Sacral Bioneuromodulation: The Role of Bone Marrow Aspirate in Spinal Cord Injuries

Bioengineering, 2024 · DOI: https://doi.org/10.3390/bioengineering11050461 · Published: May 6, 2024

Spinal Cord Injury Regenerative Medicine Neurology

Simple Explanation

Spinal cord injuries (SCI) cause lasting nerve damage, inflammation, and pain. Current treatments often don't fully fix the problem. This review looks at using bone marrow aspirate (BMA) to help. BMA has regenerative and anti-inflammatory properties. It might help repair nerve tissue and restore function lost due to SCI, especially when applied near the sacrum. The review suggests BMA's components can boost cellular repair, offering a new way to manage SCI. This approach could go beyond just easing symptoms to actually improving how well patients function.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Level 5, Review

Key Findings

1
BMA contains mesenchymal stem cells (MSCs) and hematopoietic stem cells (HSCs) that secrete molecules to modulate inflammation, promote angiogenesis, and regenerate damaged neural tissues.
2
MSCs can downregulate pro-inflammatory cytokines such as TNF-α, IL-1, and IL-6, which are pivotal in the inflammatory cascade following SCI.
3
MSCs from BMA can enhance the expression of neurotrophic factors and promote the activation of endogenous neural progenitor cells, potentially fostering remyelination and neuronal repair.

Research Summary

This review explores the potential of BMA to modulate inflammatory pathways, enhance tissue regeneration, and restore neurological function disrupted by SCI. The authors hypothesize that BMA’s bioactive components may stimulate reparative processes at the cellular level, particularly when applied at strategic sites like the sacral hiatus. This review aims to establish a foundation for BMA's application in clinical settings, potentially offering a transformative approach to SCI management that extends beyond symptomatic relief to promoting functional recovery.

Practical Implications

Therapeutic Potential

BMA may offer a transformative approach to SCI management by promoting functional recovery beyond symptomatic relief.

Targeted Application

Strategic application of BMA at sites like the sacral hiatus may influence lumbar centers and higher neurological structures.

Inflammation Modulation

BMA may help attenuate the inflammatory response and mitigate secondary damage to the spinal cord via MSCs downregulation of pro-inflammatory cytokines.

Study Limitations

1
Limited number of clinical trials specifically evaluating BMA for spinal cord injuries.
2
Functional recovery still lacks reliable results and reproducibility.
3
The exact underlying mechanisms of MSC-EVs remains unclear.

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