Regenerative Rehabilitation and Stem Cell Therapy Targeting Chronic Spinal Cord Injury: A Review of Preclinical Studies

Cells, 2022 · DOI: 10.3390/cells11040685 · Published: February 16, 2022

Spinal Cord Injury Regenerative Medicine

Simple Explanation

Stem cell medicine has shown promise in restoring function after spinal cord injury (SCI) in the acute-to-subacute phase, but has not yet been as successful in the chronic phase, when the spinal cord tissue undergoes significant changes making it resistant to treatment. Regenerative rehabilitation combines regenerative medicine, such as stem cell therapy, with rehabilitation techniques to achieve synergistic effects. This review summarizes regenerative rehabilitation studies, categorizing them by the type of intervention, the location of the intervention, and the mechanism of action, with the goal of establishing a treatment regimen that induces robust functional recovery upon chronic SCI.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Level 5, Review of Preclinical Studies

Key Findings

1
Regenerative rehabilitation can directly influence transplanted cells, promoting differentiation into neurons and oligodendrocytes, and inducing plastic changes in the lumbar enlargement of the spinal cord.
2
However, regenerative rehabilitation does not induce any remarkable histological change at the lesion epicenter of the chronically injured spinal cord.
3
Combining regenerative rehabilitation with stem cell therapy shows limited effects on fibrotic and glial scarring in the chronic phase, indicating a need for further combinatorial treatments like medication.

Research Summary

Stem cell therapies have shown promise in the acute-to-subacute phase of SCI, but are less effective in the chronic phase due to tissue remodeling. Regenerative rehabilitation, combining regenerative medicine with rehabilitation, aims to enhance functional recovery. Regenerative rehabilitation promotes neuronal differentiation and plasticity, but has limited impact on histological changes at the lesion epicenter in chronic SCI. Further combinatorial treatments, such as medication targeting fibrotic and glial scarring, are needed to complement regenerative rehabilitation for robust functional recovery in chronic SCI.

Practical Implications

Optimizing Rehabilitation Strategies

Tailoring rehabilitative strategies to maximize therapeutic effects by understanding mechanisms in chronic SCI.

Developing Combinatorial Treatments

Exploring additional treatments, like medication, to address limitations of regenerative rehabilitation alone.

Improving Clinical Trial Design

Enhancing clinical trial designs by accurately elucidating mechanisms of rehabilitation and transplantation.

Study Limitations

1
Lack of standardized methods or systematic review for regenerative rehabilitation.
2
Limited number of preclinical studies on regenerative rehabilitation in the chronic phase of SCI.
3
Unclear causal relationships between histological changes and regenerative rehabilitation.

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