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  4. Neuronal Pre- and Postconditioning via Toll-like Receptor 3 Agonist or Extracorporeal Shock Wave Therapy as New Treatment Strategies for Spinal Cord Ischemia: An In Vitro Study

Neuronal Pre- and Postconditioning via Toll-like Receptor 3 Agonist or Extracorporeal Shock Wave Therapy as New Treatment Strategies for Spinal Cord Ischemia: An In Vitro Study

J. Clin. Med., 2022 · DOI: 10.3390/jcm11082115 · Published: April 11, 2022

Spinal Cord InjuryImmunologyOrthopedics

Simple Explanation

This study investigates potential treatments for spinal cord ischemia (SCI), a serious complication of aortic repair surgery. Researchers explored whether pre-treating or post-treating nerve cells with a Toll-like receptor 3 (TLR3) agonist or shock wave therapy (SWT) could reduce damage after a simulated ischemic event in cultured cells. The study found that both TLR3 activation and SWT could decrease apoptosis (cell death) and pro-inflammatory cytokine expression in vitro. Specifically, pre-ischemic TLR3 activation seemed more effective, while post-ischemic SWT also showed promise. These findings suggest that TLR3 agonists and SWT might offer new treatment strategies for ischemic spinal cord injury by reducing inflammation and cell death in the spinal cord after aortic repair.

Study Duration
Not specified
Participants
Cultured SHSY-5Y cells
Evidence Level
In Vitro Study

Key Findings

  • 1
    TLR3 activation via poly(I:C) significantly reduced apoptotic markers in both pre- and postconditioning, with preconditioning yielding more favorable results due to additional suppression of TLR4 signaling.
  • 2
    SWT showed slightly more favorable effects in postconditioning with significantly reduced markers of apoptosis.
  • 3
    Both poly(I:C) and SWT resulted in a shift in the genetic expression of (pro)inflammatory cytokines.

Research Summary

The study investigated the effects of pre- and postconditioning with a TLR3 agonist (poly(I:C)) or shock wave therapy (SWT) on spinal cord ischemia (SCI) in cultured SHSY-5Y cells. TLR3 activation with poly(I:C) reduced apoptotic markers in both pre- and postconditioning, with preconditioning also suppressing TLR4 signaling. SWT was more effective in postconditioning in reducing apoptosis. The findings suggest that both TLR3 agonists and SWT could be potential treatment strategies for ischemic spinal cord injury by decreasing apoptosis and pro-inflammatory cytokine expression.

Practical Implications

Potential Therapeutic Strategies

The study suggests that both TLR3 agonists and SWT could be explored as potential therapeutic strategies for mitigating spinal cord ischemia following aortic repair.

Modulation of Inflammation

The research highlights the importance of modulating inflammation in the context of SCI and provides insights into how TLR3 activation and SWT can influence the inflammatory response.

Neuroprotection

The findings indicate that pre- and postconditioning with TLR3 agonists or SWT can offer neuroprotection by reducing neuronal apoptosis in the setting of ischemic neuronal injury.

Study Limitations

  • 1
    In vitro study, which may not fully replicate the complexity of in vivo conditions.
  • 2
    The significance of the findings in a clinical setting of spinal cord ischemia cannot be comprehensively evaluated yet.
  • 3
    Clinical applications of poly(I:C) as peri-interventional conditioning strategies are improbable due to its toxic effects in vivo.

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