title: Co-treatment with riluzole and GDNF is necessary for functional recovery after ventral root avulsion injury.
abstract: Unilateral avulsion of lumbar ventral roots kills approximately 50% of injured motoneurons within 2 weeks of surgery. Immediate treatment involving surgical reimplantation of the ventral root (VRI) or intrathecal glial cell line-derived neurotrophic factor (GDNF) delivery or intraperitoneal injection of riluzole for 2 weeks ameliorates motoneuron death to 80% of control but combining the different treatment paradigms did not further enhance survival except when GDNF was combined with VRI. At 3 months, all combined treatments provided a neuroprotective effect compared to avulsion only, but the neuroprotective effect of surgical reimplantation alone was not maintained unless combined with riluzole and GDNF treatment. Analysis of regenerating motoneurons using retrograde labelling techniques showed that riluzole, but not GDNF, increased the number of dendrites per labelled motoneuron. However, when functional motor recovery was assessed using the BBB locomotor score and rotarod tests, only VRI animals treated with riluzole and GDNF application showed significantly improved locomotor function in both tests. Our results show that functional recovery appears related to a combination of enhanced dendrite formation, increased motoneuron survival and the neurotrophic actions of GDNF. Thus, combination treatment may offer a new therapeutic strategy for treating patients with avulsion injury.
authors.affiliation: Department of Anatomy and Developmental Biology, University College London, WC1 6BT London, UK.
authors.forename: Astrid
authors.initials: A
authors.lastname: Bergerot
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Shortland
authors.forename: Praveen
authors.initials: P
authors.lastname: Anand
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Hunt
authors.forename: Thomas
authors.initials: T
authors.lastname: Carlstedt
mesh_terms: D000818:Animals; D016923:Cell Death / Q000187:drug effects; D002470:Cell Survival / Q000187:drug effects; D003712:Dendrites / Q000187:drug effects; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D005260:Female; D051100:Glial Cell Line-Derived Neurotrophic Factor; D009043:Motor Activity / Q000187:drug effects; D009046:Motor Neurons / Q000187:drug effects / Q000473:pathology; D009414:Nerve Growth Factors / Q000627:therapeutic use*; D009416:Nerve Regeneration / Q000187:drug effects; D018696:Neuroprotective Agents / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D020127:Recovery of Function / Q000187:drug effects*; D012092:Replantation; D019782:Riluzole / Q000627:therapeutic use*; D013126:Spinal Nerve Roots / Q000187:drug effects* / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: C495041:Gdnf protein, rat; D051100:Glial Cell Line-Derived Neurotrophic Factor; D009414:Nerve Growth Factors; D018696:Neuroprotective Agents; D019782:Riluzole