Sobani Zain A, Quadri Syed A, Enam S Ather
Department of Neurosurgery, Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan.
Surg Neurol Int. 2010 Dec 25;1:93. doi: 10.4103/2152-7806.74240.
Nearly 11,000 cases of spinal cord injury (SCI) are reported in the United States annually. Current management options give a median survival time of 38 years; however, no rehabilitative measures are available. Stem cells have been under constant research given their ability to differentiate into neural cell lines replacing non functional tissue. Efforts have been made to establish new synapses and provide a conducive environment, by grafting cells from autologous and fetal sources; including embryonic or adult stem cells, Schwann cells, genetically modified fibroblasts, bone stromal cells, and olfactory ensheathing cells and combinations/ variants thereof.
In order to discuss the underlying mechanism of SCI along with the previously mentioned sources of stem cells in context to SCI, a simple review of literature was conducted. An extensive literature search was conducted using the PubMed data base and online search engines and articles published in the last 15 years were considered along with some historical articles where a background was required.
Stem cell transplantation for SCI is at the forefront with animal and in vitro studies providing a solid platform to enable well-designed human studies. Olfactory ensheathing cells seem to be the most promising; whilst bone marrow stromal cells appear as strong candidates for an adjunctive role.
The key strategy in developing the therapeutic basis of stem cell transplantation for spinal cord regeneration is to weed out the pseudo-science and opportunism. All the trials should be based on stringent scientific criteria and effort to bypass that should be strongly discouraged at the international level.
在美国,每年报告的脊髓损伤(SCI)病例近11,000例。目前的治疗方案给出的中位生存时间为38年;然而,尚无康复措施。鉴于干细胞能够分化为神经细胞系以替代无功能组织,一直在对其进行持续研究。人们已努力通过移植来自自体和胎儿来源的细胞来建立新的突触并提供有利环境;这些细胞包括胚胎或成体干细胞、雪旺细胞、基因改造的成纤维细胞、骨基质细胞和嗅鞘细胞及其组合/变体。
为了结合上述干细胞来源来探讨脊髓损伤的潜在机制,进行了一次简单的文献综述。使用PubMed数据库和在线搜索引擎进行了广泛的文献检索,并纳入了过去15年发表的文章以及一些需要背景知识的历史文章。
脊髓损伤的干细胞移植处于前沿,动物和体外研究提供了一个坚实的平台,以开展精心设计的人体研究。嗅鞘细胞似乎最具前景;而骨髓基质细胞似乎是辅助作用的有力候选者。
发展用于脊髓再生的干细胞移植治疗基础的关键策略是剔除伪科学和机会主义。所有试验都应基于严格的科学标准,应在国际层面强烈劝阻绕过这些标准的行为。