Traumatic spinal cord injury (SCI) research has recently focused on the use of rat and mouse models for in vivo SCI experiments. Such small rodent SCI models are invaluable for the field, and much has been discovered about the biologic and physiologic aspects of SCI from these models. It has been difficult, however, to reproduce the efficacy of treatments found to produce neurologic benefits in rodent SCI models when these treatments are tested in human clinical trials. A large animal model may have advantages for translational research where anatomical, physiological, or genetic similarities to humans may be more relevant for pre-clinically evaluating novel therapies. Here, we review the work carried out at the University of British Columbia (UBC) on a large animal model of SCI that utilizes Yucatan miniature pigs. The UBC porcine model of SCI may be a useful intermediary in the pre-clinical testing of novel pharmacological treatments, cell-based therapies, and the “bedside back to bench” translation of human clinical observations, which require preclinical testing in an applicable animal model.
Animals ; British Columbia ; Humans ; Mice ; Models, Animal ; Rats ; Rodentia ; Spinal Cord Injuries ; Spinal Cord ; Swine ; Translational Medical Research

Objective: While the low dose short Synacthen® test (LDSST) is considered to be the gold standard to evaluate adrenal function, it is labor-intensive, invasive and inconvenient. The aim of the study is to identify cut-offs for spot serum cortisol for in-patients and morning serum cortisol for out-patients. The study also aims to describe the disease spectrum leading to suspicion of adrenal insufficiency in a Chinese out-patient cohort. Methodology: Adult patients were recruited from a tertiary hospital in Hong Kong. 423 in-patients were included consecutively from July 2013 to December 2013, and 422 out-patients from June 2014 to October 2014. Serum cortisol responses at 0, 20 and 30 minutes were evaluated. Results: For in-patients admitted for acute illness, a spot serum cortisol of ≤92 nmol/L indicated adrenal insufficiency, and a value of ≥494 nmol/L signaled adequate adrenal reserve. The respective morning cortisol values for out-patients who were ambulatory and not under stress were ≤124 nmol/L and ≥428 nmol/L. The percentage of unnecessary LDSST was higher in the in-patient cohort than the out-patient cohort (43% and 37%, respectively). The most common referral for out-patient LDSST was for suspected iatrogenic Cushing’s syndrome (ie: iatrogenic adrenal suppression) from Rheumatology. Conclusions The LDSST is of little added value in in-patients with spot serum cortisol of ≤92 nmol/L or ≥494 nmol/L and out-patients with morning serum cortisol of ≤124 nmol/L or ≥428 nmol/L. Spot and morning cortisol levels, for in and out-patients respectively, should be incorporated into endocrine protocols preceding the LDSST in the workup of adrenal insufficiency
Adrenal Insufficiency