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Polyethylene glycol (PEG) is a hydrophilic polymer that has been used in experimental studies as a reparative agent to treat SCI and, more recently, traumatic brain injury in laboratory animals. It may soon be used in human clinical trials. At this time, the majority of the research on the use of PEG in animals has been conducted at the Center for Paralysis Research at Purdue University.
PEG is a water-soluble polymer that has been shown to
repair or seal the cellular-plasma membrane of damaged axons. PEG also
enters injured cells and protects mitochondrial function and reduces the
release of cytochrome-c, a cellular death factor. The repair of nerve
membranes by polymeric sealing can lead to rapid and dramatic improvement
in function. PEG preferentially targets injured tissue within the central-nervous
system. It has been studied using direct application to the site of trauma,
intravenous therapy and intraperitoneal and subcutaneous administration.
In experimental studies, systemically administered fluorescein labeled
PEG marked the site of the damaged spinal cord, as well as local direct
application. Much of the experimental work that is now being conducted
uses subcutaneous PEG.
There was one clinical trial in 2004 using intravenous PEG to treat dogs with severe, naturally occurring, SCI due to acute explosive disc-herniation. This study was conducted in collaboration between Veterinary Clinical Sciences Department at Purdue University and the College of Veterinary Medicine at Texas A&M University. The results of this pilot study were very positive. The dogs in the study experienced marked neurological improvement, with no unacceptable clinical complications or deaths1.
PEG is an experimental drug and there is little research
or information on side effects. Side effects described in uninjured control
animals (rats and dogs) include lethargy and mild agitation.
PEG is an experimental drug and the most recent information should be sought before any clinical use is attempted.
There appears to be a difference in the window of opportunity
for treatment using PEG to treat SCI as opposed to traumatic brain injury
(TBI). Treatment with PEG for SCI can be useful for as long as 72 hours
post injury. The window of opportunity for effective treatment of TBI
appears to be within two to four hours post injury.
When PEG is applied focally to the injured tissue, there appears to be
minimal toxicity if applied for less than five minutes, or in a pulsatile
fashion for up to 25 minutes.
No drug interactions have been discussed in the experimental literature.
This drug is not in widespread clinical use.
No information was available from the experimental literature regarding overdose.
1. Laverty, P.H. et al., Journal of Neurotrauma. Dec. 1, 2004, 21(12):1767-1777
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
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