What were the researchers looking at and why?
The researchers were investigating the use of a drug called Cilostazol in cervical spondylotic myelopathy (CSM). This drug has been shown to be a safe and effective drug in humans, which can reduce nerve cell damage. The group therefore wanted to test whether this drug can protect nerve cells in CSM.
What did this study show?
Rats with CSM had reduced running ability on a treadmill and reduced grip strength. There was also increased loss of nerve cells. Rats that received the drug Cilostazol had preserved grip strength and running ability. Cilostazol also prevented nerve cell loss.
Cilostazol is a drug, which inhibits the enzyme phosphodiesterase (PDE). PDE normally breaks down a molecule called cyclic adenosine monophosphate (cAMP). cAMP is involved in relaxation of the blood vessels. Cilostazol therefore increases levels of cAMP and causes relaxation of the blood vessels. Cilostazol may therefore improve function in CSM by widening the blood vessels and improving blood flow (Figure 1).
Cilostazol appears to improve function in CSM, however its' mechanism of action in CSM needs to be studied. In particular, its effect on blood flow and whether it does indeed cause widening of the arteries or has other affects must be investigated.
What does this mean for patients with CSM?
As Cilostazol is licensed for use in humans, this drug has huge potential for use in CSM. Its exact mechanism of action and potential side effects in CSM need to be tested.
Yamamoto S, Kurokawa R, Kim P. Cilostazol, a selective Type III phosphodiesterase inhibitor: prevention of cervical myelopathy in a rat chronic compression model Laboratory investigation. J Neurosurg Spine. 2014. 20 (1):93-101.
Proposed mechanism of action of Cilostazol.
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