Gifts from the molecular revolution: protection and repair of the injured spinal cord.
Progress in molecular neurobiology is occurring at an accelerating rate, and the newer results carry with them an almost unprecedented degree of specificity. This, together with the development of techniques that permit, at least in principle, the targeting of DNA, RNA, and proteins in vivo, opens up a spectrum of possible new interventions, which almost certainly will have significant impact on the search for new therapies, and ultimately cures, for spinal cord injury and its consequences. This article outlines several areas of progress, based on progress in the author's laboratory, which supports the suggestion that, in the foreseeable future, it will be possible to protect and repair the injured spinal cord. In particular, this article focuses on progress in 3 interrelated areas: (a) neuroprotection (ie, the search for treatments that will protect vulnerable axons within the descending and ascending tracts within the spinal cord, so that they do not die after the initial traumatic insult); (b) restoration of conduction in spinal cord axons that survive the traumatic insult but fail to conduct impulses due to damage to their myelin; and (c) the targeting of molecules along the pain-signaling pathway, so as to reduce neuronal hyperexcitability that produces pain following SCI. Although much work remains to be done, we are coming much closer to our goals in each of these areas, and the overall objective--of protecting and repairing the injured spinal cord--appears achievable.
Waxman
Stephen G
SG
Department of Neurology, Center for Neuroscience and Regeneration Research, LCI 707, Yale School of Medicine, 15 York Street, New Haven, CT 06520-8018, USA. stephen.waxman@yale.edu
D000818:Animals; D001369:Axons; D008967:Molecular Biology / Q000379:methods*; D009416:Nerve Regeneration; D009431:Neural Conduction; D018696:Neuroprotective Agents / Q000494:pharmacology*; D010146:Pain / Q000503:physiopathology; D010166:Palliative Care; D013116:Spinal Cord / Q000187:drug effects*; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000628:therapy*
D018696:Neuroprotective Agents