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J Neurosci. 2011 Apr 20;31(16):5977-88. doi: 10.1523/JNEUROSCI.4498-10.2011.

Inosine augments the effects of a Nogo receptor blocker and of environmental enrichment to restore skilled forelimb use after stroke.

The Journal of neuroscience : the official journal of the Society for Neuroscience

Laila Zai, Christina Ferrari, Carlie Dice, Sathish Subbaiah, Leif A Havton, Giovanni Coppola, Daniel Geschwind, Nina Irwin, Eric Huebner, Stephen M Strittmatter, Larry I Benowitz

Affiliations

  1. Laboratories for Neuroscience Research in Neurosurgery, Children's Hospital, Boston, Massachusetts 02115, USA.

PMID: 21508223 PMCID: PMC3101108 DOI: 10.1523/JNEUROSCI.4498-10.2011

Abstract

Stroke is the leading cause of disability in much of the world, with few treatment options available. Following unilateral stroke in rats, inosine, a naturally occurring purine nucleoside, stimulates the growth of projections from the undamaged hemisphere into denervated areas of the spinal cord and improves skilled use of the impaired forelimb. Inosine augments neurons' intrinsic growth potential by activating Mst3b, a component of the signal transduction pathway through which trophic factors regulate axon outgrowth. The present study investigated whether inosine would complement the effects of treatments that promote plasticity through other mechanisms. Following unilateral stroke in the rat forelimb motor area, inosine combined with NEP1-40, a Nogo receptor antagonist, doubled the number of axon branches extending from neurons in the intact hemisphere into the denervated side of the spinal cord compared with either treatment alone, and restored rats' level of skilled reaching using the impaired forepaw to preoperative levels. Similar functional improvements were seen when inosine was combined with environmental enrichment (EE). The latter effect was associated with changes in gene expression in layer 5 pyramidal neurons of the undamaged cortex well beyond those seen with inosine or EE alone. Inosine is now in clinical trials for other indications, making it an attractive candidate for the treatment of stroke patients.

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