Current Concepts of Stem Cell Therapy for Chronic Spinal Cord Injury

International Journal of Molecular Sciences, 2021 · DOI: https://doi.org/10.3390/ijms22147435 · Published: July 11, 2021

Spinal Cord Injury Regenerative Medicine

Simple Explanation

Chronic spinal cord injury (SCI) is a severe condition with limited treatment options. Recent research focuses on regenerative strategies, including stem cell therapies, to address the persistent challenges of SCI. Stem cell therapies, such as mesenchymal stem cells, neural stem cells, and induced pluripotent stem cells, are being explored in clinical trials to regenerate neural circuits and support endogenous cells. Future successful therapies will likely combine stem cells with other approaches to overcome barriers like glial scarring and immunorejection, facilitating regeneration in the injured spinal cord.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Exogenous neural stem cell (NSC) therapies hold promise due to their ability to differentiate into neurons, astrocytes, and oligodendrocytes, potentially regenerating neural circuits and providing trophic support.
2
Chondroitinase ABC (ChABC) can degrade CSPGs, promoting axonal regeneration and enhancing transplant survival, making the injured spinal cord more receptive to regenerative iPSC therapy.
3
Mesenchymal stem cells (MSCs) exert therapeutic effects through paracrine activities, secreting factors that protect neurons and oligodendrocytes, promote angiogenesis, and modulate the immune response.

Research Summary

This review summarizes recent insights into preclinical and clinical studies using stem cells and supportive drugs for chronic SCI, highlighting the challenges and potential of stem cell therapy. The authors provide an overview of chronic SCI, focusing on the barriers to regeneration such as glial scarring and CSPGs, and consider current clinical stem cell therapy approaches. The review emphasizes the need for combinatory therapies involving stem cells, biomaterial scaffolds, and other synergistic approaches to address persistent barriers to regeneration in chronic SCI.

Practical Implications

Clinical Translation

Advancements in stem cell technology and neuroimaging can accelerate the translation of novel therapeutic strategies from bench to bedside for chronic SCI.

Combinatorial Approaches

Combining stem cell therapies with molecular therapies and supportive scaffolds can enhance cell-material interactions and improve regenerative outcomes.

Targeting the Microenvironment

Unlocking the inhibitory microenvironment in chronic SCI by addressing glial scarring and immunorejection is crucial for successful stem cell-based therapies.

Study Limitations

1
Ethical considerations in human chronic SCI trials make comparisons between treatment and control groups difficult.
2
Results of animal experiments cannot be directly applied to humans due to inherent limitations.
3
Tumorigenicity and host immune rejection remain key challenges for iPSC-based therapies.

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