Kanno Haruo, Pearse Damien D, Ozawa Hiroshi, Itoi Eiji, Bunge Mary Bartlett
Rev Neurosci. 2015;26(2):121-8. doi: 10.1515/revneuro-2014-0068.
Transplantation of Schwann cells (SCs) is a promising therapeutic strategy for spinal cord repair. The introduction of SCs into the injured spinal cord has been shown to reduce tissue loss, promote axonal regeneration, and facilitate myelination of axons for improved sensorimotor function. The pathology of spinal cord injury (SCI) comprises multiple processes characterized by extensive cell death, development of a milieu inhibitory to growth, and glial scar formation, which together limits axonal regeneration. Many studies have suggested that significant functional recovery following SCI will not be possible with a single therapeutic strategy. The use of additional approaches with SC transplantation may be needed for successful axonal regeneration and sufficient functional recovery after SCI. An example of such a combination strategy with SC transplantation has been the complementary administration of neuroprotective agents/growth factors, which improves the effect of SCs after SCI. Suspension of SCs in bioactive matrices can also enhance transplanted SC survival and increase their capacity for supporting axonal regeneration in the injured spinal cord. Inhibition of glial scar formation produces a more permissive interface between the SC transplant and host spinal cord for axonal growth. Co-transplantation of SCs and other types of cells such as olfactory ensheathing cells, bone marrow mesenchymal stromal cells, and neural stem cells can be a more effective therapy than transplantation of SCs alone following SCI. This article reviews some of the evidence supporting the combination of SC transplantation with additional strategies for SCI repair and presents a prospectus for achieving better outcomes for persons with SCI.
施万细胞(SCs)移植是脊髓修复的一种有前景的治疗策略。已表明将施万细胞引入受损脊髓可减少组织损失、促进轴突再生,并促进轴突髓鞘形成以改善感觉运动功能。脊髓损伤(SCI)的病理包括多个过程,其特征为广泛的细胞死亡、形成抑制生长的环境以及胶质瘢痕形成,这些共同限制了轴突再生。许多研究表明,单一治疗策略无法实现脊髓损伤后显著的功能恢复。脊髓损伤后成功的轴突再生和充分的功能恢复可能需要将施万细胞移植与其他方法联合使用。这种与施万细胞移植相结合的策略的一个例子是联合给予神经保护剂/生长因子,这可改善脊髓损伤后施万细胞的作用。将施万细胞悬浮于生物活性基质中也可提高移植的施万细胞的存活率,并增强其在受损脊髓中支持轴突再生的能力。抑制胶质瘢痕形成可在施万细胞移植与宿主脊髓之间产生更有利于轴突生长的界面。施万细胞与其他类型的细胞(如嗅鞘细胞、骨髓间充质基质细胞和神经干细胞)共移植可能比脊髓损伤后单独移植施万细胞更有效。本文综述了一些支持施万细胞移植与其他脊髓损伤修复策略相结合的证据,并提出了为脊髓损伤患者取得更好治疗效果的方案。