Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, United States.
Respir Physiol Neurobiol. 2009 Nov 30;169(2):171-82. doi: 10.1016/j.resp.2009.07.016. Epub 2009 Aug 7.
Devastating central nervous system injuries and diseases continue to occur in spite of the tremendous efforts of various prevention programs. The enormity and annual escalation of healthcare costs due to them require that therapeutic strategies be responsibly developed. The dysfunctions that occur after injury and disease are primarily due to neurotransmission damage. The last two decades of both experimental and clinical research have demonstrated that neural and non-neural tissue and cell transplantation is a viable option for ameliorating dysfunctions to markedly improve quality of life. Moreover, significant progress has been made with tissue and cell transplantation in studies of pathophysiology, plasticity, sprouting, regeneration, and functional recovery. This article will review information about the ability and potential, particularly for traumatic spinal cord injury, that neural and non-neural tissue and cell transplantation has to replace lost neurons and glia, to reconstruct damaged neural circuitry, and to restore neurotransmitters, hormones, neurotrophic factors, and neurotransmission. Donor tissues and cells to be discussed include peripheral nerve, fetal spinal cord and brain, central and peripheral nervous systems' glia, stem cells, those that have been genetically engineered, and non-neural ones. Combinatorial approaches and clinical research are also reviewed.
尽管各种预防计划都付出了巨大的努力,但中枢神经系统的毁灭性损伤和疾病仍时有发生。由于这些损伤和疾病导致的医疗保健费用的巨大规模和每年的递增,需要负责任地开发治疗策略。损伤和疾病后发生的功能障碍主要是由于神经传递损伤引起的。过去二十年,无论是实验研究还是临床研究都表明,神经组织和非神经组织及细胞的移植是改善功能障碍、显著提高生活质量的可行选择。此外,在研究病理生理学、可塑性、发芽、再生和功能恢复方面,组织和细胞移植也取得了重大进展。本文将综述有关神经组织和非神经组织及细胞移植的能力和潜力的信息,特别是在创伤性脊髓损伤方面,这些移植可以替代丧失的神经元和神经胶质细胞,重建受损的神经网络,并恢复神经递质、激素、神经营养因子和神经传递。将讨论的供体组织和细胞包括周围神经、胎儿脊髓和大脑、中枢和周围神经系统的神经胶质细胞、干细胞、经过基因工程改造的细胞以及非神经细胞。还将综述组合方法和临床研究。