Metformin Attenuates Ferroptosis and Promotes Functional Recovery of Spinal Cord Injury

World Neurosurg. 2022 Nov:167:e929-e939. doi: 10.1016/j.wneu.2022.08.121. Epub 2022 Sep 2.

Abstract

Background: Ferroptosis is involved in traumatic spinal cord injury (SCI), and its inhibition may improve functional recovery after traumatic SCI. This study investigated whether metformin (Met) can have a neuroprotective effect in SCI repair by inhibiting ferroptosis.

Methods: We assessed functional change to determine the long-term effects after intraperitoneal injection of Met in SCI rats with the Basso-Beattie-Bresnahan locomotor rating scale. Malondialdehyde level and relative expression of key proteins, inflammatory cytokines, and nuclear factor E2-related factor 2 signalling molecules were determined in SCI rats and PC12 cells exposed to FeCl3 solution.

Results: Met treatment decreased the contents of malondialdehyde, regulated the levels of inflammatory factors, activated the nuclear factor E2-related factor 2 signalling pathway, and improved long-term outcomes by ameliorating SCI-induced locomotor deficits. In vitro studies further confirmed the beneficial and antiferroptotic actions of Met partly through activation of nuclear factor E2-related factor 2 signalling.

Conclusion: Met can have a neuroprotective effect on SCI repair partly through antiferroptotic effects.

Keywords: Ferroptosis; Inflammation; Metformin; Neuroprotection; Spinal cord injury.

MeSH terms

  • Animals
  • Ferroptosis*
  • Malondialdehyde
  • NF-E2-Related Factor 2
  • Neuroprotective Agents* / pharmacology
  • Neuroprotective Agents* / therapeutic use
  • Rats
  • Rats, Sprague-Dawley
  • Spinal Cord Injuries*

Substances

  • Neuroprotective Agents
  • NF-E2-Related Factor 2
  • Malondialdehyde