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Rapid and robust restoration of breathing long after spinal cord injury

Research output: Contribution to journalArticlepeer-review

Philippa M. Warren, Stephanie Steiger, Thomas Dick, Peter MacFarlane, Warren Alilain, Jerry Silver

Original languageEnglish
Article number 4843
JournalNature Communications
Early online date27 Nov 2018
Accepted/In press3 Oct 2018
E-pub ahead of print27 Nov 2018
Published27 Nov 2018


King's Authors


There exists an abundance of barriers that hinder functional recovery following spinal cord injury, especially at chronic stages. Here, we examine the rescue of breathing up to 1.5 years following cervical hemisection in the rat. In spite of complete hemidiaphragm paralysis, a single injection of chondroitinase ABC in the phrenic motor pool restored robust and persistent diaphragm function while improving neuromuscular junction anatomy. This treatment strategy was more effective when applied chronically than when assessed acutely after injury. The addition of intermittent hypoxia conditioning further strengthened the ventilatory response. However, in a sub-population of animals, this combination treatment caused excess serotonergic (5-HT) axon sprouting leading to aberrant tonic activity in the diaphragm that could be mitigated via 5-HT2 receptor blockade. Through unmasking of the continuing neuroplasticity that develops after injury, our treatment strategy ensured rapid and robust patterned respiratory recovery after a near lifetime of paralysis.

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