Teng Yang D, Liao Wei-Lee, Choi Howard, Konya Deniz, Sabharwal Sunil, Langer Robert, Sidman Richard L, Snyder Evan Y, Frontera Walter R
Department of Neurosurgery, Harvard Medical School, Brigham and Women's Hospital and Children's Hospital Boston, Boston, MA 02115, USA.
Regen Med. 2006 Nov;1(6):763-76. doi: 10.2217/17460751.1.6.763.
As data elucidating the complexity of spinal cord injury pathophysiology emerge, it is increasingly being recognized that successful repair will probably require a multifaceted approach that combines tactics from various biomedical disciplines, including pharmacology, cell transplantation, gene therapy and material sciences. Recently, new evidence highlighting the benefit of physical activity and rehabilitation interventions during the post-injury phase has provided novel possibilities in realizing effective repair after spinal cord injury. However, before a comprehensive therapeutic strategy that optimally utilizes the benefits of each of these disciplines can be designed, the basic mechanisms by which these various interventions act must be thoroughly explored and important synergistic and antagonistic interactions identified. In examining the mechanisms by which physical activity-based functional recovery after spinal cord injury is effected, endogenous neural stem cells, in our opinion, engender a potentially key role. Multipotent neural stem cells possess many faculties that abet recovery, including the ability to assess the local microenvironment and deliver biofactors that promote neuroplasticity and regeneration, as well as the potential to replenish damaged or eradicated cellular elements. Encouragingly, the functional recovery owing to physical activity-based therapies appears relatively robust, even when therapy is initiated in the chronic stage of spinal cord injury. In this article, we review experimental outcomes related to our hypothesis that endogenous neural stem cells mediate the functional recovery noted in spinal cord injury following physical activity-based treatments. Overall, the data advocates the incorporation of increased physical activity as a component of the multidimensional treatment of spinal cord injury and underscores the critical need to employ research-based mechanistic approaches for developing future advances in the rehabilitation of neurological injury and disorders.
随着阐明脊髓损伤病理生理学复杂性的数据不断涌现，人们越来越认识到，成功的修复可能需要多方面的方法，该方法结合了来自各种生物医学学科的策略，包括药理学、细胞移植、基因治疗和材料科学。最近，新的证据突出了损伤后阶段体育活动和康复干预的益处，为脊髓损伤后实现有效修复提供了新的可能性。然而，在设计一种能最佳利用这些学科各自优势的综合治疗策略之前，必须深入探索这些不同干预措施起作用的基本机制，并确定重要的协同和拮抗相互作用。在研究脊髓损伤后基于体育活动的功能恢复机制时，我们认为内源性神经干细胞起着潜在的关键作用。多能神经干细胞具有许多有助于恢复的能力，包括评估局部微环境和释放促进神经可塑性和再生的生物因子的能力，以及补充受损或被清除的细胞成分的潜力。令人鼓舞的是，即使在脊髓损伤的慢性阶段开始治疗，基于体育活动的疗法所带来的功能恢复似乎也相对强劲。在本文中，我们回顾了与我们的假设相关的实验结果，即内源性神经干细胞介导了基于体育活动的治疗后脊髓损伤中所观察到的功能恢复。总体而言，这些数据主张将增加体育活动纳入脊髓损伤的多维治疗中，并强调迫切需要采用基于研究的机制方法来推动未来神经损伤和疾病康复方面的进展。
