Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Hokkaido, Japan.
Int J Mol Sci. 2020 Jun 2;21(11):3994. doi: 10.3390/ijms21113994.
There are more than one million patients worldwide suffering paralysis caused by spinal cord injury (SCI). SCI causes severe socioeconomic problems not only to the patients and their caregivers but also to society; therefore, the development of innovative treatments is crucial. Many pharmacological therapies have been attempted in an effort to reduce SCI-related damage; however, no single therapy that could dramatically improve the serious long-term sequelae of SCI has emerged. Stem cell transplantation therapy, which can ameliorate damage or regenerate neurological networks, has been proposed as a promising candidate for SCI treatment, and many basic and clinical experiments using stem cells for SCI treatment have been launched, with promising results. However, the cell transplantation methods, including cell type, dose, transplantation route, and transplantation timing, vary widely between trials, and there is no consensus regarding the most effective treatment strategy. This study reviews the current knowledge on this issue, with a special focus on the clinical trials that have used stem cells for treating SCI, and highlights the problems that remain to be solved before the widespread clinical use of stem cells can be adopted.
全球有超过 100 万名患者因脊髓损伤 (SCI) 而瘫痪。SCI 不仅给患者及其护理人员,也给社会带来了严重的社会经济问题;因此,开发创新疗法至关重要。人们尝试了许多药物治疗方法,以期减轻与 SCI 相关的损伤;然而,尚无任何单一疗法能够显著改善 SCI 的严重长期后遗症。干细胞移植疗法可以改善损伤或再生神经网络,被提议作为 SCI 治疗的一种有前途的候选方法,许多使用干细胞治疗 SCI 的基础和临床实验已经开展,并取得了有希望的结果。然而,细胞移植方法,包括细胞类型、剂量、移植途径和移植时机,在试验之间差异很大,对于最有效的治疗策略尚未达成共识。本研究综述了这一问题的现有知识,特别关注了使用干细胞治疗 SCI 的临床试验,并强调了在广泛采用干细胞治疗之前仍需要解决的问题。