In this paper we provide evidence that matrix stiffness regulates intracellular

not improve long-term neurological recovery. Rather, DMSO alone was responsible for the beneficial outcomes in dogs with severe SCIs. The clinical trial BML-210 described here was designed to Ellipticine include dogs with both severe and mild-tomoderate SCIs for several reasons. First, there is an abnormal elevation of MMP-9 in serum, CSF and spinal cords of dogs with IVDH across a spectrum of injury severities. Second, while longterm recovery of ambulation is common in the mild-to-moderate injury group, few animals normalize with reference to motor or postural scores. Thus, there is an opportunity, even within animals that are likely to show marked recovery, to examine the effect of therapeutics. We chose to stratify our population based on SCI severity to examine the effect of treatment on neurologic recovery. This approach was necessary given the well-known difference in outcome between these populations and the potential for differential activation of secondary injury pathways based on SCI severity. Stratification based on SCI severity is common and accepted in human clinical trials because of expected differences in recovery between injury groups and the potential impact of this difference on evaluation of effectiveness of therapies. GM6001 is a broad-spectrum MMP inhibitor that has been shown to exert neuroprotection in rodent models of brain and SCIs, primarily via antagonism of MMP-9 associated with neutrophils. Evidence supporting this position includes a temporal association between neutrophil trafficking and MMP-9 expression, reduced expression of MMP-9 in spinal cord injured mice that are neutrophil-depleted, and reduced neutrophil content within injured spinal cords of MMP-9 null mice. In this study, GM6001 was delivered SC using DMSO as a vehicle. While the high prevalence of injection site reactions and route of administration may have altered drug absorption in comparison to studies in other species, our data support favorable PK via SC administration of GM6001. Furthermore, relatively small plasma concentrations of GM6001 present 3 days post-delivery appear capable of modulating MMP-2/MMP-9 activity in study dogs. Here we studied the effects of GM6001 on MMP-2/MMP-9 activity in serum. While there was no relationship between injury severity and level of MMP-2/9 activity in serum, spinal cord injured dogs showed a

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