Leal-Filho Manoel Baldoino
Department of Neurosurgery, Casamater Hospital, Teresina, PI, Brazil.
Surg Neurol Int. 2011;2:112. doi: 10.4103/2152-7806.83732. Epub 2011 Aug 13.
Glial scar (GS) is the most important inhibitor factor to neuroregeneration after spinal cord injury (SCI) and behaves as a tertiary lesion. The present review of the literature searched for representative studies concerning GS and therapeutic strategies to neuroregeneration.
The author used the PubMed database and Google scholar to search articles published in the last 20 years. Key words used were SCI, spinal cord (SC) inflammation, GS, and SCI treatment.
Both inflammation and GS are considered important events after SCI. Despite the fact that firstly they seem to cause benefit, in the end they cause more harm than good to neuroregeneration. Each stage has its own aspects under the influence of the immune system causing inflammation, from the primary to secondary lesion and from those to GS (tertiary lesion).
Future studies should stress the key points where and when GS presents itself as an inhibitory factor to neuroregeneration. Considering GS as an important event after SCI, the author defends GS as being a tertiary lesion. Current strategies are presented with emphasis on stem cells and drug therapy. A better understanding will permit the development of a therapeutic basis in the treatment of the SCI patients considering each stage of the lesion, with emphasis on GS and neuroregeneration.
胶质瘢痕（GS）是脊髓损伤（SCI）后神经再生最重要的抑制因素，表现为三级损伤。本综述检索了有关GS及神经再生治疗策略的代表性研究。
作者使用PubMed数据库和谷歌学术搜索过去20年发表的文章。使用的关键词为SCI、脊髓（SC）炎症、GS和SCI治疗。
炎症和GS均被认为是SCI后的重要事件。尽管它们最初似乎有益，但最终对神经再生弊大于利。在免疫系统引起炎症的影响下，从原发性损伤到继发性损伤，再到GS（三级损伤），每个阶段都有其自身特点。
未来的研究应强调GS在何时何地成为神经再生抑制因素的关键点。考虑到GS是SCI后的一个重要事件，作者认为GS是一种三级损伤。目前的策略重点介绍了干细胞和药物治疗。更好地理解将有助于在考虑损伤各阶段的情况下，为SCI患者的治疗建立治疗基础，重点是GS和神经再生。
