Molecular approaches for spinal cord injury treatment

Neural Regeneration Research, 2023 · DOI: 10.4103/1673-5374.344830 · Published: January 1, 2023

Spinal Cord Injury Pharmacology Regenerative Medicine

Simple Explanation

Injuries to the spinal cord result in permanent disabilities that limit daily life activities. The main reasons for these poor outcomes are the limited regenerative capacity of central neurons and the inhibitory milieu that is established upon traumatic injuries. Many strategies are tested in preclinical studies that focus on ameliorating the functional outcomes after spinal cord injury. Among these, molecular compounds are currently being used for neurological recovery, with promising results. In this review we focused on molecules that are being used, either in preclinical or clinical studies, to treat spinal cord injuries, such as drugs, growth and neurotrophic factors, enzymes, and purines.

Study Duration

Not specified

Participants

Traumatic spinal cord injury in rodents and humans

Evidence Level

Review of preclinical experimental studies and human clinical trials

Key Findings

1
Molecular compounds, including drugs, growth factors, enzymes, and purines, are being explored in preclinical and clinical studies to treat spinal cord injuries.
2
Pharmacological treatments targeting blood perfusion, inflammation, voltage-gated cation channels, and growth cone collapse are being investigated for SCI.
3
Enzymes like chondroitinase ABC and sialidases are being studied for their ability to promote axonal regeneration by modifying the glial scar and myelin inhibitors.

Research Summary

Central axons fail to regenerate appropriately after a traumatic lesion. Therefore, the damaged connections are not reestablished after SCI, leaving permanent dysfunctions. Among several therapeutic interventions, molecular therapy has been showing promising results in terms of functional recovery. Pharmaceuticals, growth and neurotrophic factors, enzymes, and purines are being tested as a treatment after SCI. Experimental studies focusing on combinations of molecules and/or pro-regenerative strategies are needed and, hopefully, will provide better outcomes in terms of functional recovery after SCI.

Practical Implications

Drug Development

The review identifies potential drug targets for SCI treatment, including growth cone collapse inhibitors, anti-inflammatory compounds, and blood-perfusion controlling drugs.

Combination Therapies

The need for combinatorial treatments involving different drugs or regenerative therapies to overcome the inhibitory environment of the injured spinal cord is highlighted.

Clinical Trial Advancement

The review encourages the translation of promising preclinical results for molecular compounds into well-designed clinical trials for SCI patients.

Study Limitations

1
Most molecules are still at the preclinical stage.
2
Few studies focus on combining molecules or molecular therapy with other strategies.
3
There is a need for more judicious and well-designed experimental studies.

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