Department of Biomedical Engineering, Auburn Science and Engineering Center 275, West Tower, University of Akron, Akron, OH 44325-3908, United States of America.
Biomed Mater. 2018 Feb 8;13(2):024105. doi: 10.1088/1748-605X/aa9bbb.
The nature of traumatic spinal cord injury (SCI) often involves limited recovery and long-term quality of life complications. The initial injury sets off a variety of secondary cascades, which result in an expanded lesion area. Ultimately, the native tissue fails to regenerate. As treatments are developed in the laboratory, the management of this secondary cascade is an important first step in achieving recovery of normal function. Current literature identifies four broad targets for intervention: inflammation, oxidative stress, disruption of the blood-spinal cord barrier, and formation of an inhibitory glial scar. Because of the complex and interconnected nature of these events, strategies that combine multiple therapies together show much promise. Specifically, approaches that rely on biomaterials to perform a variety of functions are generating intense research interest. In this review, we examine each target and discuss how biomaterials are currently used to address them. Overall, we show that there are an impressive amount of biomaterials and combinatorial treatments which show good promise for slowing secondary events and improving outcomes. If more emphasis is placed on growing our understanding of how materials can manage secondary events, treatments for SCI can be designed in an increasingly rational manner, ultimately improving their potential for translation to the clinic.
创伤性脊髓损伤（SCI）的性质通常涉及有限的恢复和长期的生活质量并发症。初始损伤引发了多种继发性级联反应，导致病变区域扩大。最终，原生组织无法再生。随着实验室中治疗方法的不断发展，控制这种继发性级联反应是实现正常功能恢复的重要第一步。目前的文献确定了四个广泛的干预靶点：炎症、氧化应激、血脊髓屏障破坏和抑制性神经胶质瘢痕形成。由于这些事件的复杂性和相互关联性，联合多种疗法的策略显示出很大的前景。具体来说，依赖于生物材料来执行多种功能的方法正在引起强烈的研究兴趣。在这篇综述中，我们检查了每个靶点，并讨论了生物材料目前如何用于解决这些靶点。总的来说，我们表明有大量的生物材料和组合治疗方法显示出了很好的前景，可以减缓继发性事件并改善结果。如果更加重视提高我们对材料如何管理继发性事件的理解，那么 SCI 的治疗方法可以以越来越合理的方式进行设计，最终提高它们向临床转化的潜力。
