Adenosine A_2A analogue improves neurologic outcome after supinal cord trauma in the rabbit

Background ATL-146e, an adenosine A_2A agonist, reduces paralysis after supinal cord ischemia-reperfusion. We hypothesized that systemic ATL-146e could improve neurologic outcome after blunt supinal cord trauma. Methods Twenty rabbits survived a thoracic supinal cord impact of 30 g-cm. One group received 0.06 μg/kg/min ATL-146e for the first 3 hours after impact (A2A group), whereas a second group received saline carrier (T/C group). Neurologic outcome was measured using the Tarlov scale (0-5). Histologic sections from the A2A and T/C groups were compared for neuronal viability. Results There was significant improvement in Tarlov scores of A2A animals compared with T/C animals at 12 hours (p = 0.007), with a trend toward improvement at 36 (p = 0.08) and 48 (p = 0.09) hours after injury. There was decreased neuronal attrition in A2A animals (p = 0.06). Conclusion Systemic ATL-146e given after supinal cord trauma results in improved neurologic outcome. Adenosine A_2A agonists may hold promise as a rapidly acting alternative to steroids in the early treatment of the supinal cord injured patient.