The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model

Yıl: 2016 Cilt: 26 Sayı: 4 Sayfa Aralığı: 622 - 631 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model

Öz:
AIM: To evaluate the neuroprotective effects of adalimumab in an experimental spinal cord injury model and compare them withthose of the widely-used methylprednisolone.MATERIAL and METHODS: Forty male Wistar rats were divided into as the sham, trauma, adalimumab, methylprednisolone,and adalimumab+methylprednisolone groups. Only Iaminectomy was performed in the sham group. Laminectomy and trauma wasperformed to the trauma group but no treatment was given. single dose of 40 mg/kg subcutaneous adalimumab was administeredafter the Iaminectomy and trauma to group 3. single dose of intravenous 30 mg/kg methylprednisolone was administered right afterIaminectomy and trauma to group 4. Single doses of 40 mg/kg adalimumab and 30 mg/kg methylprednisolone were administeredtogether after Iaminectomy and trauma to group 5. Serum malondialdehyde (MDA), TNF-cı, IL-1B and IL—6 levels were measuredand sections were obtained for histopathological study at the end of the 7‘h day.RESULTS: MDA, TNF-o, IL—1B and IL—6 levels in serum were significantly decreased in the adalimumab group with clinical andhistopathological improvement not less than the methylprednisolone group. The serum MDA levels were similar when the twodrugs were given together or separately but there was statistically quite significant decrease in TNF-a, IL-1B and IL—6 levels withconcurrent use. Statistically significantly better results were obtained on histopathological evaluation with the use of both drugstogether.CONCLUSION: This study revealed that adalimumab is as effective as methylprednisolone in compressive spinal cord injury in rats.
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  • Agrawal SK, Nashmi R, Fehlings MG: Role of L-and N-type calcium channels in the pathophysiology of traumatic spinal cord white matter injury. Neuroscience 99:179-188, 2000
  • Alexopoulou A, Koskinas J, Soultati A, Katsaounis P, Kilidireas K, Papageorgiou C, Antoniou C, Katsambas A, Archimandritis A: Acute bilateral phrenic neuropathy following treatment with adalimumab. Clin Rheumatol 28(11):1337-1340, 2009
  • Anderson DK, Means ED, Waters TR, Green ES Microvascular perfusion and metabolism in injured spinal cord after methylprednisolone treatment. Neurosurg 56:106-113, 1982
  • Aslan A, Cemek M, Eser O, Altunbaş K, Buyukokuroglu ME, Cosar M, Baş 0, Ela Y, Fidan H: Does dexmedetomidine reduce secondary damage after spinal cord injury? An experimental study. Eur Spine 8:336—344, 2009
  • Bartholdi D, Schwab ME: Expression of pro—inflammatory cytokine and chemokine mRNA upon experimental spinal cord injury in mouse: An in situ hybridization study. Eur Neurosci 9(7):1422-1438,1997
  • Bracken MB: Steroids for acute spinal cord injury. Cochrane Database Syst Rev (3):CD001046,2002
  • Bracken MB, Holford TR: Effects of timing of methylprednisolone or naloxone administration on recovery of segmental and long—tract neurological function in NASCIS 2. Neurosurg 79(4):500—507, 1993
  • Bracken MB, Shepard MJ, Holford TR, Leo-Summers L, Aldrich EF, Fazl M, Fehlings MG, Herr DL, Hitchon PW, Marshall LF, Nockels RP, Pascale V, Perot PL Jr, Piepmeier JM, Sonntag VKH, Wagner F, Wilberger JE, Winn HR, Young W: Methylprednisolone or tirilazad mesylate administration after acute cord injury: 1—year follow—up—results of the third national acute cord injury study randomized controlled trial. Neurosurg 89: 699—706, 1998
  • Can M, Gul S, Bektas S, Hancı V, Acıkgoz S: Effects of dexmedetomidine or methylprednisolone on inflammatory responses in spinal cord injury. Acta Anaesthesiol Scand 53(8):1068—1072, 2009
  • Cheng H, Cao Y, Olson L: Spinal cord repair in adult paraplegic rats: Partial restoration of hind limb function. Science 273(5274):510—513, 1996
  • Christie SD, Comeau B, Myers T, Sadi D, Purdy M, Mendez l: Duration of lipid peroxidation after acute spinal cord injury in rats and the effect of methylprednisolone. Neurosurg Focus 25(5):E5, 2008
  • Chvatal SA, Kim YT, Bratt-Leal AM, Lee H, Bellamkonda RV: Spatial distribution and acute anti-inflammatory effects of methylprednisolone after sustained local delivery to the contused spinal cord. Biomaterials 29(12):1967-1975, 2008
  • Celik H. et al: Neuroprotective Effects of Adalimumab Colombel JF, Sandborn WJ, Panaccione R, Robinson AM, Lau W, Li J, Cardoso AT: Adalimumab safety in global clinical trials of patients with Crohn’s disease. lnflamm Bowel Dis 15(9):1308-1319, 2009
  • CosarM, EserO, Fidan H, Sahin O, Buyukbas S, ElaY, Yagmurca M, Ozen OA: The neuroprotective effect of dexmedetomidine in hippocampus of rabbits after subarachnoid hemorrhage. Surg Neurol 71 (1):54—59, 2009
  • Cre'ange A, Be'lec L, Clair B, Raphael JC, Gherardi RK: Circulating tumor necrosis factor (TNF)—o and soluble TNF-a receptors in patients with Guillain—Barre syndrome. Neuroimmunol 68: 95—99, 1996
  • Draper HH, Hadley M: Malondialdehyde determination as index of lipid peroxidation. Methods Enzymol 186:421-431, 1990
  • Dumont RJ, Okonkwo DO, Verma S, Hurlbert J: Acute spinal cord injury, Part I: Pathophysiologic Mechanisms. Clin Neuropharmacology 24 (5): 254—264,2001
  • Emery E, Aldana P, Bunge MB, Puckett W, Srinivasan A, Keane RW, Bethea J, Levi AD: Apoptosis after traumatic human spinal cord injury. Neurosurg 89:911—920,1998
  • Erman T, Tuna M, ildan F, Göçer Aİ, Vezir M, Boyar B: Spinal kord travmasının fizyopatolojisi ve medikal tedavi prensipleri. Arşiv 11:270-273, 2002 (in Turkish)
  • Faden Al, Simon RP: potential role for excitotoxins in the pathophysiology of spinal cord injury. Ann Neurol 23(6):623- 626, 1988
  • Fehlings MG, Sekhon LH, Tator C: The role and timing of decompression in acute spinal cord injury. Spine 26: 101 —1 10, 2001
  • Fehlings MG, Tator CH, Linden RD: The relationships among the severity of spinal cord injury, motor and somatosensory evoked potentials and spinal cord blood flow. Electroencephalogr Clin Neurophysiol 74(4):241—259, 1989
  • Fiford RJ, Bilston LE, Waite P, Lu J: vertebral dislocation model of spinal cord injury in rats. Neurotrauma 21(4):451- 458, 2004
  • Fu ES, Saporta S: Methylprednisolone inhibits production of interleukin—1 beta and interleukin—6 in the spinal cord following compression injury in rats. Neurosurg Anesthesiol 17:82—85, 2005
  • Gartlehner G, Thieda P, Morgan LC, Thaler K, Hansen RA, Jonas B: Drug Class Review: Targeted Immune Modulators: Final Report Update 2. Portland (OR): Oregon Health Science University, 2009
  • Gong G, Yuan LB, Hu L,Wu W, Yin L, Hou JL, Liu YH, Zhou LS: Glycyrrhizin attenuates rat ischemic spinal cord injury by suppressing inflammatory cytokines and HMGB1. Acta Pharmacol Sin 33: 11-18, 2012
  • .Hall ED: Inhibition of lipid peroxidation in CNS trauma. Neurotrauma (Suppl 1):SS1—40 discussion S1, 1991
  • Hall ED: Lipid antioxidants in acute central nervous system injury. Ann Emerg Med 22(6):1022—1027, 1993
  • Hall ED: The neuroprotective pharmacology of methylpred— nisolone. Neurosurg 76(1):13-22, 1992
  • Hall ED, Wolf DL: pharmacological analysis of the pathophysiological mechanisms of posttraumatic spinal cord ischhemia. Neurosurg 64: 951-961, 1986
  • Hartung HP, Jung S, Stoll, Zielasek J, Schmidt B, Archelos JJ, Toyka KV: The role of inflammatory mediators in demyelinating disorders of the CNS and PNS. Neuroimmunol 40:197-210, 1992
  • Hasturk A, Atalay B, Caliskaneller T, Ozdemir O, Oruckaptan H, Altinors N: Analysis of serum pro-inflammatory cytokine levels after rat spinal cord ischemia/reperfusion injury and correlation with tissue damage. Turk Neurosurg 19:353-359, 2009
  • Hugenholtz H, Cass DE, Dvorak MF, Fewer DH, Fox RJ, lzukawa DM, Lexchin J, Tuli S, Bharatwal N, Short C: Highdose methylprednisolone for acute closed spinal cord injury: Only treatment option. Can Neurol Sci 29(3):227—235, 2002
  • Ildan F, Polat S, Oner A, lsbir T, Gocer AI, Tap O, Kaya M, Karadayi A: Effects of naloxone on sodium and potassium— activated and magnesium-dependent adenosine-5’—triphos— phatase activity and lipid peroxidation and early ultrastructural findings after experimental spinal cord injury. Neurosurgery 36:797—805, 1995
  • Iplikçioglu C: Omurilik yaralanmasının fizyopatolojisi. In: Zileli M, Özer AF (ed), Omurilik Omurga Cerrahisi, ikinci baskı. İzmir: Saray Medikal Yayıncılık, 2002:459-465 (In Turkish) Ji B, Li M, Budel S, Pepinsky RB, Walus L, Engber
  • TM, Strittmatter SM, Relton JK: Effect of combined treatment with methylprednisolone and soluble Nogo-66 receptor after rat spinal cord injury. Eur Neurosci 22(3):587—594, 2005
  • Kaptanoglu E, Beskonakli E, Solaroglu I, Kilinc A, Taskin Y: Magnesium sulfate treatment in experimental spinal cord injury: Emphasis on vascular changes and early clinical results. Neurosurg Rev 26: 283-287, 2003
  • Kaptanoglu E, Caner HH, Surucu HS, Akbiyik F: Effect of mexiletine on lipid peroxidation and early ultrastructural findings in experimental spinal cord injury. Neurosurg 91 Suppl :200—204, 1999
  • Kaptanoglu E, Solaroglu l, Okutan O, Surucu HS, Akbiyik F, Beskonakli E: Erythropoietin exerts neuroprotection after acute spinal cord injury in rats: Effect on lipid peroxidation and early ultrastructural findings. Neurosurg Rev 27:113-120, 2004
  • Kaptanoglu E, Tuncel M, Palaoglu S, Konan A, Demirpence E, Kilinc K: Comparison of the effects of melatonin and methylprednisolone in experi mental spinal cord injury. Neurosurg 93 Suppl:77-84, 2000
  • Kaynar MY, Hanoi M, Kafadar A, Gümüştaş K, Belce A, Ciplak N: The effect of duration of compression on lipid peroxidation after experimental spinal cord injury. Neurosurg Rev 21 (2— 3):117-120, 1998
  • Keystone EC, Kavanaugh AF, Sharp JT, Tannenbaum H, Hua Y, Teoh LS, Fischkoff SA, Chartash EK: Radiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy: randomized, placebo—controlled, 52- week trial. Arthritis Rheum 50(5):1 400-141 1, 2004
  • Keystone EC, van der Heijde D, Kavanaugh A, Kupper H, Liu S, Guérette B, Mozaffarian N: Clinical, functional, and radiographic benefits of longterm adalimumab plus methotrexate: Final 10-year data in longstanding rheumatoid arthritis. Rheumatol 40(9):1487-1497, 2013 630 Turk Neurosurg 26(4): 622-631 2016
  • Kieseier BC, Kiefer R, Gold R, Hemmer B, Willison HJ, Hartung HP: Advances in understanding and treatment of immunemediated disorders of the peripheral nervous system. Muscle Nerve 30:131—156, 2004
  • Kim KT, Kim MJ, Cho DC, Park SH, Hwang JH, Sung JK, Cho HJ, Jeon Y: The neuroprotective effect of treatment with curcumin in acute spinal cord injury: Laboratory investigation. Neurol Med Chir (Tokyo) 54(5):387—394, 2014
  • Kokoszka JE, Coşkun P, Esposito LA, Wallace DC: Increased mitochondrial oxidative stress in the sod2 (+/-) mouse results in the age-related decline of mitochondrial function culminating in increased apoptosis. Proc Natl Acad Sci USA 98:2278-2283, 2001
  • Kurt G, Ergün E, Cemil B, Borcek AO, Borcek P, Gülbahar O, Ceviker N: Neuroprotective effects of infliximab in experimental spinal cord injury. Surg Neurol 71:332—336, 2009
  • Kurt G, Yildirim Z, Cemil B, Celtikci E, Kaplanoglu GT: Ef— fects of curcumin on acute spinal cord ischemia-reperfusion injury in rabbits. Laboratory investigation. Neurosurg Spine 20(4):464-470, 2014
  • Kurtoglu T, Basoglu H, Ozkisacik EA, Cetin NK, Tataroglu C, Yenisey C, Discigil B: Effects of cilostazol on oxidative stress, systemic cytokine release, and spinal cord injury in rat model of transient aortic occlusion. Ann Vasc Surg 28:479—488, 2014
  • Lammertse DP: Update on pharmaceutical trials in acute spinal cord injury. Spinal Cord Med 27(4):319—325, 2004
  • Makol A, Grover M: Adalimumab induced mononeuritis multiplex in patient with refractory rheumatoid arthritis: case report. Cases 1(1):287,2008
  • Merola A, O’Brian MF, Castro BA, Smith DA, Eule JM, Lowe TG, Dwyer AP, Haher TR, Espat NJ: Histologic characterization of acute spinal cord injury treated with intravenous methylprednisolone. Orthop Trauma 16:155—161, 2002
  • Misawa S, Kuwabara S, Mori M, Kawagushi N, Yoshiyama Y, Hattori T: Serum levels of tumor necrosis factor—a in chronic inflammatory polyneuropathy. Neurology 56:666-669, 2001
  • Mohan N, Edwards ET, Cupps TR, Oliverio PJ, Sandberg G, Crayton H, Richert JR, Siegel JN: Demyelination occurring during anti—tumor necrosis factor alpha therapy for inflamma— tory arthritides. Arthritis Rheum 44(12):2862—2869, 2001
  • Nielsen F, Mikkelsen BB, Nielsen JB, Andersen HR, Grandjean P: Plasma malondialdehyde as biomarker for oxidative stress: Reference interval and effects of life-style factors. Clin Chem 43: 1209-1214, 1997
  • Noble LJ, Wrathall JR: Spinal cord contusion in the rat: Morphometric analyses of alterations in the spinal cord. Exp Neurol 88(1):135-149, 1985
  • Noyes DH: Electromechanical impactor for producing experimental spinal cord injury in animals. Med Biol Eng Comput 25(3):335-340, 1987
  • Redford EJ, Hall SM, Smith KJ: Vascular changes and demyelination induced by the intraneural injection of tumor necrosis factor. Brain 118: 869-878, 1995
  • Reenaers C, Louis E, Belaiche J: Current directions of biologic therapies in inflammatory bowel disease. Therap Adv Gastroenterol 3(2):99—106, 2010
  • Rivlin AS, Tator CH: Effect of duration of acute spinal cord compression in new acute cord injury model in the rat. Surg Neurol 10(1):38-43, 1978
  • Rivlin AS, Tator CH: Objective clinical assessment of motor function after experimental spinal cord injury in the rat. Neurosurg 47(4):577-581, 1977
  • Sayer FT, Kronvall E, Nilsson OG: Methylprednisolone treatment in acute spinal cord injury: The myth challenged through structured analysis of published literature. Spine 6:335—343, 2006
  • Scheinfeld N: Adalimumab: review of side effects. Expert Opin Drug Saf 4(4):637-641, 2005
  • Schmidley JW: Free radicals in central nervous system ischemia. Stroke 21(7):1086-1090, 1990
  • Shah SB, Hanauer SB: Risks and benefits of the use of concomitant immunosuppressives and biologics in inflammatory bowel disease. Rev Gastroenterol Disord 8(3):159-168, 2008
  • Sharief MK, Ciardi M, Thompson EJ: Blood—brain barrier damage in patients with bacterial meningitis: Association with tumor necrosis factor-alpha but not interleukin-1 beta. Infect Dis 166: 350—358, 1992
  • Sharief MK, McLean B, Thompson EJ: Elevated serum levels of tumor necrosis factor-o in Guillain-Barre syndrome. Ann Neurol 33:591-596, 1993
  • Smith PD, Puskas F, Meng X, Lee JH, Cleveland JC Jr, Weyant MJ, Fullerton DA, Reece TB: The evolution of chemokine release supports bimodal mechanism of spinal cord ischemia and reperfusion injury. Circulation 126:S110-117, 2012
  • Taoka Y, Okajima K: Spinal cord injury in the rat. Prog Neurobiol 56: 341—358, 1998
  • Taoka J, Okajima K, Uchiba M, Johno M: Methylprednisolone reduces spinal cord injury in rats without affecting tumor necrosis factor—alpha production. Neurotrauma 18: 533— 543, 2001
  • Taoka Y, Okajima K, Uchiba M, Murakami K, Harada N, Johno M, Naruo M: Activated protein reduces the severity of compression— induced spinal cord injury in rats by inhibiting activation of leukocytes. Neurosci 18(4):1393—1398, 1998
  • .Tator CH: Fehlings MG: Review of the secondary injury theory of acute spinal cord trauma with emphasis on vascular mechanisms. Neurosurg 75:15-26, 1991
  • Celik H. et al: Neuroprotective Effects of Adalimumab Topsakal C, Kilic N, Ozveren F, Akdemir I, Kaplan M, Tiftikci M: Effects of prostaglandin E1, melatonin, and oxytetracycline on lipid peroxidation, antioxidant defense system, paraoxonase (PON1) activities, and homocysteine levels in an animal model of spinal cord injury. Spine 28(15):1643-1652, 2003
  • Tsang RS, Valdivieso-Garcia A: Pathogenesis of Guillain—Barre syndrome. Expert Rev Anti Infect Ther 1: 597—608, 2003
  • Tufan K, Oztanir N, Ofluoglu E, Ozogul C, Uzum N,Dursun A, Pasaoglu H, Pasaoglu A: Ultrastructure protection and attenuation of lipid peroxidation ter blockade of presynaptic release of glutamate by Iamotrigine in experimental spinal cord injury. Neurosurg Focus 25:E6, 2008
  • Usul H, Arslan E, Cansever T, Cobanoglu U, Baykal S: Effects of clotrimazole on experimental spinal cord ischemia/ reperfusion injury in rats. Spine 33: 2863-2867, 2008
  • Wang CX, Nuttin B, Heremans H, Dom R, Gybels J: Production of tumor necrosis factor in spinal cord following traumatic injury in rats. Neuroimmunol 69(1-2):151-156, 1996
  • Wang CX, Olschowka JA, Wrathall JR: Increase of interleukin-1 beta mRNA and protein in the spinal cord following experimental traumatic injury in the rat. Brain Res 759(2):190— 196, 1997
  • Yakovlev AG, Faden Al: Sequential expression of c-fos protooncogene, TNF—alpha, and dynorphin genes in spinal cord following experimental traumatic injury. Mol Chem Neuropathol 23(2-3):179—190, 1994
  • Yaman O, Yaman B, Aydın F, Var A, Temiz C: Hyperbaric oxygen treatment in the experimental spinal cord injury model. Spine 14(9):2184—2194,2014
  • Yu Y, Matsuyama Y, Yanase M, Ito S, Adachi K, Satake K, Ishiguro N, Kiuchi K: Effects of hyperbaric oxygen on GDNF expression and apoptosis in spinal cord injury. Neuroreport 15: 2369-2373, 2004
  • Yuji T, Kenji 0: Role of neutrophils in spinal cord injury in the rat. Neuroscience 79: 1177—1182, 1997
  • Zileli M: Omurilik yaralanmasında farmakolojik tedavi. In: Zileli M, Özer (ed). Omurilik ve Omurga Cerrahisi. İzmir: Saray Yayıncılık, 1997:466-478 (In Turkish)
APA ÇELİK H, Karatay M, erdem y, YILDIRIM A, sertbaş i, karatay e, Kul H, Guvenc Y, KÖKSAL İ, MENEKŞE G, Alagöz F, KERTMEN H, CAYDERE M (2016). The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model. , 622 - 631.
Chicago ÇELİK Haydar,Karatay Mete,erdem yavuz,YILDIRIM Ali Erdem,sertbaş idris,karatay eylem,Kul Halil,Guvenc Yahya,KÖKSAL İsmet,MENEKŞE Güner,Alagöz Fatih,KERTMEN Hüseyin Hayri,CAYDERE MUZAFFER The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model. (2016): 622 - 631.
MLA ÇELİK Haydar,Karatay Mete,erdem yavuz,YILDIRIM Ali Erdem,sertbaş idris,karatay eylem,Kul Halil,Guvenc Yahya,KÖKSAL İsmet,MENEKŞE Güner,Alagöz Fatih,KERTMEN Hüseyin Hayri,CAYDERE MUZAFFER The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model. , 2016, ss.622 - 631.
AMA ÇELİK H,Karatay M,erdem y,YILDIRIM A,sertbaş i,karatay e,Kul H,Guvenc Y,KÖKSAL İ,MENEKŞE G,Alagöz F,KERTMEN H,CAYDERE M The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model. . 2016; 622 - 631.
Vancouver ÇELİK H,Karatay M,erdem y,YILDIRIM A,sertbaş i,karatay e,Kul H,Guvenc Y,KÖKSAL İ,MENEKŞE G,Alagöz F,KERTMEN H,CAYDERE M The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model. . 2016; 622 - 631.
IEEE ÇELİK H,Karatay M,erdem y,YILDIRIM A,sertbaş i,karatay e,Kul H,Guvenc Y,KÖKSAL İ,MENEKŞE G,Alagöz F,KERTMEN H,CAYDERE M "The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model." , ss.622 - 631, 2016.
ISNAD ÇELİK, Haydar vd. "The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model". (2016), 622-631.
APA ÇELİK H, Karatay M, erdem y, YILDIRIM A, sertbaş i, karatay e, Kul H, Guvenc Y, KÖKSAL İ, MENEKŞE G, Alagöz F, KERTMEN H, CAYDERE M (2016). The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model. Turkish Neurosurgery, 26(4), 622 - 631.
Chicago ÇELİK Haydar,Karatay Mete,erdem yavuz,YILDIRIM Ali Erdem,sertbaş idris,karatay eylem,Kul Halil,Guvenc Yahya,KÖKSAL İsmet,MENEKŞE Güner,Alagöz Fatih,KERTMEN Hüseyin Hayri,CAYDERE MUZAFFER The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model. Turkish Neurosurgery 26, no.4 (2016): 622 - 631.
MLA ÇELİK Haydar,Karatay Mete,erdem yavuz,YILDIRIM Ali Erdem,sertbaş idris,karatay eylem,Kul Halil,Guvenc Yahya,KÖKSAL İsmet,MENEKŞE Güner,Alagöz Fatih,KERTMEN Hüseyin Hayri,CAYDERE MUZAFFER The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model. Turkish Neurosurgery, vol.26, no.4, 2016, ss.622 - 631.
AMA ÇELİK H,Karatay M,erdem y,YILDIRIM A,sertbaş i,karatay e,Kul H,Guvenc Y,KÖKSAL İ,MENEKŞE G,Alagöz F,KERTMEN H,CAYDERE M The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model. Turkish Neurosurgery. 2016; 26(4): 622 - 631.
Vancouver ÇELİK H,Karatay M,erdem y,YILDIRIM A,sertbaş i,karatay e,Kul H,Guvenc Y,KÖKSAL İ,MENEKŞE G,Alagöz F,KERTMEN H,CAYDERE M The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model. Turkish Neurosurgery. 2016; 26(4): 622 - 631.
IEEE ÇELİK H,Karatay M,erdem y,YILDIRIM A,sertbaş i,karatay e,Kul H,Guvenc Y,KÖKSAL İ,MENEKŞE G,Alagöz F,KERTMEN H,CAYDERE M "The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model." Turkish Neurosurgery, 26, ss.622 - 631, 2016.
ISNAD ÇELİK, Haydar vd. "The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model". Turkish Neurosurgery 26/4 (2016), 622-631.