Mesenchymal stem cells in the treatment of spinal cord injury: Mechanisms, current advances and future challenges

Spinal cord injury (SCI) causes physical, mental, and financial problems for patients. Secondary SCI involves inflammation and vascular damage, leading to permanent nervous system damage. Mesenchymal stem cells (MSCs) show promise for SCI treatment because they reduce inflammation, help regenerate blood vessels, and release substances that nourish nerves. While MSCs have shown some success in clinical trials, their effectiveness remains debated due to concerns about tumor formation and the difficulty of MSCs surviving in the harsh SCI environment.

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  MSCs can suppress immunity against inflammation by direct contact with immune cells or paracrine activity, modulating the release of cytokines and growth factors at the injury site.
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  MSCs promote axon regeneration through the secretion of neurotrophic factors such as BDNF and b-NGF, and by modulating signaling pathways like MEK/ERK and Wnt/b-catenin.
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  MSCs promote vascular repair by secreting angiogenic factors like VEGF, FGF, PDGF, and IGF-1, which promote pericyte recruitment and angiogenesis, crucial for recovery of motor function.