Remyelination of the injured spinal cord

Prog Brain Res, 2007 · DOI: 10.1016/S0079-6123(06)61030-3 · Published: January 1, 2007

Spinal Cord Injury Regenerative Medicine

Simple Explanation

Contusive spinal cord injury often leads to demyelination of long white matter tracts. Transplantation of myelin-forming cells, like olfactory ensheathing cells (OECs), is explored to remyelinate axons and improve conduction after SCI. OECs are specialized glial cells that can promote axonal remyelination and regeneration. They associate with olfactory receptor neurons and have shown potential in encouraging axonal regeneration and functional recovery in SCI models. Transplantation of OECs after SCI can lead to functional improvement, potentially through mechanisms like axonal regeneration, axonal sparing, sprouting, recruitment of endogenous Schwann cells, and remyelination.

Study Duration

Not specified

Participants

Experimental models of SCI and demyelination

Evidence Level

Not specified

Key Findings

1
Transplanted OECs can integrate into the injury site of a dorsal funiculus transection, distribute, associate longitudinally with axons spanning the lesion site, and form myelin.
2
OEC transplantation into the injured spinal cord has a neuroprotective effect on corticospinal neurons, leading to reduced apoptosis and increased cortical neuronal density.
3
Axons remyelinated by transplanted OECs form appropriate nodal sodium channel clusters, and conduction is improved.

Research Summary

This review focuses on transplantation studies using olfactory ensheathing cells (OEC) to improve functional outcome in experimental models of SCI and demyelination. Experimental work indicates that cell transplantation approaches can facilitate axonal regeneration, remyelination, neuroprotection and possible neovascularization. Several clinical studies are ongoing using cell therapy approaches for SCI. Future translational studies are highly expected to bridge the gap between basic and clinical research in OEC transplantation for SCI.

Practical Implications

Potential Therapeutic Strategy

OEC transplantation shows promise as a therapeutic strategy for spinal cord injury by promoting remyelination, axonal regeneration, and neuroprotection.

Clinical Trial Advancement

Ongoing clinical trials using OEC transplantation in SCI patients indicate feasibility and safety, paving the way for further investigations into long-term efficacy.

Improved Understanding

Further research is needed to fully elucidate the mechanisms underlying OEC-mediated repair and optimize transplantation protocols for enhanced functional recovery after SCI.

Study Limitations

1
Controversy exists regarding whether transplanted OECs directly form myelin or recruit endogenous Schwann cells.
2
The phenotype and fate of transplanted cells in some clinical studies remain unclear.
3
Long-term safety and efficacy of OEC transplantation need further evaluation.

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