Protective Role of Platelet Rich Plasma in Cardiovascular Dysfunction and Autonomic Dysreflexia Induced by Spinal Cord Injury in Rats

Background: Patients with spinal cord injury (SCI) have a high risk of cardiovascular complications during the acute phase following the trauma, affecting their prognosis and quality of life. These cardiovascular complications require prompt medical attention to avoid neurological compromisation, morbidity, and mortality. This work aims to provide an overview of the impact of platelet-rich plasma (PRP) treatment on SCI and its cardiovascular hazardous sequelae. Methods: 26 adult female Wister rats were randomly allocated into three groups; shamoperated control group, a group that underwent compression of the spinal cord at the T4 level, with no further intervention (SCI group), and a treated group with PRP following spinal cord injury at T4 level on the site of injury (SCI-PRP group). Mean arterial pressure (MAP), heart rate (HR), as well as core temperature, were recorded under basal conditions and in response to colorectal distension (CRD). Results: Under the basal condition, hypotension and hypothermia were observed during the initial 4 weeks post-injury while tachycardia was prominent all through the study starting from the 2 week onwards in the SCI rats compared to sham controls. Meanwhile, the study of cardiovascular sequelae of SCI in response to CRD revealed a marked elevation in the MAP, hyperthermia as well as bradycardia associated with ventricular/supraventricular ectopic rhythm in the SCI group which may be accounted for by autonomic dysreflexia (AD). PRP treatment ameliorated partially the cardiovascular complications under basal conditions and in response to CRD as well. Moreover, rats with SCI showed a significant increase in atherogenic index, body weight gain in addition to hypercholesterolemia and hypertriglyceridemia. This effect was blunted in the SCI-PRP group compared to the SCI group, though not normalized. Histopathological and electron microscopic (EM) examination revealed that the SCI-PRP group had more myelinated regenerating axons of the spinal cord (SC) than the injured group but fewer than the sham group. Conclusion: The application of PRP immediately to the site of SCI facilitated its regeneration, had a potential repairing effect, and prevented, at least partially, cardiovascular complications.