Mechanisms of Stem Cell Therapy in Spinal Cord Injuries

This review explores stem cell therapies for spinal cord injury (SCI), highlighting that current treatments like rehabilitation have limited tissue restoration. It emphasizes the need for precision medicine in SCI, similar to cancerology, considering individual injury characteristics for effective treatment. The review details the complex nature of SCI, including changes over time, chronic phase characteristics, and complete injury subtypes, suggesting appropriate stem cell therapy targets for each pathological condition. The article categorizes stem cell therapies into supportive (non-neural stem cells like MSCs) and loading (neural stem cells like OECs, NSPCs, NPCs) types. Supportive therapies use intravenous or intrathecal administration, relying on neurotrophic factors for therapeutic effects, while loading therapies involve direct transplantation into the injured spinal cord for neural cell replacement. The review also focuses on cervical spinal cord injuries, which account for a significant proportion of SCI cases and have severe sequelae. It highlights that the Activity of Daily Living (ADL) depends on the injury's spinal level, emphasizing the potential for effective functional regeneration through stem cell therapy, even after complete injury.

• 1
  SCI pathophysiology is multifaceted, necessitating treatments that address dynamic interactions between various cell types. Stem cells are suited for this purpose due to their ability to duplicate, differentiate, and secrete trophic factors.
• 2
  Complete SCI can be classified into pseudo-complete (non-functional but reactivatable tissue remains) and true complete (no reactivatable tissue remains) injuries, impacting treatment strategies and expected outcomes.
• 3
  Neurotrophic factors secreted by stem cells exert neuroprotective and anti-inflammatory effects, making the acute and subacute phases optimal for transplantation to mitigate cell death and inflammation.