Effects of cerebrolysin on spinal cord injury; a narrative review

Background and Aim : Spinal cord injury (SCI) is one of the most common neurological diseases among central nervous system (CNS) deficiency. According to the World Health Organization reports, the prevalence and epidemiology of SCI around the world are between 250,000 to 500,000 people every year, and annually about 11,000 new cases added to this population. Following the SCI, conduction of the normal motor and sensory neurons, as well as the autonomic function has been changed temporary across the site(s) of the lesion(s). inasmuch as CNS is unable to recover itself truly, SCI recovery faces numerous challenges. The early management of SCI was surgical decompression and steroid therapy for blood pressure augmentation, in the next stage, some treatment approaches like pharmacological and non-pharmacologic therapies, and stem cell therapies were recommended. Cerebrolysin (CL) is a biotechnologically produced drug with a combination of low molecular weight peptides derived from pig brain, consisting of important neurotrophic factors such as BDNF, GDNF, NGF, ciliary neurotrophic factor and free amino acids. A remarkable similarity was shown among the pharmacological features of CL and endogenous neurotrophic factors. CL is one of the important treatment strategies in CNS dysfunctions, so the aim of this review was considering the influence of spinal cord injuries.Methods : This study conducted based on a comprehensive search from the last ten years, and articles related to the effects of cerebrolysin on spinal cord injury were considered.Results : The neurotrophic aspects and potential neuroprotection properties of CL have made it a choice for the treatment of neurological diseases in the clinical setting. In CNS injuries, such as multiple sclerosis, dementia, Parkinson’s disease, Alzheimer’s disease, and acute or chronic stroke, CL is used to neuronal regeneration and neuroprotection in these diseases. In SCI animals, CL has been proven to improved neuroprotection inside the spinal cord, and its effect is time- and dose-dependent. Also, CL induces significant neuroprotection and marked a reduction in neural injury, glial cell activation, reduction in blood-spinal cord barrier (BSCB) breakdown and edema formation, caused to the survival of motoneurons following ventral root avulsion, prevents apoptosis of lesioned motoneurons and promotes functional recovery in rats after SCI.Conclusion : Our investigations show that Cerebrolysin as a mixed growth factor could play a critical role in the improvement of neural pathways, neuroprotection, and neurogenesis in the spinal cord injured rats.

Keywords:

Spinal cord injury , cerebrolysin , animal