Experimental Study Of Combined Treatment With Methylprednisolone And Melatonin On The Acute Spinal Cord Injury

Preface:Spinal cord injury (SCI)results in the loss of function below the lesion. Secondary injury following the primary impact includes a number of biochemical and cellular alterations leading to tissue necrosis and cell death. Among the numerous pathophydiological mechanisms had been postulated to explain the secondary damage,oxygen free radical-induced lipid peroxidation is one of the most important factors participating in posttraumatic degeneration of the spinal cord.Methylprednisolone (MP), by reducing edema and protecting the cell membrane against peroxidation, is the only pharmacological agent with a proven clinically beneficial effect on SCI. Melatonin, known as a free radical scavenger, has been shown to have an effect on lipid peroxidation following experimental SCI,and it has been showed better ultrastructural findings than MP. The purpose of this study was to examine the therapeutic efficay of MP and melatonin combined treatment modalities on the Acute spinal cord injury.Methods:Adult Wirst rats weighing 200–250 g were randomized into four groups of 18 rats each .Allen,s weight-drop trauma was performed for each group and a 30-mg/kg single dose of MP for rats in group 1, a 10-mg/kg single dose of melatonin for rats in group 2,and MP and melatonin in the same doses for rats in group 3 were administered immediately after trauma. The rats in group 4 were the control group (treated with ethanol). Every group was divided into three subsets: the posttraumatic 4th hour, the posttraumatic 24th hour and the posttraumatic 10th day. There are 6 rats in every subset at least.The rats were terminated at the 4th hour, the 24th hour, and on the 10th day posttraumatic. Neurological recovery of the 10 days group was recorded using"motor function score"and inclined plane test at the 1th,3th,5th,10th day.The lipid peroxidation level of the injured site of the spinal cord was observed by the determination of MDA of the injured site of the spinal cord.A observation of patho-morph of the injured site of the spinal cord was made by HE coloretur, Olsiwski,s body coloretur. Electron microscopic studies were performed to determine the effects of melatonin, MP, and the combined treatment with MP and melatonin on axons, neurons, myelin, nucleus, and intracytoplasmic edema.Result:The groups treated with MP, melatonin, and a combination of both had significantly enhanced on lipid peroxidation, and score of ethology and also showed better patho-morph and ultrastructural findings than the ethanol groups. But the three treated groups were at the same level on the obove mentioned aspects.Conclusion: The therapeutic efficay of MP, melatonin, and MP and melatonin combined treatment modalities is at the same level on the Acute spinal cord injury. Future studies involving different doses of melatonin and different dose combinatiothewith MP could promise better results since each drug has a different antioxidative mechanism of action.