Combinatorial Strategies with Schwann Cell Transplantation to Improve Repair of the Injured Spinal Cord

Neurosci Lett, 2009 · DOI: 10.1016/j.neulet.2008.08.092 · Published: June 12, 2009

Spinal Cord Injury Regenerative Medicine Neurology

Simple Explanation

Spinal cord injury (SCI) causes direct damage at the injury site, followed by secondary damage that leads to loss of cells. This results in paralysis, loss of sensation, and altered autonomic responses. The body attempts to repair itself after SCI, but this repair is limited. Therefore, additional treatments are needed, such as neuroprotection, regeneration, and tissue replacement. Schwann cells (SCs) from the peripheral nervous system can be transplanted into the injured spinal cord to promote axonal regeneration, myelination and neuroprotection. This review discusses the use of SCs alone or in combination with other strategies.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
SCs can fill cystic cavities, increase white matter sparing, myelinate axons, and promote axonal regeneration in various SCI models.
2
SCs from bone marrow stromal cells (BMSCs) or from skin-derived precursors (SKPs) can enhance the growth of descending brainstem axons.
3
Combining SCs with neuroprotective agents (like Rolipram or methylprednisolone) or neurotrophic factors can enhance axonal growth and functional recovery after SCI.

Research Summary

Spinal cord injury (SCI) results in direct mechanical trauma followed by secondary responses, leading to paralysis and loss of sensation. Current treatment options are inadequate, necessitating therapeutic interventions focusing on neuroprotection, regeneration, and tissue replacement. Schwann cells (SCs) are promising candidates for transplantation into the injured spinal cord. They promote axonal growth, myelination, and tissue sparing. However, they are limited in their ability to promote long-distance axon regeneration and exiting of axons from the grafts. Combining SCs with neuroprotective agents (e.g., Rolipram, methylprednisolone), molecules that modify the glial scar (e.g., chondroitinase ABC), or neurotrophic factors (NTFs) can enhance axonal regeneration and functional recovery. An ideal combination would enhance transplant survival, host tissue sparing, axonal growth, and neutralization of inhibitory signals.

Practical Implications

Improved SCI Therapies

Combining SC transplantation with neuroprotective and regenerative strategies holds promise for improving outcomes in SCI patients.

Alternative SC Sources

SCs derived from BMSCs or SKPs may offer advantages over traditional PN-derived SCs for transplantation.

Targeted Combination Therapies

Future research should focus on developing targeted combination therapies that address multiple aspects of SCI repair, including neuroprotection, regeneration, and scar modification.

Study Limitations

1
Difficulty discerning axonal regeneration in contusion models due to fiber sparing.
2
Limited long-distance regeneration and exiting of axons from SC grafts.
3
Variability in study results due to differences in injury models, surgical techniques, and cell preparation methods.

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