The potential of gene therapies for spinal cord injury repair: a systematic review and meta-analysis of pre-clinical studies

Neural Regeneration Research, 2023 · DOI: https://doi.org/10.4103/1673-5374.347941 · Published: February 1, 2023

Spinal Cord Injury Regenerative Medicine Genetics

Simple Explanation

This research investigates gene therapy as a potential treatment for spinal cord injuries in animal models. Gene therapy involves using genetic material to repair damaged cells or deliver therapeutic molecules. The study combines data from multiple animal studies to assess the overall effectiveness of gene therapy in promoting recovery after spinal cord injury. The researchers analyzed outcomes like locomotor function and nerve regeneration. While the findings suggest gene therapy shows promise, the review highlights the lack of agreement on which specific genes should be targeted. The study also points out potential biases in the published research.

Study Duration

Not specified

Participants

71 studies (pre-clinical models of spinal cord injury)

Evidence Level

Level 1: Systematic review and meta-analysis

Key Findings

1
Gene therapies show an overall improvement in locomotor scores in preclinical models of spinal cord injury.
2
Gene therapies led to an improvement in axonal regrowth compared with the control groups.
3
There is significant asymmetry in the funnel plots of both outcome measures indicating the presence of publication bias.

Research Summary

This systematic review and meta-analysis evaluated the efficacy of gene therapies in preclinical models of spinal cord injury (SCI). The analysis included 71 studies and assessed outcomes like locomotor score and axonal regrowth. The results indicated that gene therapies are associated with significant improvements in locomotor function and axonal regeneration in animal models of SCI. However, there was significant heterogeneity in the therapies administered. The review also revealed potential publication bias and highlighted the need for more rigorous study designs, particularly regarding allocation concealment and power calculations, to enhance the translational potential of gene therapies for SCI.

Practical Implications

Future Research

Future studies should focus on cervical SCI models and subacute/chronic administration to increase clinical translation potential.

Combinatorial Approaches

Gene therapies may need to be combined with cell therapies, biomaterials, and other strategies such as rehabilitation and epidural stimulation.

Improved Study Reporting

Address inadequate study reporting, particularly measures to reduce bias such as blinding and randomization.

Study Limitations

1
The focus on motor recovery as the primary outcome may have excluded studies focusing on sensory nerve regeneration and neuropathic pain.
2
All comparisons in subgroup analysis were insignificant, possibly due to a lack of statistical power and unbalanced subgroups.
3
There was high heterogeneity in the therapies administered.

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