Abstract
Chronic spinal cord injury (SCI) is a devastating condition that results in major neurological deficits and social burden. It continues to be managed symptomatically, and no real therapeutic strategies have been devised for its treatment. Neural stem/neural progenitor cells (NSCs/NPCs) being used for the treatment of chronic SCI in experimental SCI models can not only replace the lost cells and remyelinate axons in the injury site but also support their growth and provide neuroprotective factors. Currently, several clinical studies using NSCs/NPCs are underway worldwide. NSCs/NPCs also have the potential to differentiate into all three neuroglial lineages to regenerate neural circuits, demyelinate denuded axons, and provide trophic support to endogenous cells. This article explains the challenging pathophysiology of chronic SCI and discusses key NSC/NPC-based techniques having the greatest potential for translation over the next decade.
Highlights
Severe traumatic spinal cord injury (SCI) disrupts long descending and ascending nerve fibers as well as the orientated glial framework of white matter tracts, causing a loss of motor, sensory, and autonomic function
We reported that Chondroitinase ABC (ChABC) administration reduced chronic injury scar and significantly improved neural stem cells (NSCs) derived from induced pluripotent stem cell survival with clear differentiation into all three neuroglial lineages
These articles indicate that NSCs/NPCs injection sites and the synergic effects of ChABC and neurotrophic factors are important factors leading to motor functional recovery following chronic SCI as a combinatory treatment with NSCs/NPCs transplantation
Summary
Severe traumatic spinal cord injury (SCI) disrupts long descending and ascending nerve fibers as well as the orientated glial framework of white matter tracts, causing a loss of motor, sensory, and autonomic function. Treadmill exercise combined with NPC transplantation was found to promote neuronal differentiation and regeneration and maturation of neural circuits It enhanced the recovery of motor and sensory functions even when the intervention took place during the chronic phase (Tashiro et al, 2016). Among the articles we reviewed that reported neurologically functional recovery, all reported transplantation rostral and/or distal to the site of the SCI epicenter (Kusano et al, 2010; Salazar et al, 2010; Cheng et al, 2016; Suzuki et al, 2017; Nori et al, 2018; Okubo et al, 2018; Jones et al, 2021) These articles indicate that NSCs/NPCs injection sites and the synergic effects of ChABC and neurotrophic factors are important factors leading to motor functional recovery following chronic SCI as a combinatory treatment with NSCs/NPCs transplantation.
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