Abstract
Transected axons are unable to regenerate after spinal cord injury (SCI). Glial scar is thought to be responsible for this failure. Regulating the formation of glial scar post-SCI may contribute to axonal regrow. Over the past few decades, studies have found that the interaction between immune cells at the damaged site results in a robust and persistent inflammatory response. Current therapy strategies focus primarily on the inhibition of subacute and chronic neuroinflammation after the acute inflammatory response was executed. Growing evidences have documented that mesenchymal stem cells (MSCs) engraftment can be served as a promising cell therapy for SCI. Numerous studies have shown that MSCs transplantation can inhibit the excessive glial scar formation as well as inflammatory response, thereby facilitating the anatomical and functional recovery. Here, we will review the effects of inflammatory response and glial scar formation in spinal cord injury and repair. The role of MSCs in regulating neuroinflammation and glial scar formation after SCI will be reviewed as well.
Highlights
Spinal cord injury (SCI) is a permanent and disabling disorder that generates great personal loss and social burden [1]
Numerous studies have documented that inflammatory cells will persist in the lesion area post-spinal cord injury (SCI), and these cells further aggravate the injury of the surrounding normal spinal cord tissue by secreting various inflammatory cytokines, reactive oxygen species and proteolytic enzymes, leading to more serious neurological dysfunction [12, 13]
Studies have shown that transplantation of bone marrow mesenchymal stem cells (BM-MSCs) into SCI rat contusion models could significantly up-regulate the number of M2 macrophages and down-regulate the number of M1 macrophages at the injury site, accompanied by increased levels of IL-4 and IL-13, and decreased levels of tumor necrosis factor alpha (TNF-a) and IL6, which might contribute to the recovery of motor function, increased retention of axon and myelin sheath as well as less glial scar formation after injury [76]
Summary
Spinal cord injury (SCI) is a permanent and disabling disorder that generates great personal loss and social burden [1]. Neuroinflammation and Scarring Post-SCI between these cells underlies the glial scar, inflammation, ionic imbalance, and free radical formation, which together inhibit the formation of axonal regeneration and myelination (Figure 1) [7, 8]. Both initial traumatic injury and secondary events cause damage of the neuronal conduction pathways, and result in the deficits of a range of senses and movements below the damaged plane [9]. Dozens of evidences indicated that transplanted MSCs could modulate the formation of glial scar via changing the level of cytokines, promoting axonal regeneration, inhibiting cavity formation, and promoting functional recovery [22]. We will pay special attention to the therapeutic role of MSCs on neuroinflammation and glial scar formation
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