Regenerative medicine for the treatment of spinal cord injury: more than just promises?

J. Cell. Mol. Med., 2012 · DOI: 10.1111/j.1582-4934.2012.01603.x · Published: November 1, 2012

Spinal Cord Injury Regenerative Medicine

Simple Explanation

Spinal cord injury (SCI) leads to sensory and motor deficits because the spinal cord doesn't regenerate well. The environment around the injury prevents axons from regenerating. Cell-based therapies are promising treatments because the cells can fulfill many roles. The source, dose, timing, and administration route are still being researched. Biomaterials are becoming more important in SCI treatment. They can deliver cells, fill cysts in chronic lesions, and deliver therapeutic agents to help regeneration.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Cell-based therapy for SCI can replace lost cellular elements, including neurons and oligodendrocytes, which form myelin sheaths around axons.
2
Transplanted cells, especially MSCs, can facilitate functional recovery by trophic support, modulating the inflammatory response, improving vascularization, providing a permissive growth substrate, and suppressing cavity formation.
3
The effectiveness of cell-based therapy for SCI depends on several factors, including the source of stem cells, delivery strategies, optimal dosing, timing of cell transplantation, and survival of transplanted cells.

Research Summary

This review highlights promising clinical approaches to promote spinal cord regeneration, including those in clinical trials, but notes that axonal re-growth is modest, even with cleared inhibitory cues. Cell therapies will play a key role in future SCI treatment strategies, especially MSCs, due to their safety and availability. Biomaterials also receive increased attention as cell vehicles or therapeutic agent vectors. SCI treatment is moving toward combinatorial strategies due to the complex series of events after the injury. A challenge is translating basic research advances into safe and effective clinical therapies.

Practical Implications

Combination Therapies

Future SCI treatments will likely combine cell therapies, biomaterials, and strategies to enhance intrinsic regenerative capacity.

Clinical Translation

Efforts are needed to translate basic research findings into safe and effective clinical therapies for SCI.

MSCs as Promising Candidate

MSCs are promising cell source due to their safety and availability.

Study Limitations

1
Axonal re-growth after SCI is modest, even when inhibitory cues are cleared.
2
The contribution of axonal re-growth to functional recovery is mostly unknown.
3
The review acknowledges the challenges surrounding the selection of the best cell source for cell therapies.

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