Therapeutic Strategies Targeting Respiratory Recovery after Spinal Cord Injury: From Preclinical Development to Clinical Translation

Cells, 2023 · DOI: 10.3390/cells12111519 · Published: May 31, 2023

Simple Explanation

High spinal cord injuries often lead to permanent respiratory problems, with many patients needing ventilators to survive. Current treatments can't fully restore diaphragm function, which is crucial for breathing. Researchers are exploring new therapies that target inflammation and promote the body's natural healing processes after a spinal cord injury. These strategies aim to help patients regain voluntary control of their breathing. These therapeutic approaches are typically first developed and tested in relevant preclinical models, with some of them having been translated into clinical studies.

Study Duration

Not specified

Participants

Relevant preclinical models and human studies

Evidence Level

Review

Key Findings

1
Activity-based therapies, like intermittent hypoxia, have shown promise in improving respiratory function after spinal cord injuries by amplifying plasticity in damaged respiratory networks.
2
Invasive and non-invasive stimulation techniques, such as epidural stimulation and transcranial magnetic stimulation, can modulate neuronal excitability and promote respiratory recovery after spinal cord injury.
3
Cell transplantation strategies, including astrocyte and neuronal transplantation, aim to protect neurons, modulate the immune system, and create new neuronal networks to restore respiratory function after spinal cord injury.

Research Summary

High spinal cord injuries (SCIs) lead to permanent functional deﬁcits, including respiratory dysfunction. A better understanding of inﬂammatory and pro-regenerative processes, as well as how they can be therapeutically manipulated, will be the key to achieving optimal functional recovery following SCIs. Combinatorial strategies that can each target unique aspects of an injury’s pathology to enhance recovery in an additive or even synergistic manner are an important step toward achieving respiratory restoration after SCIs.

Practical Implications

Clinical Translation of Preclinical Findings

The review emphasizes the importance of translating successful preclinical therapeutic strategies into human clinical trials to improve respiratory outcomes for SCI patients.

Combination Therapies

Future research should focus on developing combination therapies that target multiple aspects of SCI pathology to maximize respiratory recovery.

Targeted Neurotrophin Delivery

Speciﬁcally targeting phrenic motoneurons with neurotrophins may avoid undesirable side effects and enhance respiratory recovery.

Study Limitations

1
No therapies can completely restore respiratory function post-SCI
2
Efficacy of treatments remains limited when translated to human studies
3
Clinical information about respiratory recovery after cell transplantation remains scarce

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