The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, United States of America.
Biomed Mater. 2018 Apr 25;13(4):044105. doi: 10.1088/1748-605X/aaa9d8.
Spinal cord injury (SCI) causes immediate damage to the nervous tissue accompanied by loss of motor and sensory function. The limited self-repair competence of injured nervous tissue underscores the need for reparative interventions to recover function after SCI. The vasculature of the spinal cord plays a crucial role in SCI and repair. Ruptured and sheared blood vessels in the injury epicenter and blood vessels with a breached blood-spinal cord barrier (BSCB) in the surrounding tissue cause bleeding and inflammation, which contribute to the overall tissue damage. The insufficient formation of new functional vasculature in and near the injury impedes endogenous tissue repair and limits the prospect of repair approaches. Limiting the loss of blood vessels, stabilizing the BSCB, and promoting the formation of new blood vessels are therapeutic targets for spinal cord repair. Inflammation is an integral part of injury-mediated vascular damage, which has deleterious and reparative consequences. Inflammation and the formation of new blood vessels are intricately interwoven. Biomaterials can be effectively used for promoting and guiding blood vessel formation or modulating the inflammatory response after SCI, thereby governing the extent of damage and the success of reparative interventions. This review deals with the vasculature after SCI, the reciprocal interactions between inflammation and blood vessel formation, and the potential of biomaterials to support revascularization and immunomodulation in damaged spinal cord nervous tissue.
脊髓损伤 (SCI) 会立即导致神经组织损伤，并伴有运动和感觉功能丧失。受伤神经组织自我修复能力有限，这凸显了需要进行修复干预以在 SCI 后恢复功能。脊髓的脉管系统在 SCI 和修复中起着至关重要的作用。损伤中心破裂和剪切的血管以及周围组织中血-脊髓屏障 (BSCB) 破裂的血管会导致出血和炎症，从而导致整体组织损伤。损伤部位和周围组织中新功能性脉管系统的形成不足会阻碍内源性组织修复，并限制修复方法的前景。限制血管损失、稳定 BSCB 和促进新血管形成是脊髓修复的治疗靶点。炎症是损伤介导的血管损伤的一个组成部分，具有有害和修复的后果。炎症和新血管的形成是错综复杂地交织在一起的。生物材料可有效用于促进和引导血管形成或调节 SCI 后的炎症反应，从而控制损伤的程度和修复干预的成功。本综述讨论了 SCI 后的脉管系统、炎症和血管形成之间的相互作用，以及生物材料在支持受损脊髓神经组织再血管化和免疫调节方面的潜力。
