Journal of Brain and Neurology

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Opinion Article - Journal of Brain and Neurology (2023) Volume 6, Issue 4

Role of autophagy and apoptosis after spinal cord injury

Lilli Kristen*

Department of Neurology

*Corresponding Author:
Lilli Kristen
Department of Neurology
NYU Langone Medical Center
United States

Received:01-Jul-2023, Manuscript No. AAJBN-23-105467; Editor assigned:04-Jul-2023, PreQC No. AAJBN-23-105467 (PQ); Reviewed:18-Jul-2023, QC No. AAJBN-23-105467; Revised:21-Jul-2023, Manuscript No. AAJBN-23-105467 (R); Published:28-Jul-2023, DOI:10.35841/aajbn-6.4.154

Citation: Kristen L. Role of autophagy and apoptosis after spinal cord injury. J Brain Neurol. 2023;6(4):154

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Spinal cord injury (SCI) is a devastating condition that often results in permanent loss of motor and sensory functions. The pathophysiology of SCI involves a complex interplay of various cellular processes, including inflammation, oxidative stress, and cell death. Among these processes, autophagy and apoptosis have emerged as critical mechanisms that influence the outcome of SCI. In this article, we will explore the roles of autophagy and apoptosis in spinal cord injury and their potential as therapeutic targets. Autophagy is a cellular process responsible for the degradation and recycling of damaged organelles and proteins within cells. It acts as a quality control mechanism, ensuring cellular homeostasis and promoting cell survival under stress conditions. Autophagy involves the formation of autophagosomes, which engulf cellular components and fuse with lysosomes for degradation. By eliminating dysfunctional cellular components, autophagy maintains cellular integrity and promotes tissue repair. Following SCI (Spinal Cord Injury), autophagy is upregulated as a response to the cellular stress caused by the injury. Studies have shown that autophagy contributes to both beneficial and detrimental effects in SCI. On one hand, autophagy can remove damaged proteins and organelles, thus reducing cellular stress and promoting cell survival. On the other hand, excessive or dysregulated autophagy can lead to the death of neural cells, exacerbating the injury [1].

Regulation of autophagy and apoptosis in spinal cord injury

The mammalian target of rapamycin (mTOR) pathway is a central regulator of autophagy. mTOR inhibits autophagy under normal conditions. However, in response to cellular stress, such as SCI, mTOR activity is suppressed, leading to autophagy induction. Targeting mTOR signaling with rapamycin or other mTOR inhibitors can modulate autophagy and potentially promote neuroprotection. Beclin-1 is a critical protein involved in autophagosome formation. It interacts with other proteins to initiate autophagy. Upregulation of Beclin-1 has been observed in SCI models and is associated with increased autophagy. Manipulating Beclin-1 levels or its interaction partners could impact autophagy levels in SCI. The Bcl-2 family proteins are key regulators of apoptosis. Anti-apoptotic members, such as Bcl-2 and Bcl-xL, inhibit apoptosis, while pro-apoptotic members, such as Bax and Bak, promote it. The balance between these proteins determines the fate of the cell. Modulating the expression or activity of Bcl-2 family members can influence apoptotic cell death after SCI [2].

The tumor suppressor protein p53 has dual roles in autophagy and apoptosis. In SCI, p53 can activate apoptosis by promoting the expression of pro-apoptotic proteins and inhibiting anti-apoptotic factors. Additionally, p53 can inhibit autophagy by repressing Beclin-1 expression. Targeting p53 may provide a means to modulate both autophagy and apoptosis in SCI. Recent research has shed light on the intricate relationship between autophagy and inflammation in SCI. Autophagy can modulate the immune response by influencing the activation of immune cells and the release of pro-inflammatory cytokines. Moreover, autophagy can regulate the polarization of immune cells, such as microglia and macrophages, which play vital roles in the secondary injury cascade following SCI. Apoptosis, or programmed cell death, is another crucial cellular process involved in SCI. It is characterized by a tightly regulated sequence of events, including cell shrinkage, chromatin condensation, and DNA fragmentation. Apoptosis can occur in both neurons and glial cells after SCI and contributes significantly to the loss of neural tissue [3].

Caspases, a family of proteases, are key mediators of apoptosis. Activation of caspases leads to the cleavage of various cellular proteins, ultimately resulting in cell death. In SCI, apoptosis can be triggered by multiple factors, such as excitotoxicity, oxidative stress, and inflammation. The death of neural cells through apoptosis exacerbates the initial injury and contributes to the formation of a glial scar, which inhibits axonal regeneration. Targeting autophagy and apoptosis holds great potential for therapeutic interventions in spinal cord injury [4].

Modulating autophagy to enhance its beneficial effects while preventing excessive or dysregulated autophagy could promote cell survival and tissue repair. Several pharmacological agents, such as rapamycin and resveratrol, have shown promising results in preclinical studies by modulating autophagy in SCI models. Similarly, inhibiting apoptosis has been explored as a therapeutic strategy. Caspase inhibitors, such as Z-VAD-FMK, have demonstrated neuroprotective effects by preventing apoptotic cell death in animal models of SCI. Additionally, strategies aimed at promoting the survival and regeneration of neural cells, such as stem cell transplantation and gene therapy, have shown potential in attenuating apoptosis and promoting functional recovery [5].


Autophagy and apoptosis play intricate roles in the pathophysiology of spinal cord injury. While autophagy can act as a protective mechanism by eliminating damaged cellular components, dysregulated autophagy and apoptosis can contribute to secondary injury and hinder recovery. Harnessing the therapeutic potential of these processes holds promise for developing novel treatment strategies to improve outcomes in individuals with SCI. Further research is needed to unravel the complex mechanisms underlying autophagy and apoptosis in SCI and translate these findings into effective clinical interventions.


  1. Xia Y, Xia H, Chen D, et al. Mechanisms of autophagy and apoptosis mediated by JAK2 signaling pathway after spinal cord injury of rats.. Exp Thera Med. 2017;14:1589-93.
  2. Indexed at, Google Scholar, Cross Ref

  3. Zhang YB, Li SX, Chen XP, et al. Autophagy is activated and might protect neurons from degeneration after traumatic brain injury. Neurosci Bull. 2008;24:143-9.
  4. Indexed at, Google Scholar, Cross Ref

  5. Wang ZY, Liu WG, Muharram A, et al. Neuroprotective effects of autophagy induced by rapamycin in rat acute spinal cord injury model. Neuroimmunomodulat. 2014;21:257-67.
  6. Indexed at, Google Scholar, Cross Ref

  7. Bai L, Mei X, Shen Z, et al. Netrin-1 improves functional recovery through autophagy regulation by activating the AMPK/mTOR signaling pathway in rats with spinal cord injury. Sci Rep. 2017;7:42288.
  8. Indexed at, Google Scholar, Cross Ref

  9. Zhao H, Chen S, Gao K, et al. . Resveratrol Protects Against Spinal Cord Injury by Activating Autophagy and Inhibiting Apoptosis Mediated by the SIRT1/AMPK Signaling Pathway. Neuroscience. 2017;348:241-51.
  10. Indexed at, Google Scholar, Cross Ref

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