Current treatments after spinal cord injury: Cell engineering, tissue engineering, and combined therapies

Smart Medicine, 2022 · DOI: 10.1002/SMMD.20220017 · Published: October 20, 2022

Spinal Cord Injury Biomedical Regenerative Medicine & Stem Cells

Simple Explanation

Spinal cord injuries (SCIs) are damages to the central nervous system that can significantly impact a person's physical and mental health. Current treatments focus on bioengineering strategies using cells, biomaterials, and biomolecules to repair the spinal cord. This review provides an overview of the physiology, causes, and mechanisms of SCI, and emphasizes clinical treatments and bioengineering strategies, including cell-based, biomaterial-based, and biomolecule-based approaches for spinal cord regeneration. The article aims to give scientists and clinicians a comprehensive perspective on recent advances in preclinical and clinical SCI treatments, with the goal of identifying potential solutions for functional regeneration of the spinal cord.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review Article

Key Findings

1
Recent advances in bioengineering have shown that therapies based on cells, biomaterials, and biomolecules are effective in spinal cord regeneration.
2
Despite advances in SCI repair with novel strategies, achieving successful functional regeneration of the injured spinal cord remains a complex physiological process.
3
Cell-based strategies, particularly stem cell therapy, have many uncertainties to consider before being fully publicized, regarding cell dose and application route.

Research Summary

This review summarizes recent advances in cell engineering, tissue engineering, and combined therapies for spinal cord injury (SCI) treatment. It covers cell-based strategies with neuroprotective and neuroregenerative characteristics, scaffold-based strategies using hydrogels and ECM-derived scaffolds, and biomolecule-based strategies involving growth factors and exosomes. The review emphasizes the importance of combining cell-based, biomolecule-based, and biomaterial-based approaches to address the complex syndromes of SCI and achieve functional regeneration of the spinal cord.

Practical Implications

Ideal Biomaterial Development

Focus on creating biomaterials with controllable drug release rates and degradation rates synchronized with spinal cord regeneration.

Standardization of Cell-Based Therapies

Establish precise principles for cell numbers, cell types, and universal standards for cell-based therapies in clinical trials.

Clinical Translation

Overcome challenges in maintenance and expansion of stem cells, protocols for stem cell differentiation, and protection of cargos in delivery systems.

Study Limitations

1
Construction of ideal biomaterials for stem cell encapsulation, scaffold construction, or drug delivery vehicles.
2
Lack of clinically effective strategy for the treatment of SCI.
3
Reproducing the same effects of SCI regeneration in animal models and translating them into clinical use.

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