DC-SIGN Antagonists – A Paradigm of C-Type Lectin Binding Inhibition

Abstract

Background: Spinal cord injury (SCI) has devastating and expensive consequences for patients, carers and society. The incidence varies world-wide (Australia: 4.5/million; USA: 25.2-52.5/million) with motor vehicle accidents the major cause. Extensive and promising basic research has yet to be translated into clinical practice. Results: A search of http://clinicaltrials.gov/, China SCI Net http://www.chinascinet.org/ and the Australian and New Zealand Spinal Cord Registry www.anzctr.org.au was undertaken to map the current global status of clinical trials. Internationally, there are over 100 registered trials covering a wide range of interventions with exercise comprising the majority followed by drug treatments. Cell-based and biologicallyinspired drug-based trials are also emerging. Nevertheless, medical management, rehabilitation and exercise are still the predominant treatments. However, strong evidence to support the role of exercise in promoting neurological recovery and overall health is lacking. In Australia and New Zealand, we are undertaking 3 randomized controlled trials, Spinal Cord Injury and Physical Activity (SCIPA), to test novel interventions that move the paralysed limbs and determine whether they improve neurological recovery and overall health. The trials span acute care, in-patients and the chronic phase after discharge and we are also developing a community program to overcome barriers and promote participation and activity. Another Australian trial in the planning stage aims to prevent massive secondary loss of tissue spared by the initial injury by administering immediate hypothermia Conclusion: The global search to develop effective therapies continues. Rehabilitation is still the main form of therapy and better treatments for acute injury to prevent the catastrophic loss of tissue, as well as for chronic patients living with SCI, are urgently needed.