scholarly journals Transcriptional profiling of non-injured nociceptors after spinal cord injury reveals diverse molecular changes

2019 ◽  
Author(s):  
Jessica R. Yasko ◽  
Isaac L. Moss ◽  
Richard E. Mains

AbstractTraumatic spinal cord injury (SCI) has devastating implications for patients, including a high predisposition for developing chronic pain distal to the site of injury. Chronic pain develops weeks to months after injury, consequently patients are treated after irreparable changes have occurred. Nociceptors are central to chronic pain; however, the diversity of this cellular population presents challenges to understanding mechanisms and attributing pain modalities to specific cell types. To begin to address how peripheral sensory neurons distal to the site of injury may contribute to the below-level pain reported by SCI patients, we examined SCI-induced changes in gene expression in lumbar dorsal root ganglia (DRG) below the site of injury. SCI was performed at the T10 vertebral level, with injury produced by a vessel clip with a closing pressure of 15g for 1 minute. Alterations in gene expression produce long-term sensory changes, therefore we were interested in studying SCI-induced transcripts before the onset of chronic pain, which may trigger changes in downstream signaling pathways and ultimately facilitate the transmission of pain. To examine changes in the nociceptor subpopulation in DRG distal to the site of injury, we retrograde labeled sensory neurons projecting to the hairy hindpaw skin with fluorescent dye and collected the corresponding lumbar (L2-L6) DRG 4 days post-injury. Following dissociation, labeled neurons were purified by fluorescence-activated cell sorting. RNA was extracted from sorted sensory neurons of naïve, sham, or SCI mice and sequenced. Transcript abundances validated that the desired population of nociceptors were isolated. Cross-comparisons to data sets from similar studies confirmed we were able to isolate our cells of interest and identify a unique pattern of gene expression within a subpopulation of neurons projecting to the hairy hindpaw skin. Differential gene expression analysis showed high expression levels and significant transcript changes 4 days post-injury in SCI cell populations relevant to the onset of chronic pain. Regulatory interrelationships predicted by pathway analysis implicated changes within the synaptogenesis signaling pathway as well as networks related to inflammatory signaling mechanisms, suggesting a role for synaptic plasticity and a correlation with pro-inflammatory signaling in the transition from acute to chronic pain.Contribution to the fieldTraumatic spinal cord injury (SCI) has devastating implications for patients, including a high predisposition for developing chronic pain. Much of the pain seems to emanate from tissues further away from the brain than the site of injury. Chronic pain develops weeks to months after injury, which means that patients are frequently treated only after enduring pain has developed. Nociceptors are the specialized sensory neurons central to chronic pain. We were interested in studying SCI-induced gene transcript (RNA) changes before the onset of chronic pain, in the hope of identifying mechanisms which could become therapeutic targets. Nociceptors below the site of spinal injury were isolated and their RNAs were sequenced. The results identified a unique pattern of gene expression in the subpopulation of nociceptors projecting to the relevant peripheral tissue. Particularly interesting were sets of genes crucial to synapse formation and maturation – the ability of neurons to talk to each other – and genes involved in inflammatory responses, since treatment of inflammation of nervous tissue could also be important for therapeutic approaches. It is evident that the transition from acute to chronic pain occurs in distinct steps that involve numerous signaling pathways, providing a host of potential new drug targets.

2014 ◽  
Vol 60 (3) ◽  
pp. 188-193 ◽  
Author(s):  
Ozlem Celik Avluk ◽  
Eda Gurcay ◽  
Ozgur Zeliha Karaahmet ◽  
Ahmet Gurhan Gurcay ◽  
Oktay Gurcan ◽  
...  

Spinal Cord ◽  
2019 ◽  
Vol 57 (11) ◽  
pp. 953-959 ◽  
Author(s):  
Laura Mordillo-Mateos ◽  
Antonio Sánchez-Ramos ◽  
Francesca Coperchini ◽  
Ines Bustos-Guadamillas ◽  
Carlos Alonso-Bonilla ◽  
...  

2016 ◽  
Vol 37 (3) ◽  
pp. 1355 ◽  
Author(s):  
Marta Rocha Araujo ◽  
Pablo Herthel Carvalho ◽  
Taís Silva de Paula ◽  
Bárbara Silva Okano ◽  
Ricardo Junqueira Del Carlo ◽  
...  

Traumatic spinal cord injury results in severe neurological deficits, mostly irreversible. The cell therapy represents a strategy for treatment particularly with the use of stem cells with satisfactory results in several experimental models. The aim of the study was to compare the treatment of spinal cord injury (SCI) with and without mesenchymal stem cells (MSC), to investigate whether MSCs migrate and/or remain at the site of injury, and to analyze the effects of MSCs on inflammation, astrocytic reactivity and activation of endogenous stem cells. Three hours after SCI, animals received bone marrow-derived MSCs (1×107 in 1mL PBS, IV). Animals were euthanized 24 hours, 7 and 21 days post-injury. The MSC were not present in the site of the lesion and the immunofluorescent evaluation showed significant attenuation of inflammatory response with reduction in macrophages labeled with anti-CD68 antibody (ED1), decreased immunoreactivity of astrocytes (GFAP+) and greater activation of endogenous stem cells (nestin+) in the treated groups. Therefore, cell transplantation have a positive effect on recovery from traumatic spinal cord injury possibly due to the potential of MSCs to attenuate the immune response.


2020 ◽  
Author(s):  
Lisa Nicole Sharwood ◽  
Bharat P Vaikuntam ◽  
Christiana L Cheng ◽  
Vanessa Noonan ◽  
Anthony P Joseph ◽  
...  

Background Timely treatment is essential for achieving optimal outcomes after traumatic spinal cord injury (TSCI), and expeditious transfer to a specialist spinal cord injury unit (SCIU) is recommended within 24 hours from injury. Previous research in New South Wales (NSW) found only 57% of TSCI patients were admitted to SCIU for acute post-injury care; 73% transferred within 24 hours from injury. Methods This record linkage study included administrative pre-hospital, admissions and costs data for all patients aged ≥16 years with incident TSCI in NSW (2013-2016). Its aim was to examine potential geographical disparities in access to specialist care following TSCI using geospatial methods, and to better understand the impact of post-injury care pathways on patient outcomes. Results Of 316 cases with geospatial data, injury location analysis showed that over half (53%, n=168) of all patients were injured within 60 minutes road travel of a SCIU, yet only 28.6% (n=48) were directly transferred to a SCIU. Direct transfers received earlier operative intervention (median (IQR) 12.9(7.9) hours), compared with patients transferred indirectly to SCIU (median (IQR) 19.5(18.9) hours), and had lower risk of complications (OR 3.2 v 1.4, p<0.001). Conclusions Getting patients with acute TSCI patients to the right place at the right time is dependent on numerous factors; some are still being triaged directly to non-trauma services which delays specialist and surgical care and increases complication risks. More stringent adherence to recommended guidelines would prioritise direct SCIU transfer for patients injured within 60 minutes radius, enabling the benefits of specialised care.   


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa N. Sharwood ◽  
David Whyatt ◽  
Bharat P. Vaikuntam ◽  
Christiana L. Cheng ◽  
Vanessa K. Noonan ◽  
...  

Abstract Background Timely treatment is essential for achieving optimal outcomes after traumatic spinal cord injury (TSCI), and expeditious transfer to a specialist spinal cord injury unit (SCIU) is recommended within 24 h from injury. Previous research in New South Wales (NSW) found only 57% of TSCI patients were admitted to SCIU for acute post-injury care; 73% transferred within 24 h from injury. We evaluated pre-hospital and inter-hospital transfer practices to better understand the post-injury care pathways impact on patient outcomes and highlight areas in the health service pathway that may benefit from improvement. Methods This record linkage study included administrative pre-hospital (Ambulance), admissions (Admitted Patients) and costs data obtained from the Centre for Health Record Linkage, NSW. All patients aged ≥16 years with incident TSCI in NSW (2013–2016) were included. We investigated impacts of geographical disparities on pre-hospital and inter-hospital transport decisions from injury location using geospatial methods. Outcomes assessed included time to SCIU, surgery and the impact of these variables on the experience of inpatient complications. Results Inclusion criteria identified 316 patients, geospatial analysis showed that over half (53%, n = 168) of all patients were injured within 60 min road travel of a SCIU, yet only 28.6% (n = 48) were directly transferred to a SCIU. Patients were more likely to experience direct transfer to a SCIU without comorbid trauma (p < 0.01) but higher ICISS (p < 0.001), cervical injury (p < 0.01), and transferred by air-ambulance (p < 0.01). Indirect transfer to SCIU was more likely with two or more additional traumatic injuries (p < 0.01) or incomplete injury (p < 0.01). Patients not admitted to SCIU at all were older (p = 0.05) with lower levels of injury (p < 0.01). Direct transfers received earlier operative intervention (median (IQR) 12.9(7.9) hours), compared with patients transferred indirectly to SCIU (median (IQR) 19.5(18.9) hours), and had lower risk of complications (OR 3.2 v 1.4, p < 0.001). Complications included pressure injury, deep vein thrombosis, urinary infection, among others. Conclusions Getting patients with acute TSCI patients to the right place at the right time is dependent on numerous factors; some are still being triaged directly to non-trauma services which delays specialist and surgical care and increases complication risks. The higher rates of complication following delayed transfer to a SCIU should motivate health service policy makers to investigate reasons for this practice and consent to improvement strategies. More stringent adherence to recommended guidelines would prioritise direct SCIU transfer for patients injured within 60 min radius, enabling the benefits of specialised care.


2012 ◽  
Vol 1438 ◽  
pp. 8-21 ◽  
Author(s):  
Benjamin E. Keeler ◽  
Gang Liu ◽  
Rachel N. Siegfried ◽  
Victoria Zhukareva ◽  
Marion Murray ◽  
...  

2020 ◽  
Author(s):  
Lisa Nicole Sharwood ◽  
David Whyatt ◽  
Bharat P Vaikuntam ◽  
Christiana L Cheng ◽  
Vanessa K Noonan ◽  
...  

Abstract BackgroundTimely treatment is essential for achieving optimal outcomes after traumatic spinal cord injury, and expeditious transfer to a specialist spinal cord injury unit is recommended within 24 hours from injury. Previous research in New South Wales found only 57% of TSCI patients were admitted to specialist spinal cord injury unit for acute post-injury care; 73% transferred within 24 hours from injury. We evaluated pre-hospital and inter-hospital transfer practices to identify opportunities for improving care delivery. MethodsThis record linkage study included administrative pre-hospital, admissions and costs data for all patients aged ≥16 years with incident traumatic spinal cord injury in New South Wales (2013-2016). We investigated impacts of geographical disparities on pre-hospital and inter-hospital transport decisions from injury location using geospatial methods to better understand the post-injury care pathways impact on patient outcomes.ResultsInclusion criteria identified 316 patients, geospatial analysis showed that over half (53%, n=168) of all patients were injured within 60 minutes road travel of a SCIU, yet only 28.6% (n=48) were directly transferred to a specialist spinal cord injury unit. Direct transfers received earlier operative intervention (median (IQR) 12.9(7.9) hours), compared with patients transferred indirectly to specialist spinal cord injury unit (median (IQR) 19.5(18.9) hours), and had lower risk of complications (OR 3.2 v 1.4, p<0.001).ConclusionsGetting patients with acute traumatic spinal cord injury patients to the right place at the right time is dependent on numerous factors; some are still being triaged directly to non-trauma services which delays specialist and surgical care and increases complication risks. More stringent adherence to recommended guidelines would prioritise direct specialist spinal cord injury unit transfer for patients injured within 60 minutes radius, enabling the benefits of specialised care.


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