The efficacy of erythropoietin on acute spinal cord injury. An experimental study on a rat model.
BACKGROUND
The accumulated knowledge of erythropoietin (EPO) interaction in neural injury has led to potentially novel therapeutic strategies. Previous experimental studies of recombinant human EPO (rhEPO) administration have shown favorable results after central and peripheral neural injury. In the present study we used the aneurysmal clip model to evaluate the efficacy of two different regimes of rhEPO administration on the functional outcome after severe acute spinal cord injury (ASCI).


METHODS
Thirty rats were operated on with posterior laminectomy at thoracic 10th vertebra. Spinal cord trauma produced by extradural placement of the aneurysm clip, for 1 min. Animals were divided into three groups; the first group received a low total EPO dose (EPO-L), (2 doses of 1,000 IU each s.c.). The second group was administered the high total EPO dose (EPO-H), (14 doses of 1,000 IU each s.c.), and the third was the Control group, which received normal saline in the same time fashion with EPO-H group. Follow-up was for 6 weeks. Estimation of the functional progress of each rat was calculated using the locomotor rating scale of Basso et al, with a range from 0 to 21.


RESULTS
After surgery the animals suffered paraplegia with urinary disturbances. Rats that received EPO demonstrated statistically significant functional improvement compared to the Control group, throughout study interval. On the last follow-up at 6 weeks the EPO-L rats achieved a mean score 17.3 +/- 1.15, the EPO-H 14.7 +/- 1.82, and the control group 8.2 +/- 0.78. Comparison between the two EPO groups reveals superior final outcome of the group treated with lower total dose.


CONCLUSIONS
Our study supports current knowledge, that EPO administration has a positive effect on functional recovery after experimental ASCI. These data reflect the positive impact of EPO on the pathophysiologic cascade of secondary neural damage. However, we observed a dose-related effect on functional recovery. Interestingly, large doses do not seem to favor the neurological recovery as lower doses do.
Kontogeorgakos
Vasileios A
VA
Department of Orthopaedic Surgery, School of Medicine, University of Ioannina, Ioannina 45110, Greece. kontogeorgakosav@hotmail.com
Voulgaris
Spyridon
S
Korompilias
Anastasios V
AV
Vekris
Marios
M
Polyzoidis
Konstantinos S
KS
Bourantas
Konstantinos
K
Beris
Alexandros E
AE
D000818:Animals; D002491:Central Nervous System Agents / Q000008:administration & dosage*; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D051381:Rats; D017208:Rats, Wistar; D011994:Recombinant Proteins; D013119:Spinal Cord Injuries / Q000188:drug therapy*; D016896:Treatment Outcome
D002491:Central Nervous System Agents; D011994:Recombinant Proteins; D004921:Erythropoietin