Current status of cell-mediated regenerative therapies for human spinal cord injury

Neurosci Bull, 2014 · DOI: 10.1007/s12264-013-1438-4 · Published: August 1, 2014

Spinal Cord Injury Regenerative Medicine Neurology

Simple Explanation

This review summarizes clinical studies with cell-mediated transplantation for spinal cord injury and strategies for further clinical applications. Also, we provide a practical overview of independent clinical studies published in Chinese journals. Mesenchymal stem cells (MSCs) can be obtained from bone marrow, fat, umbilical cord, periosteum, and placenta. These tissues contain small numbers of adult stem cells, which can differentiate into various mesenchymal cells In the field of neuroscience, research on cell-mediated regenerative therapy for human diseases is still at the preliminary stage. Although the desire to promote clinical trials with multiple types of stem cells for various diseases is extremely strong, current knowledge about the mechanisms of cell-mediated regenerative therapy is poor, so the situation once the cells are introduced into the patients remains unclear.

Study Duration

Not specified

Participants

More than 1700 SCI patients have received cell-mediated transplantation therapy.

Evidence Level

Review

Key Findings

1
Current transplantation therapies are relatively safe and have provided varying degrees of neurological recovery in SCI patients.
2
The leading role of MSCs is believed to be neuroprotective by secreting neurotrophic factors, rather than inducing neural regeneration by transdifferentiation into neurons or glia.
3
UC-MSCs were injected intrathecally into 22 patients with SCI and The treatment was effective in 81.25% of patients with incomplete SCI, but ineffective in all 6 patients with complete SCI.

Research Summary

This review summarizes recently-completed clinical trials using cell-mediated regenerative therapies for human SCI, together with ongoing trials using neural stem cells. Specifically, clinical studies published in Chinese journals are included. These studies show that current transplantation therapies are relatively safe, and have provided varying degrees of neurological recovery. Despite these and other challenges, with the collaboration of research groups and strong support from various organizations, cell-mediated regenerative therapies will open new perspectives for SCI treatment.

Practical Implications

Refining Clinical Trial Design

Careful selection of target populations, including staging, severity, and segmenting of SCIs, is crucial for meaningful clinical trial outcomes.

Optimizing Transplantation Material

Selecting the most suitable cell type (e.g., MSCs vs. NSCs) based on the specific condition and desired therapeutic effect is essential.

Streamlining Regulatory Procedures

Governing bodies should adjust regulatory procedures to keep pace with scientific progress, facilitating research innovation and product development.

Study Limitations

1
Many obstacles exist, hindering the introduction of a specific clinical therapy, including complications and their causes.
2
Selection of the target population is challenging.
3
Optimization of transplantation material is needed.

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