Abstract
Spinal cord injury (SCI) is a debilitating condition, often leading to severe motor, sensory, or autonomic nervous dysfunction. As the holy grail of regenerative medicine, promoting spinal cord tissue regeneration and functional recovery are the fundamental goals. Yet, effective regeneration of injured spinal cord tissues and promotion of functional recovery remain unmet clinical challenges, largely due to the complex pathophysiology of the condition. The transplantation of various cells, either alone or in combination with three-dimensional matrices, has been intensively investigated in preclinical SCI models and clinical trials, holding translational promise. More recently, a new paradigm shift has emerged from cell therapy towards extracellular vesicles as an exciting “cell-free” therapeutic modality. The current review recapitulates recent advances, challenges, and future perspectives of cell-based spinal cord tissue engineering and regeneration strategies.
Highlights
Spinal cord injury (SCI) refers to damage to the spinal cord that temporarily or permanently changes its function
PLGA can be combined with poly-L-lactic acid (PLLA) to form the PLLA/PLGA scaffolds, which serve as biocompatible and biodegradable matrices for cell attachment, proliferation, differentiation and organization in muscle, bone and spinal cord tissue engineering [34,64,94,95,96]
extracellular vesicles (EVs) are broadly divided into microvesicles, larger vesicles directly released from cells by budding of the cell membrane and exosomes, smaller vesicles secreted via multivesicular endosomal pathway [101]
Summary
Spinal cord injury (SCI) refers to damage to the spinal cord that temporarily or permanently changes its function. Modification of the microenvironment of the injured spinal cord focusing on glial scar formation and inflammatory phenotype should be considered to maximize the therapeutic potential of NSPCs in the chronic phase [21] Another translational concern is the risk of immune rejection, and the use of immunosuppressants, since NSPCs are most commonly derived from embryonic stem cells or allogeneic adult sources [22], and human NSPCs with time in culture will increase their Major Histocompatibility Complex Class I and II expressions [23]. Standardized manufacturing processes and potential bioengineering approaches should be introduced to develop more potent and predictable MSC-based therapies
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