Cell Therapeutic Strategies for Spinal Cord Injury

Advances in Wound Care, 2019 · DOI: 10.1089/wound.2019.1046 · Published: November 1, 2019

Spinal Cord Injury Regenerative Medicine

Simple Explanation

Spinal cord injury (SCI) disrupts the spinal cord's long axis, leading to cystic cavities, glial scar formation, myelin inhibition, and inflammation, hindering spinal cord repair. Current SCI treatments face significant challenges, but cell therapeutics offer a promising new approach. Cell therapeutics involves transplanting cells to treat SCI. This approach offers neuroprotection, immune regulation, axonal regeneration, neuron relay formation, and re-myelination, potentially overcoming the limitations of existing treatments. The future of SCI therapy may involve combining multiple strategies, focusing on comprehensive spinal cord injury treatment. Combining different cell therapy strategies could lead to more significant success in spinal cord repair.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Schwann cells (SCs) promote neuroprotection, reduce cyst and glial scar formation, and enhance axonal regeneration and myelinization, leading to improved functional outcomes after SCI.
2
Olfactory ensheathing cells (OECs) enhance axon regeneration and functional recovery after SCI by creating a positive microenvironment, regulating glial scar formation, and promoting axon remyelination.
3
Neural stem cells (NSCs) facilitate spinal cord recovery by differentiating into neurons and oligodendrocytes, replacing lost cells, secreting neurotrophic molecules, reducing lesion volume, and improving electrophysiological and motor functional recovery.

Research Summary

Cell therapeutics is a promising approach for nerve regeneration, playing roles in neuron and glial cell replacement, neurotrophic factor and anti-inflammatory cytokine secretion, tissue retention and angiogenesis stimulation, neural pathway reconstruction, cystic cavity lesion filling, and axonal regeneration and remyelination. There are noteworthy differences between similar cells depending on the species, age, culture conditions and delivery patterns of the donor. Most studies focus on subacute and acute conditions, with chronic treatment being rare. Future SCI therapy in clinical practice may involve combining multiple strategies for comprehensive treatment. The combination of different cell therapy strategies will lead to more dramatic success in spinal cord repair.

Practical Implications

Combination Therapies

Combining different cell therapy strategies with drug delivery, gene therapy, and biomaterials to promote regeneration after SCI.

Clinical Translation

Thorough investigation of cell therapies to ensure no increased likelihood of tumors and infections before clinical use.

Primate Models

Utilizing primate models for SCI research due to their spinal cord's similarity to the human spinal cord.

Study Limitations

1
Challenges after SCI include cystic cavities, glial scar, myelin inhibitor, and inflammation.
2
Limitations to iPSCs, such as genetic/epigenetic abnormalities and tumor formation due to artificial induction genes.
3
Unstable physicochemical properties of NGF, and its ability to cross the blood/spinal cord barrier is low.

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