Contents

Domain-Resolved Concordance of Gelatin Sponge and OM–MSC-Loaded Gelatin Sponge After Complete T10 Transection

Seyed Asad Alireza1, Seyed Alireza Taghavi1
1Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Complete spinal cord injury (SCI) simultaneously alters hindlimb function, tissue inflammation, lesion structure, and inflammasome-associated cell-death signaling. These outcomes are measured on incompatible scales, which makes direct numerical pooling inappropriate. The study determined how consistently acellular gelatin sponge (GS) and GS carrying olfactory mucosal mesenchymal stromal cells (GS+OM–MSC) satisfied a common favorable-response criterion across locomotor recovery, inflammatory tissue injury, and pyroptotic signaling after complete T10 transection. Fourteen endpoints from a four-group rat experiment were fixed before calculation of the domain-resolved concordance index (DRCI). An endpoint received a value of 1 when the treatment-versus-SCI comparison was significant at p < 0.05 and changed in the favorable biological direction; otherwise it received 0. Functional recovery contained BBB scores at days 14 and 28 and day-28 stride length; inflammatory tissue injury contained LDH, IL-1β, and TNF-α; pyroptotic signaling contained NLRP3, pro-caspase-1, cleaved caspase-1 at 22 and 20 kDa, GSDMD-FL, GSDMD-N, IL-1β, and IL-18. Domain breadth was the responsive proportion within each domain, and DRCI was the equally weighted mean of the three breadth values. GS produced breadth values of 0.333, 1.000, and 0.500 for function, inflammatory injury, and pyroptotic signaling, yielding DRCI=0.611. GS+OM–MSC produced 1.000, 1.000, and 0.875, yielding DRCI=0.958. BBB scores at days 14 and 28, pro-caspase-1, western-blot IL-1β, and IL-18 met the criterion under GS+OM–MSC but not under GS. Endpoint weighting gave 0.571 and 0.929, and omission of any one domain preserved the numerical ordering. GS was biologically active across all three inflammatory endpoints and selected functional and pyroptotic endpoints. OM–MSC loading was associated with complete functional coverage and broader coverage of the NLRP3–caspase-1–GSDMD pathway while retaining the GS-associated inflammatory response. DRCI quantifies response breadth rather than effect magnitude and does not establish causal mediation.

Keywords: spinal cord injury, olfactory mucosal mesenchymal stromal cells, gelatin sponge, pyroptosis, neuroinflammation, locomotor recovery, domain-resolved concordance index
Copyright © 2026 Seyed Asad Alireza, Seyed Alireza Taghavi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.