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  4. Neuroprotection and Axonal Regeneration After Lumbar Ventral Root Avulsion by Re-implantation and Mesenchymal Stem Cells Transplant Combined Therapy

Neuroprotection and Axonal Regeneration After Lumbar Ventral Root Avulsion by Re-implantation and Mesenchymal Stem Cells Transplant Combined Therapy

Neurotherapeutics, 2013 · DOI: 10.1007/s13311-013-0178-5 · Published: February 26, 2013

Spinal Cord InjuryRegenerative MedicineNeurology

Simple Explanation

Ventral spinal root avulsion causes muscles to lose their nerve supply, leading to paralysis. The chances for recovery are slim because neurons die and surviving neurons must regrow their axons over a long distance to reach the muscles. Researchers combined surgical re-implantation of the damaged roots with a transplant of mesenchymal stem cells (MSCs). They found that MSCs helped more neurons survive. The combination of re-implantation and MSC transplant led to better motor axon regeneration and functional re-innervation of muscles. This suggests MSCs can enhance neuronal survival and axon regrowth after this type of injury.

Study Duration
8 Weeks
Participants
75 adult female Sprague–Dawley rats
Evidence Level
Level II; Experimental Study

Key Findings

  • 1
    Transplantation of MSCs significantly increased the survival of motoneurons after ventral root avulsion, with a 45% survival rate in MSC-treated animals compared to 28% in vehicle-injected rats.
  • 2
    Combining root re-implantation with MSC transplant resulted in a higher number of surviving motoneurons (60%) compared to re-implantation alone (46%) at 28 days post-injury.
  • 3
    Electromyographic tests showed evidence of functional re-innervation of anterior tibialis and gastrocnemius muscles by regenerated motor axons only in rats that received the combined treatment of root re-implantation and MSC transplant.

Research Summary

This study investigates the potential of combined therapy involving surgical re-implantation of avulsed lumbar spinal roots and intraspinal transplantation of mesenchymal stem cells (MSCs) to promote neuroprotection and axonal regeneration after ventral root avulsion (VRA) in adult rats. The results demonstrate that MSC transplantation enhances motoneuron survival and reduces astrocyte reactivity following VRA. Furthermore, the combination of root re-implantation with MSCs significantly improves axonal regeneration and functional re-innervation of target muscles compared to re-implantation alone. The findings suggest a synergistic neuroprotective effect of the combined approach on motoneurons and axonal regeneration, offering a promising therapeutic strategy for spinal root avulsion injuries, although further optimization is needed for clinical translation.

Practical Implications

Enhanced Neuronal Survival

MSC transplantation can significantly improve the survival of motoneurons after ventral root avulsion, which is critical for functional recovery.

Improved Axonal Regeneration

The combined approach of root re-implantation and MSC transplantation enhances axonal regeneration and muscle re-innervation compared to re-implantation alone.

Potential Clinical Application

The study provides a proof-of-concept for a combined therapeutic strategy involving MSC transplantation and surgical root re-implantation for the treatment of spinal root lesions in humans.

Study Limitations

  • 1
    Limited Long-Term Efficacy
  • 2
    Incomplete Functional Recovery
  • 3
    Lack of Selective Re-innervation

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