Neural Regeneration Research ›› 2023, Vol. 18 ›› Issue (5): 940-946.doi: 10.4103/1673-5374.355749

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Clemastine in remyelination and protection of neurons and skeletal muscle after spinal cord injury

Ali Myatich1, 2, Azizul Haque1, 2, 3, *, Christopher Sole4, Naren L. Banik1, 2, 3, *   

  1. 1Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA;  2Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA;  3Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA; 4Department of Health and Human Performance, The Citadel, Charleston, SC, USA 
  • Online:2023-05-15 Published:2022-10-31
  • Contact: Azizul Haque, PhD, haque@musc.edu; Naren L. Banik, PhD, baniknl@musc.edu.
  • Supported by:
    This work was supported in part by funding from the Veterans Administration (1IOBX001262, 1I01 BX004269) and South Carolina State Spinal Cord Injury Research Fund (SCIRF-2015P-01, SCIRF-2015P-04, SCIRF-2015-I-01, SCIRF #2016 I-03, and SCIRF #2018 I-01) (to AH). This work was also supported in part by funding from the National Institutes of Health (1R21NS118393-01) (to AH). Dr. Naren L. Banik is the recipient of a Research Career Scientist award (# IK6BX005964) from the Department of veterans Affairs.

Abstract: Spinal cord injuries affect nearly five to ten individuals per million every year. Spinal cord injury causes damage to the nerves, muscles, and the tissue surrounding the spinal cord. Depending on the severity, spinal injuries are linked to degeneration of axons and myelin, resulting in neuronal impairment and skeletal muscle weakness and atrophy. The protection of neurons and promotion of myelin regeneration during spinal cord injury is important for recovery of function following spinal cord injury. Current treatments have little to no effect on spinal cord injury and neurogenic muscle loss. Clemastine, an Food and Drug Administration-approved antihistamine drug, reduces inflammation, protects cells, promotes remyelination, and preserves myelin integrity. Recent clinical evidence suggests that clemastine can decrease the loss of axons after spinal cord injury, stimulating the differentiation of oligodendrocyte progenitor cells into mature oligodendrocytes that are capable of myelination. While clemastine can aid not only in the remyelination and preservation of myelin sheath integrity, it also protects neurons. However, its role in neurogenic muscle loss remains unclear. This review discusses the pathophysiology of spinal cord injury, and the role of clemastine in the protection of neurons, myelin, and axons as well as attenuation of skeletal muscle loss following spinal cord injury.

Key words: axonal damage, clemastine, myelination, neuronal death, oligodendrocytes, skeletal muscle, spinal cord injury