Clinical Trials Targeting Secondary Damage after Traumatic Spinal Cord Injury

Int. J. Mol. Sci., 2023 · DOI: 10.3390/ijms24043824 · Published: February 14, 2023

Spinal Cord Injury Neurology Research Methodology & Design

Simple Explanation

Spinal cord injuries often lead to loss of sensory and motor abilities, significantly impacting a patient's life. Currently, there are no treatments to repair the spinal cord tissue itself. After the initial injury, the body's inflammatory response causes further damage, known as secondary injury. Focusing on treatments to prevent this secondary damage in the acute (initial) and subacute (shortly after initial) phases of SCI is a promising method to improve patient outcomes. This paper reviews clinical trials for therapies that aim to protect the nervous system, specifically those that are expected to lessen secondary injury. The discussed strategies are grouped into surgical interventions, systemically delivered drugs, and cell-based treatments.

Study Duration

Not specified

Participants

Number of participants varies across clinical trials reviewed

Evidence Level

Review of clinical trials

Key Findings

1
Early decompression surgery (within 24 hours of injury) is associated with better neurological recovery in thoracic or thoracolumbar SCI patients.
2
Minocycline, an anti-inflammatory drug, shows promise in improving motor scores in patients with cervical spinal cord injuries.
3
Umbilical cord mesenchymal stem cells (UC-MSCs) show promise in improving motor function and sensory abilities in patients with incomplete subacute or chronic cervical and/or thoracic SCI.

Research Summary

This review summarizes clinical trials focused on mitigating secondary damage after traumatic spinal cord injury (SCI). It categorizes therapeutic strategies into early procedural interventions, pharmacological therapies, cell-based therapies, and combinatorial approaches. Early interventions like maintaining mean arterial pressure (MAP), therapeutic hypothermia (TH), cerebrospinal fluid (CSF) drainage, and decompression surgery (DS) aim to reduce tissue loss caused by secondary damage. Pharmacological agents like glibenclamide, minocycline, riluzole, sovateltide, and G-CSF target mechanisms such as intra-spinal bleeding, inflammation, neuroexcitation toxicity, and promotion of angiogenesis and neurogenesis.

Practical Implications

Acute SCI Management

Highlights the importance of aggressive management of acute SCI, including MAP augmentation and surgical decompression.

Pharmacological Interventions

Suggests potential for repurposing existing drugs like minocycline and riluzole for SCI treatment.

Cell-Based Therapies

Supports further research into cell-based therapies, particularly UC-MSCs and OPCs, for neuroprotection and regeneration.

Clinical Trials Targeting Secondary Damage after Traumatic Spinal Cord Injury

Simple Explanation

Key Findings

Research Summary

Practical Implications

Acute SCI Management

Pharmacological Interventions

Cell-Based Therapies

Study Limitations

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Clinical Trials Targeting Secondary Damage after Traumatic Spinal Cord Injury

Simple Explanation

Key Findings

Research Summary

Practical Implications

Acute SCI Management

Pharmacological Interventions

Cell-Based Therapies

Study Limitations

Your Feedback

Was this summary helpful?