Abstract
Affecting approximately 17,000 new people each year, spinal cord injury (SCI) is a devastating injury that leads to permanent paraplegia or tetraplegia. Current pharmacological approaches are limited in their ability to ameliorate this injury pathophysiology, as many are not delivered locally, for a sustained duration, or at the correct injury time point. With this review, we aim to communicate the importance of combinatorial biomaterial and pharmacological approaches that target certain aspects of the dynamically changing pathophysiology of SCI. After reviewing the pathophysiology timeline, we present experimental biomaterial approaches to provide local sustained doses of drug. In this review, we present studies using a variety of biomaterials, including hydrogels, particles, and fibers/conduits for drug delivery. Subsequently, we discuss how each may be manipulated to optimize drug release during a specific time frame following SCI. Developing polymer biomaterials that can effectively release drug to target specific aspects of SCI pathophysiology will result in more efficacious approaches leading to better regeneration and recovery following SCI.
Highlights
Affecting approximately 17,000 new people in the United States (US) each year, Spinal cord injury (SCI) is devastating because there is currently no cure, and individuals with SCI experience permanent paraplegia or tetraplegia (NSCISC, 2016)
The dogma had been that the macrophage and astrocyte responses during injury have primarily negative impacts on regeneration
Studies have since proven that macrophage (Kigerl et al, 2009) and astrocyte (Anderson et al, 2016) responses are beneficial and imperative to recovery
Summary
Affecting approximately 17,000 new people in the United States (US) each year, SCI is devastating because there is currently no cure, and individuals with SCI experience permanent paraplegia or tetraplegia (NSCISC, 2016). Following SCI, vertebrae surrounding the soft spinal cord tissue are dislodged, resulting in the compression of the spinal cord and death of glia and neurons. This initial mechanical damage propagates away from the epicenter of the injury site via secondary injury, preventing regeneration of spinal cord tissue. The aim of this review is to discuss experimental approaches utilizing biomaterials to deliver drugs locally to the injured spinal cord.
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