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Background/Aims: Spinal cord injury (SCI) is a serious global problem that leads to permanent motor and sensory deficits. This study explores the anti-apoptotic and neuroprotective effects of the natural extract β-elemene in vitro and in a rat model of SCI. Methods: CCK-8 assay was used to evaluate cell viability and lactate dehydrogenase assay was used to evaluate cytotoxicity. A model of cell injury was established using cobalt chloride. Apoptosis was evaluated using a fluorescence-activated cell sorting assay of annexin V-FITC and propidium iodide staining. A rat SCI model was created via the modified Allen’s method and Basso, Beattie, and Bresnahan (BBB) scores were used to assess locomotor function. Inflammatory responses were assessed via enzyme-linked immunosorbent assay (ELISA). Apoptotic and surviving neurons in the ventral horn were respectively observed via terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining and Nissl staining. Western blotting was used to measure protein expression. Results: β-elemene (20 μg/ml) promoted cell viability by activating phosphorylation of the PI3K-AKT-mTOR pathway. β-elemene reduced CoCl2-induced cellular death and apoptosis by suppressing the expression levels of CHOP, cleaved-caspase 12, 78-kilodalton glucose-regulated protein, cleaved-caspase 3, and the Bax/Bcl-2 ratio. In the rat model of SCI, Nissl and TUNEL staining showed that β-elemene promoted motor neuron survival and reduced neuronal apoptosis in the spinal cord ventral horn. BBB scores showed that β-elemene significantly promoted locomotor behavioral recovery after SCI. In addition, β-elemene reduced the ELISA-detected secretion of interleukin (IL)-6 and IL-1β. Conclusion: β-elemene reduces neuronal apoptosis by alleviating endoplasmic reticulum stress in vitro and in vivo. In addition, β-elemene promotes locomotor function recovery and tissue repair in SCI rats. Thus, our study provides a novel encouraging strategy for the potential treatment of β-elemene in SCI patients. [ABSTRACT FROM AUTHOR]

RhoA signaling pathway inhibitors such as Y27632 (a ROCK inhibitor) have recently been applied as treatments for spinal cord injury (SCI) because they promote neurite outgrowth and axonal regeneration in neurons. β-Elemene, a compound that is extracted from a natural plant (Curcuma zedoary), influences the expression level of RhoA protein. Whether it can promote neurite outgrowth in motor neurons or enhance locomotor recovery in SCI remains unclear. Here, we initially demonstrated that β-elemene promotes neurite outgrowth of ventral spinal cord 4.1 (VSC4.1) motoneuronal cells and primary cortical neurons. Pull-down assays showed that β-elemene significantly inhibits the activation of RhoA kinase. Western blotting assays suggested β-elemene markedly inhibits the phosphorylation of limk and confilin and significantly increases the expression level of GAP-43. Then, in a rat model of SCI, hematoxylin-eosin and myelin staining showed that β-elemene reduces the area of lesion cavity and spares the white matter. BBB scores showed β-elemene significantly promotes locomotor behavioral recovery. In addition, western blotting assays and immunofluorescence staining demonstrated that the expression level of GAP-43 is upregulated by β-elemene treatment in vivo . Thus, our study provided an encouraging novel strategy for the potential treatment of SCI patients with β-elemene. [ABSTRACT FROM AUTHOR]