Abstract
Spinal cord injury (SCI) is a distressing incident with abrupt onset of the motor as well as sensory dysfunction, and most often, the injury occurs as result of high-energy or velocity accidents as well as contact sports and falls in the elderly. The key challenges associated with nerve repair are the lack of self-repair as well as neurotrophic factors and primary and secondary neuronal apoptosis, as well as factors that prevent the regeneration of axons locally. Neurons that survive the initial traumatic damage may be lost due to pathogenic activities like neuroinflammation and apoptosis. Implanted stem cells are capable of differentiating into neural cells that replace injured cells as well as offer local neurotrophic factors that aid neuroprotection, immunomodulation, axonal sprouting, axonal regeneration, and remyelination. At the microenvironment of SCI, stem cells are capable of producing growth factors like brain-derived neurotrophic factor and nerve growth factor which triggers neuronal survival as well as axonal regrowth. Although stem cells have proven to be of therapeutic value in SCI, the major disadvantage of some of the cell types is the risk for tumorigenicity due to the contamination of undifferentiated cells prior to transplantation. Local administration of stem cells via either direct cellular injection into the spinal cord parenchyma or intrathecal administration into the subarachnoid space is currently the best transplantation modality for stem cells during SCI.
Highlights
Spinal cord injury (SCI) is a distressing incident with abrupt onset of the motor as well as sensory dysfunction [1, 2]
Lu et al demonstrated that stem cells transplanted into the cavity and/or surrounding tissue regenerated as well as expressed neurotropic factors that triggered the growth of axons, both endogenous and graft-derived, across the lesion to form synapses as well as repaired spinal cord connectivity [212]
Rong et al demonstrated that Neural stem cells (NSCs)-derived small extracellular vesicles were capable of inhibiting neuronal apoptosis, microglia stimulation, and neuroinflammation resulting in the stimulation of functional recovery in SCI model rats [233]
Summary
Spinal cord injury (SCI) is a distressing incident with abrupt onset of the motor as well as sensory dysfunction [1, 2]. Human SCI remains a serious challenge with currently no successful treatments [1, 4]. Stem cell transplantation may provide an effective treatment for SCI due to the selfrenewing and multipotential nature of these cells [7]. Analytical hypotheses to consider in translating stem cell therapies for SCI comprise injury severity; cell type; spinal level such as cervical, thoracic, and lumber levels; cell delivery system, and epicenter and/or perilesional injections. The search terms were functional anatomy of the spine, spinal dynamics, and stem cell transplantation and/or SCI in animal models and humans
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