Abating progressive tissue injury and preserving function after CNS trauma: The role of inflammation modulatory therapies.

Abstract

Brain and spinal cord injuries result in cognitive and/or sensorimotor impairments that can significantly diminish the quality of life for the patient and their carers, and result in healthcare system costs totaling in the billions. The current gold-standard of acute care for spinal cord injury is to administer high doses of glucocorticoids within 8 h of injury; administration after 8 h may be without effect or detrimental to the outcome of the patient. Therefore, improved pharmacological approaches for limiting the extent of tissue damage and neurological dysfunction in the acute injury setting are urgently needed. Early intervention in CNS injury by antagonizing or controlling the post-injury inflammatory process with pharmaceutical agents is a major focus of current clinical and preclinical investigations. In this editorial overview, recent clinical trials and preclinical studies of brain and spinal cord injuries are discussed, including studies focusing on the use of broad-spectrum immunosuppressive drugs (eg, minocycline); growth factors (eg, erythropoietin); dual anti-inflammatory and anti-vasospasm drugs, such as Rho and ROCK kinase inhibitors; and broad-spectrum anti-inflammatory drugs, such as PDE4 inhibitors. These new approaches hold great promise to improve outcomes for patients with brain and spinal injuries.