Paralysis / Q000517:prevention & control*; D058906:Purinergic P1 Receptor Agonists; D011687:Purines / Q000627:therapeutic use*; D011817:Rabbits; D043705:Receptor, Adenosine A2A; D013119:Spinal Cord Injuries / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D018709:Statistics, Nonparametric; D014949:Wounds, Nonpenetrating / Q000188:drug therapy*
C431129:ATL 146e; D003509:Cyclohexanecarboxylic Acids; D018696:Neuroprotective Agents; D058906:Purinergic P1 Receptor Agonists; D011687:Purines; D043705:Receptor, Adenosine A2A