Stem cell therapies for spinal cord injury in humans: A review of recent clinical research

Brain and Spine, 2025 · DOI: https://doi.org/10.1016/j.bas.2025.104207 · Published: February 7, 2025

Spinal Cord Injury Regenerative Medicine

Simple Explanation

Spinal cord injury (SCI) is a devastating condition that can suddenly leave a healthy individual severely paralyzed, with little chance of spontaneous recovery. In this context, cell transplantation has garnered attention as a new treatment approach. Clinical studies on regenerative treatments for SCI have increased since 2000, and remarkable progress has been made in recent years. This review provides an overview of recent advances in cell transplantation therapy, focusing on patients involved in clinical research.

Study Duration

Not specified

Participants

Patients with spinal cord injuries

Evidence Level

Review of clinical trials

Key Findings

1
Promising results have been reported for patients with subacute SCI, especially in studies involving MSCs, such as those conducted with Stemirac, although no universally recognized breakthroughs have been achieved.
2
Allogenic NS/PCs may offer advantages over autologous MSCs because they have the potential for cell engraftment within the spinal cord and can be prepared in advance, facilitating their administration during the hyperacute phase.
3
Recent advances achieved with induced pluripotent stem cells indicate their promise potential to be used in future therapies.

Research Summary

This review provides an overview of recent advances in cell transplantation therapy, focusing on patients involved in clinical research. Over the past decade, numerous clinical studies of SCI have been conducted using various types of cells, including fetal neural stem/progenitor cells (NS/PCs), pluripotent stem cell-derived NS/PCs, mesenchymal stem/stromal cells (MSCs), olfactory ensheathing cells, and Schwann cells. In Japan, the regenerative medicine product Stemirac has been recognized by the Ministry of Health, Labor, and Welfare as effective for patients with subacute SCI and has received conditional insurance coverage.

Practical Implications

Advancement of Cell Transplantation Therapies

Continued research and refinement of cell transplantation techniques hold promise for improving outcomes in SCI patients.

Personalized Treatment Approaches

The use of iPS cells allows for the generation of patient-specific therapies, potentially leading to more effective and targeted treatments.

Combination Therapies

Combining cell transplantation with neurorehabilitation and other innovative techniques may enhance functional recovery in SCI patients.

Study Limitations

1
The medical burden on each patient is large, making recruiting more patients to clinical trials difficult.
2
SCI often results in functional changes long after injury (Kirshblum et al., 2004), making it more difficult to evaluate the efficacy of new treatments.
3
The high costs of developing cell preparations and the scarcity of clear standards for determining their efficacy have led several pharmaceutical companies to withdraw from developing regenerative medicines for SCI.

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