Testosterone Propionate as a Nitrogen-Sparing Agent After Spinal Cord Injury

Cooper, Irving S.

doi:10.1001/jama.1951.02920260017005

Cited by 11 publications

(1 citation statement)

References 15 publications

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“…Several small clinical trials have also assessed TRT in men with motor-complete SCI. For example, Cooper et al observed ~40% lower urinary protein and creatinine excretion in SCI patients receiving TRT acutely after injury [ 103 , 104 ], indicating reduced whole body and muscle protein catabolism. Additionally, Bauman et al reported that 12 months of TRT increased upper- and lower-extremity lean mass and resting energy expenditure in hypogonadal men with motor-complete SCI [ 12 ], with improvement persisting for at least 12-months after TRT discontinuation [ 105 ].…”

Section: Androgenic Regulation Of Musclementioning

confidence: 99%

Activity-Based Physical Rehabilitation with Adjuvant Testosterone to Promote Neuromuscular Recovery after Spinal Cord Injury

Otzel

Lee

et al. 2018

IJMS

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Neuromuscular impairment and reduced musculoskeletal integrity are hallmarks of spinal cord injury (SCI) that hinder locomotor recovery. These impairments are precipitated by the neurological insult and resulting disuse, which has stimulated interest in activity-based physical rehabilitation therapies (ABTs) that promote neuromuscular plasticity after SCI. However, ABT efficacy declines as SCI severity increases. Additionally, many men with SCI exhibit low testosterone, which may exacerbate neuromusculoskeletal impairment. Incorporating testosterone adjuvant to ABTs may improve musculoskeletal recovery and neuroplasticity because androgens attenuate muscle loss and the slow-to-fast muscle fiber-type transition after SCI, in a manner independent from mechanical strain, and promote motoneuron survival. These neuromusculoskeletal benefits are promising, although testosterone alone produces only limited functional improvement in rodent SCI models. In this review, we discuss the (1) molecular deficits underlying muscle loss after SCI; (2) independent influences of testosterone and locomotor training on neuromuscular function and musculoskeletal integrity post-SCI; (3) hormonal and molecular mechanisms underlying the therapeutic efficacy of these strategies; and (4) evidence supporting a multimodal strategy involving ABT with adjuvant testosterone, as a potential means to promote more comprehensive neuromusculoskeletal recovery than either strategy alone.

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