Therapeutic Approaches Targeting Vascular Repair After Experimental Spinal Cord Injury: A Systematic Review of the Literature

Neurospine, 2022 · DOI: https://doi.org/10.14245/ns.2244624.312 · Published: December 1, 2022

Spinal Cord Injury Cardiovascular Science Regenerative Medicine & Stem Cells

Simple Explanation

Traumatic spinal cord injury (SCI) disrupts the spinal cord vasculature resulting in ischemia, amplification of the secondary injury cascade and exacerbation of neural tissue loss. Restoring functional integrity of the microvasculature to prevent neural loss and to promote neural repair is an important challenge and opportunity in SCI research. The MEDLINE databases PubMed, Embase, and OVID MEDLINE were searched using the keywords “spinal cord injury,” “angiogenesis,” “angiogenesis inducing agents,” “tissue engineering,” and “rodent subjects.”

Study Duration

Not specified

Participants

Rodent subjects

Evidence Level

Level 4: Systematic Review

Key Findings

1
Five main therapeutic approaches to diminish hypoxia-ischemia and promote vascular repair were identified as (1) the application of angiogenic factors, (2) genetic engineering, (3) physical stimulation, (4) cell transplantation, and (5) biomaterials carrying various factor delivery.
2
Combinatorial approaches using implanted biomaterials and angiogenic factor delivery appear promising for clinical translation.
3
The application of angiogenic factors is a well-studied approach, with growth factors like VEGF showing potential to regenerate functional blood vessels.

Research Summary

Traumatic spinal cord injury (SCI) disrupts the spinal cord vasculature resulting in ischemia, amplification of the secondary injury cascade and exacerbation of neural tissue loss. Restoring functional integrity of the microvasculature to prevent neural loss and to promote neural repair is an important challenge and opportunity in SCI research. Combinatorial approaches, like implanted biomaterials with the ability to release angiogenic factors or therapeutic cells in a temporally and spatially controlled manner seem most promising to restore functional vasculature and to be translatable into clinical patient care in the future.

Practical Implications

Clinical Translation Potential

Combinatorial approaches using biomaterials and angiogenic factors show promise for clinical application.

Targeted Therapies

Genetic engineering allows for direct activation of endogenous growth factor expression, potentially improving vascular repair.

Rehabilitative Strategies

Physical stimulation techniques, like water treadmill training, could supplement clinical therapies to induce vascular repair.

Study Limitations

1
The exact degradation time of most biomaterials in SCI is unknown.
2
Degradation byproducts of biomaterials might cause immunological reactions.
3
Limited comparability from controlled animal models into individual human SCI cases makes translation difficult.

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