A preliminary study of intravenous surfactants in paraplegic dogs: Polymer therapy in canine clinical SCI
A preliminary study of intravenous surfactants in paraplegic dogs: Polymer therapy in canine clinical SCI
复制标题
DOI：
10.1089/0897715042664867
复制
发表时间：
2004-12-01
影响因子：
4.2
通讯作者：
Borgens, RB
中科院分区：
文献类型：
--
作者：
Laverty, PH;Leskovar, A;Borgens, RB
已知亲水性聚合物（表面活性剂和三嵌段聚合物）可以密封细胞膜中的缺陷。在之前使用实验室动物进行的实验中，我们利用聚乙二醇（PEG）的这种能力来修复豚鼠严重、标准化脊髓损伤（SCI）后的脊髓轴突。使用相关的共聚物泊洛沙姆 188 (P 188) 进行了类似的研究。在这里，我们对静脉注射 PEG 或 P 188（3500 道尔顿，30·70 w/w 的生理盐水；分别为 2 mL/kg I.V. 和 2 mL/kg 体重或 300 mL P 188/kg）对狗的神经完全性截瘫病例进行了初步研究。我们的目的是首先确定对于狗自然发生的严重 SCI 病例，这是否是一种临床安全的手术。其次，我们希望获得初步证据，与大量类似但历史的对照病例相比，这种疗法是否具有临床益处。严格的进入标准只允许招募神经系统完全截瘫的狗进入这项研究。在入院后约 72 小时内，通过常规技术和实验技术相结合的方法对动物进行继发于急性、爆炸性椎间盘突出症的脊柱创伤的治疗。结果测量包括自愿行走、深浅疼痛知觉、后肢有意识本体感觉和诱发电位（体感诱发电位[SSEP]）的测量。我们确定聚合物注射是犬严重神经损伤常规治疗的安全辅助手段。我们没有观察到聚合物注射有任何不可接受的临床反应；没有死亡，也没有因该程序引起或与之相关的任何其他问题。与历史病例相比，注射聚合物改善了 6-8 周试验的结果指标。与这些比较组相比，这种恢复出乎意料地快。该试点试验的结果提供了与以下观点一致的证据：在急性神经创伤中注射无机聚合物可能是损伤急性期的一种简单而有用的干预措施。
Hydrophilic polymers, both surfactants and triblock polymers, are known to seal defects in cell membranes. In previous experiments using laboratory animals, we have exploited this capability using polyethylene glycol (PEG) to repair spinal axons after severe, standardized spinal cord injury (SCI) in guinea pigs. Similar studies were conducted using a related co-polymer Poloxamer 188 (P 188). Here we carried out initial investigations of an intravenous application of PEG or P 188 (3500 Daltons, 30 70 w/w in saline; 2 mL/kg I.V. and 2 mL/kg body weight or 300 mL P 188 per kg, respectively) to neurologically complete cases of paraplegia in dogs. Our aim was to first determine if this is a clinically safe procedure in cases of severe naturally occurring SCI in dogs. Secondarily, we wanted to obtain preliminary evidence if this therapy could be of clinical benefit when compared to a larger number of similar, but historical, control cases. Strict entry criteria permitted recruitment of only neurologically complete paraplegic dogs into this study. Animals were treated by a combination of conventional and experimental techniques within similar to72 h of admission for spinal trauma secondary to acute, explosive disk herniation. Outcome measures consisted of measurements of voluntary ambulation, deep and superficial pain perception, conscious proprioception in hindlimbs, and evoked potentials (somatosensory evoked potentials [SSEP]). We determined that polymer injection is a safe adjunct to the conventional management of severe neurological injury in dogs. We did not observe any unacceptable clinical response to polymer injection; there were no deaths, nor any other problem arising from, or associated with, the procedures. Outcome measures over the 6-8-week trial were improved by polymer injection when compared to historical cases. This recovery was unexpectedly rapid compared to these comparator groups. The results of this pilot trial provides evidence consistent with the notion that the injection of inorganic polymers in acute neurotrauma may be a simple and useful intervention during the acute phase of the injury.