Clinical stage anti-RGMa monoclonal antibody elezanumab promotes bladder recovery and neuroplasticity after traumatic spinal cord injury - 18/08/26
, Magdy Hassouna a, b, Christopher Ahuja a, Peer B. Jacobson c, Lili Huang d, Michael G. Fehlings a, f, Philippe P. Monnier a, e, Charles H. Tator a, f, ⁎ 
Abstract |
Spinal cord injury (SCI) causes severe and often permanent neurological deficits, including neurogenic lower urinary tract dysfunction. Although restoration of bladder function is a major clinical priority after SCI and would profoundly improve care and quality of life, it remains underrepresented in neurotrauma research. Central to this pathology is Repulsive Guidance Molecule a (RGMa), a potent inhibitor of axonal outgrowth and neuronal differentiation that is upregulated following central nervous system injury. In this study, we evaluated the therapeutic efficacy of elezanumab, a human anti-RGMa monoclonal antibody tested in clinical trial for acute SCI, on bladder function in a clinically relevant bilateral impact-compression model of traumatic thoracic SCI in female rats. Quantitative urodynamic and cystometric analyses demonstrated that elezanumab administered initially at 3 h post-SCI and then weekly for 6 weeks significantly reduced urinary retention, reflex bladder activity, and intravesical pressure in SCI rats. Morphological assessment revealed that RGMa neutralization limited pathological bladder hypertrophy, with reductions in bladder mass correlating with reduced urine retention. Neuroanatomical mapping via retrograde tracing, together with exploratory transsynaptic tracing, was consistent with increased supraspinal connectivity in pathways involved in micturition. Moreover, elezanumab promoted axonal plasticity of descending catecholaminergic and serotonergic fibers within the lumbosacral spinal cord. These structural changes were associated with reduced bladder pressure and improved neurological recovery. Together, these findings suggest that RGMa inhibition via elezanumab promotes recovery within key components of the micturition circuitry following traumatic SCI.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | Elezanumab is a clinical-stage monoclonal antibody targeting inhibitory RGMa. |
• | Inhibition of RGMa promotes bladder and locomotor recovery after preclinical SCI. |
• | Elezanumab reduces urinary retention, reflex activity, and bladder pressure. |
• | Elezanumab ameliorates SCI-induced bladder pathology. |
• | Elezanumab is associated with supraspinal micturition pathway reorganization. |
Keywords : Repulsive guidance molecule a, Anti-RGMa monoclonal antibody, Elezanumab, Spinal cord injury, Neurogenic bladder dysfunction, Neurological recovery, Neuroregeneration
Plan
Vol 202
Article 119769- septembre 2026 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?
