Immunomodulatory Strategies for Spinal Cord Injury

After a spinal cord injury, the body's immune system can sometimes cause more harm than good. This is because immune cells rush to the site of the injury and release substances that create a hostile environment, making it difficult for nerves to regenerate. The review explores different ways to 'reprogram' the immune system to promote healing instead of hindering it. This can involve using gene therapy, nanoparticles, or stem cells to change the behavior of immune cells at the injury site. The goal is to shift the balance from a pro-inflammatory environment (which damages tissue) to a pro-regenerative environment (which supports nerve growth), ultimately improving functional recovery after SCI.

• 1
  Gene therapy can provide long-term sustained expression of therapeutic genes to modulate the inflammatory response after SCI, with viral vectors like lentivirus and adeno-associated virus being less immunogenic than adenovirus.
• 2
  Nanoparticles can modulate immune responses by distracting circulating immune cells or attenuating the activation of pro-inflammatory macrophages and microglia, creating a more permissive environment for nerve regeneration after SCI.
• 3
  Stem cells, particularly neural stem cells and mesenchymal stem cells, can reprogram the inflammatory environment by releasing anti-inflammatory cytokines and promoting macrophage polarization towards a pro-regenerative phenotype after SCI.