A review of regenerative therapy for spinal cord injury using human iPS cells

North American Spine Society Journal, 2023 · DOI: https://doi.org/10.1016/j.xnsj.2022.100184 · Published: January 1, 2023

Spinal Cord Injury Regenerative Medicine

Simple Explanation

Spinal cord injury (SCI) has been considered to cause sudden, irreversible loss of function in patients. However, developments in stem cell biology and regenerative medicine are changing this conventional notion. As a consequence of the establishment of human induced pluripotent stem cells (hiPSCs), hiPSC-based therapies for SCI, such as neural stem/progenitor cell (NS/PC) transplantation, have emerged as promising therapeutic modalities. In addition to NS/PCs, oligodendrocyte precursor cells (OPCs) are also a promising cell source for transplantation, as demyelinated axons aﬀected by SCI can be repaired by OPCs.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
hiPSC-NS/PC transplantation into subacute injured spinal cords has been repeatedly demonstrated to improve locomotor function.
2
The neuronal relay theory, in which the transplanted cell-derived neurons reconstruct disrupted neuronal circuits, was proven to be involved histologically, pharmaceutically, electrophysiologically, and via in vivo bioimaging.
3
Therapies with OPCs derived from hiPSCs are still in preclinical studies but have shown favorable outcomes in animal models.

Research Summary

Here we reviewed the overview of regenerative medicine of SCI. At the same time, the search for eﬀective treatments for chronic SCI is proceeding gradually, combining hiPSC-NS/PC transplantation with other treatment modalities such as rehabilitation, pharmaceuti- cal interventions, or optimal scaﬀolds. A clinical study has just begun on hiPSC-NS/PC transplantation for the treatment of subacute SCI, and the results are now being validated.

Practical Implications

Clinical Translation

hiPSC-NS/PC transplantation is progressing towards clinical trials for subacute SCI, offering a potential therapeutic option for patients.

Combination Therapies

Combining hiPSC-NS/PC transplantation with other treatments like rehabilitation and pharmaceutical interventions may enhance therapeutic efficacy, particularly for chronic SCI.

Future Directions

Further research is needed to optimize cell types and treatment strategies based on the specific pathological conditions of SCI, including addressing sensory disturbances and neuropathic pain.

Study Limitations

1
The biological mechanism underlying the eﬀectiveness of hiPSC-derived NS/PC transplantation therapy has remained elusive.
2
The application of hiPSC-NS/PC transplantation for chronic SCI has a long way to go.
3
Further studies are also necessary to focus on pain or sensory function considering the fact that this treatment is starting to be applied in human patients

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