Harnessing the power of cell transplantation to target respiratory dysfunction following spinal cord injury

Exp Neurol, 2017 · DOI: 10.1016/j.expneurol.2016.08.009 · Published: January 1, 2017

Spinal Cord Injury Pulmonology Regenerative Medicine & Stem Cells

Simple Explanation

Cell transplantation is being explored as a treatment for spinal cord injuries (SCI). It aims to repair damage and restore function by replacing lost cells, promoting nerve regeneration, protecting existing cells, and modulating the immune response. Respiratory problems are a major concern for SCI patients. Cell transplantation could help by replacing damaged neurons in the circuits that control breathing, promoting the growth of new connections, or restoring neurotransmitter signaling. Researchers have used different types of cells, including peripheral nerve grafts and olfactory ensheathing cells, to promote the regrowth of axons involved in breathing control. These approaches have shown some success in animal models of SCI.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Peripheral nerve grafts (PNGs) can promote the regrowth of respiratory-associated axons after SCI. Combining PNGs with chondroitinase ABC (ChABC) to remove growth inhibitors can enhance functional recovery of the diaphragm.
2
Olfactory ensheathing cells (OECs) have the potential to enhance axonal regrowth and sprouting following SCI, including from critical respiratory neuronal populations.
3
Transplantation of glial-restricted precursor (GRP)-derived astrocytes engineered to overexpress GLT1 can protect phrenic motor neurons and preserve diaphragm function after cervical SCI.

Research Summary

This review discusses the potential of cell transplantation for addressing respiratory dysfunction following spinal cord injury (SCI). It highlights the limited number of studies that have explored this therapeutic approach, despite the critical role of pulmonary compromise in patient outcomes. The review examines various cell types and strategies used in preclinical studies, including peripheral nerve grafts, olfactory ensheathing cells, and fetal spinal cord transplants. These approaches aim to promote axonal regrowth, replace damaged cells, and modulate the neural circuitry involved in respiratory control. The authors conclude that cell transplantation holds promise for improving respiratory function after SCI by targeting multiple cellular mechanisms. They emphasize the need for future research to explore additional cell types and combinatorial approaches to enhance therapeutic outcomes.

Practical Implications

Axonal Regeneration Strategies

Peripheral nerve grafts and olfactory ensheathing cells can be used to promote axonal regrowth and sprouting after SCI, potentially restoring respiratory function.

Cellular Replacement Therapies

Transplantation of glial progenitors and fetal spinal cord tissue can replace damaged cells and modulate neural circuitry, improving respiratory outcomes.

Gene Delivery Approaches

Cell transplantation can be used as a vehicle to deliver therapeutic molecules, such as neurotrophic factors and glutamate transporters, to the injured spinal cord.

Study Limitations

1
Limited number of studies specifically targeting respiratory dysfunction post-SCI.
2
Neuroanatomical basis of plasticity following transplantation needs further investigation.
3
Lack of respiratory outcome data in clinical trials involving cell transplantation for SCI.

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