Awad Basem I, Carmody Margaret A, Steinmetz Michael P
Department of Neurosurgery, Mansoura University School of Medicine, Mansoura, Egypt; Department of Neurosciences, MetroHealth Medical Center, Cleveland, Ohio, USA.
Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
World Neurosurg. 2015 Jan;83(1):120-31. doi: 10.1016/j.wneu.2013.01.042. Epub 2013 Jan 16.
To review central nervous system growth factors and their therapeutic potential and clinical translation into spinal cord injury (SCI), as well as the challenges that have been encountered during clinical development.
A systemic review of the available current and historical literature regarding central nervous system growth factors and clinical trials regarding their use in spinal cord injury was conducted.
The effectiveness of administering growth factors as a potential therapeutic strategy for SCI has been tested with the use of brain-derived neurotrophic factor, glial cell-derived neurotrophic factor, neurotrophin 3, and neurotrophin-4/5. Delivery of growth factors to injured SC has been tested by numerous methods. Unfortunately, most of clinical trials at this time are uncontrolled and have questionable results because of lack of efficacy and/or unacceptable side effects.
There is promise in the use of specific growth factors therapeutically for SCI. However, more studies involving neuronal regeneration and functional recovery are needed, as well the development of delivery methods that allow sufficient quantity of growth factors while restricting their distribution to target sites.
综述中枢神经系统生长因子及其治疗潜力,以及其在脊髓损伤(SCI)临床转化中的应用,同时探讨临床开发过程中遇到的挑战。
对有关中枢神经系统生长因子的现有当前和历史文献以及其在脊髓损伤中应用的临床试验进行系统综述。
已使用脑源性神经营养因子、胶质细胞源性神经营养因子、神经营养素3和神经营养素-4/5测试了给予生长因子作为SCI潜在治疗策略的有效性。已通过多种方法测试了将生长因子递送至受损脊髓的情况。不幸的是,目前大多数临床试验是无对照的,并且由于缺乏疗效和/或不可接受的副作用而结果存疑。
使用特定生长因子治疗SCI具有前景。然而,需要更多涉及神经元再生和功能恢复的研究,以及开发能够在将生长因子分布限制于靶位点的同时允许足够量生长因子的递送方法。