Oudega M, Moon L D F, de Almeida Leme R J
The Miami Project to Cure Paralysis, School of Medicine, University of Miami, Miami, FL 33136, USA.
Braz J Med Biol Res. 2005 Jun;38(6):825-35. doi: 10.1590/s0100-879x2005000600003. Epub 2005 Jun 1.
The complex nature of spinal cord injury appears to demand a multifactorial repair strategy. One of the components that will likely be included is an implant that will fill the area of lost nervous tissue and provide a growth substrate for injured axons. Here we will discuss the role of Schwann cells (SCs) in cell-based, surgical repair strategies of the injured adult spinal cord. We will review key studies that showed that intraspinal SC grafts limit injury-induced tissue loss and promote axonal regeneration and myelination, and that this response can be improved by adding neurotrophic factors or anti-inflammatory agents. These results will be compared with several other approaches to the repair of the spinal cord. A general concern with repair strategies is the limited functional recovery, which is in large part due to the failure of axons to grow across the scar tissue at the distal graft-spinal cord interface. Consequently, new synaptic connections with spinal neurons involved in motor function are not formed. We will highlight repair approaches that did result in growth across the scar and discuss the necessity for more studies involving larger, clinically relevant types of injuries, addressing this specific issue. Finally, this review will reflect on the prospect of SCs for repair strategies in the clinic.
脊髓损伤的复杂性似乎需要一种多因素修复策略。可能包含的一个组成部分是一种植入物，它将填充神经组织缺失区域，并为受损轴突提供生长基质。在此，我们将讨论施万细胞（SCs）在成年脊髓损伤的基于细胞的手术修复策略中的作用。我们将回顾一些关键研究，这些研究表明脊髓内施万细胞移植可限制损伤诱导的组织损失，并促进轴突再生和髓鞘形成，并且通过添加神经营养因子或抗炎剂可改善这种反应。这些结果将与其他几种脊髓修复方法进行比较。修复策略的一个普遍问题是功能恢复有限，这在很大程度上是由于轴突未能穿过远端移植脊髓界面处的瘢痕组织生长。因此，与参与运动功能的脊髓神经元没有形成新的突触连接。我们将重点介绍确实导致穿过瘢痕生长的修复方法，并讨论针对这一特定问题进行更多涉及更大规模、临床相关损伤类型研究的必要性。最后，本综述将思考施万细胞在临床修复策略中的前景。
