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Dr Saadoun and Prof Papadopoulos have been developing novel treatments for acute and chronic spinal cord injury. New techniques to monitor pressure, blood flow and metabolism in the injured spinal cord of patients in the neuro-intensive care unit may aid in improving patient outcome.

Traumatic spinal cord injury can lead to severe disability. The aim of research by S Saadoun and MC Papadopoulos is to better understand some of the mechanisms that can cause permanent damage and develop novel treatments to improve patient outcome.

Research highlights

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Spinal cord injury

Spinal cord injury is a devastating condition that primarily affects young people. There is no treatment for acute, severe spinal cord injury that improves outcome. The swelling of the spinal cord that occurs after injury causes further damage due to cord compression. To help guide clinical management, we set up a clinical trial termed ISCoPE, aiming to develop novel techniques to monitor the pressure at the injury site (intra spinal pressure, ISP), the spinal cord perfusion pressure (SCPP = arterial pressure minus ISP) and to compute the optimum SCPP (SCPPopt) in real time.

 Two photos, on the left is a photo taken during surgery showing insertion of probe through the dura to measure intra spinal pressure. Right is a CT scan taken after surgery shows the position of the probe in the spinal canal.

(Left) Photo taken during surgery showing insertion of probe through the dura to measure intra spinal pressure. (Right) CT scan taken after surgery shows the position of the probe in the spinal canal.

Aquaporins

Aquaporins (AQPs) are a family of water channel proteins within plasma cell membranes that facilitate the flow of water into and out of cells. We study the role of aquaporins in the brain and spinal cord, including spinal cord injury and neuromyelitis optica (NMO). NMO is an autoimmune disease caused by antibodies against aquaporin-4 (AQP4), termed AQP4-IgG. We showed that aquaporins are involved in cell migration, that AQP4-IgG is pathogenic in NMO and that reducing cord swelling after spinal cord injury improves outcome.

 AQP4-expressing CHO cells in culture exposed to AQP4-IgG and human complement. (Left) Cell death assay showing live (green) and dead (red) cells. (Right) Deposition of membrane attack complex (C5b-9, red) on plasma cell membrane. Experiment performed by D

AQP4-expressing CHO cells in culture exposed to AQP4-IgG and human complement. (Left) Cell death assay showing live (green) and dead (red) cells. (Right) Deposition of membrane attack complex (C5b-9, red) on plasma cell membrane. Experiment performed by Dr S. Saadoun. See Brain 2010, 133:349.

 

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