Multimodal Repair of Spinal Cord Injury With Mesenchymal Stem Cells

Neurospine, 2022 · DOI: https://doi.org/10.14245/ns.2244272.136 · Published: September 1, 2022

Spinal Cord Injury Regenerative Medicine

Simple Explanation

Spinal cord injury (SCI) is a devastating injury to the central nervous system and currently, there is no effective treatment available. Mesenchymal stem cell (MSC)-based treatment has been investigated extensively as a possible therapy. MSCs exert a multimodal repair mechanism targeting multiple events in the secondary injury cascade. Recent results show the perineurium-like differentiation of surviving MSCs in the injured spinal cord which may further the understanding of the fate of transplanted MSCs. Combining novel physical, chemical, and biological approaches led to significant improvements in the therapeutic efficacy of MSCs. These findings hold promise for the future of cell-based clinical treatment of SCI.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review Article

Key Findings

1
MSCs can promote angiogenesis and vasculogenesis when transplanted into tissues, which is critical for tissue regeneration after SCI.
2
MSCs possess anti-inflammatory and immunomodulatory capacities, suppressing the activity of immune cells and driving macrophage polarization towards the anti-inflammatory M2 phenotype, which can alleviate neuroinflammation after SCI.
3
Transplanted MSCs can form perineurium-like sheaths protecting nerve fibers, providing a physical barrier against the deleterious microenvironment and oxidative damage surrounding the injury.

Research Summary

This review summarizes current research findings about the role of MSCs in improving complex pathology after SCI. MSCs exert a multimodal repair mechanism targeting multiple events in the secondary injury cascade. The recent emergence of stem cell-based tissue engineering is a promising strategy for SCI repair. Amongst the possible candidate seed cells, mesenchymal stem cells (MSCs) are the most extensively studied both in basic science experiments and in translational research. In this review, we have shown that MSCs have multiple functional properties that can target a variety of pathological consequences of SCI. One of these is a novel finding, the perineurium-like differentiation of MSCs, that warrants further investigation.

Practical Implications

Clinical Translation

Findings support the clinical use of MSCs in SCI patients, offering a potential cell-based treatment approach.

Therapeutic Enhancement

Combining MSCs with physical, chemical, and biological approaches may improve therapeutic efficacy for SCI.

Further Research

Further investigation into the exact mechanisms by which MSCs improve outcomes after SCI is warranted to enhance their safe and effective therapeutic use.

Study Limitations

1
The exact mechanism by which MSCs contribute to spinal cord repair remains to be fully elucidated.
2
The fate of donor MSCs inside the human body remains largely unknown due to the absence of biopsy data and limited post-mortem studies.
3
The efficacy of MSCs in treating SCI remains controversial, with data from current clinical trials being inadequate to draw final conclusions.

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