**4.2 Growth factors**

*Neuroprotection - New Approaches and Prospects*

and their neuroprotective effect after SCI.

Vitamin E Increases functional recovery.

damage.

and TNFα.

recovery

expression.

First damage in the acute phase of injury is generated in membranes, membranes which are susceptible to the attack of ROS and reactive nitrogen species (RNS). ROS are produced in metabolic and physiological processes of cells; however, they are overproduced by inflammatory response. ROS and RNS induce LPO, which leads to demyelinating processes. Among the nonpharmacological therapies to prevent

Vitamins are one of the main natural antioxidants. **Table 3** shows some vitamins

Resveratrol is a natural polyphenolic compound that has exhibited beneficial

health properties as well as antioxidant, anti-inflammatory, and antitumor effects. Resveratrol exerts a neuroprotective effect by regulating apoptosis [118]. Studies have shown that the anti-inflammatory effects of resveratrol are mediated mainly by sirtuin (SIRT) 1 [119, 120]. Resveratrol enhances locomotor recovery [121–123]. Furthermore, resveratrol increases nuclear factor erythroid 2-related factor (Nrf-2) activation, providing antioxidant effects [121]. Further investigation is needed in order to provide more evidence about the efficacy of this

**Treatment Neuroprotection mechanism Ref.**

peroxidase and improves functional recovery.

Down-regulates the levels of TNFα and IL-1β. Modulates antioxidant status and MPO activity

Vitamin C Stops lipid hydroperoxyides formation and decreases membrane

Inhibits ROS generation and LPO.

barrier disruption after SCI.

of neutrophils and macrophages.

Vitamin A Increases the expression of IL-1β, IL-6, and TNFα after SCI.

Reduces cavitation and decreases FR, LPO, and glutathione

Decreases levels of proteins like NF-kB, iNOS, and COX-2.

Reduces necrotic tissues and improves functional recovery in rats.

Co-treatment with vitamin C + fluoxetine inhibits the blood-SC

Inhibits apoptotic cell death and improves functional recovery.

Inhibits capillary fragmentation by reducing mRNA levels of MMP-9. Prevents degradation of tight-junction proteins, inhibits infiltration

Systemic administration reduces early transcript levels of IL-1β, IL-6,

Reduces blood-SC-barrier permeability and improves functional

Decreases levels of β-catenin, P120 catenin, occluding, and claudin5. Inhibits endocytoplasmic reticulum stress and caspase-12

[108–112]

[113, 114]

[115]

[116]

[117]

damage from FR are nonenzymatic antioxidants like vitamins.

**4.1 Antioxidants**

*4.1.1 Vitamins*

*4.1.2 Resveratrol*

treatment.

Vitamin C + fluoxetine

**168**

**Table 3.**

*Vitamins in spinal cord injury.*

The use of growth factors like BDNF, transforming growth factor-β (TGF-β), and insulin-like growth factor-1 (IGF-1) as a therapy to improve morphological and behavioral outcomes after SCI has been topic of study of many investigations.
