Suzuki Hidenori, Sakai Takashi
Department of Orthopedics Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi 755-8505, Japan.
Int J Mol Sci. 2021 Jul 11;22(14):7435. doi: 10.3390/ijms22147435.
Chronic spinal cord injury (SCI) is a catastrophic condition associated with significant neurological deficit and social and financial burdens. It is currently being managed symptomatically with no real therapeutic strategies available. In recent years, a number of innovative regenerative strategies have emerged and have been continuously investigated in clinical trials. In addition, several more are coming down the translational pipeline. Among ongoing and completed trials are those reporting the use of mesenchymal stem cells, neural stem/progenitor cells, induced pluripotent stem cells, olfactory ensheathing cells, and Schwann cells. The advancements in stem cell technology, combined with the powerful neuroimaging modalities, can now accelerate the pathway of promising novel therapeutic strategies from bench to bedside. Various combinations of different molecular therapies have been combined with supportive scaffolds to facilitate favorable cell-material interactions. In this review, we summarized some of the most recent insights into the preclinical and clinical studies using stem cells and other supportive drugs to unlock the microenvironment in chronic SCI to treat patients with this condition. Successful future therapies will require these stem cells and other synergistic approaches to address the persistent barriers to regeneration, including glial scarring, loss of structural framework, and immunorejection.
慢性脊髓损伤（SCI）是一种灾难性疾病，伴有严重的神经功能缺损以及社会和经济负担。目前，该病仅进行对症治疗，尚无真正有效的治疗策略。近年来，一些创新性的再生策略不断涌现，并在临床试验中持续得到研究。此外，还有更多策略正处于转化阶段。正在进行和已经完成的试验包括那些报告使用间充质干细胞、神经干/祖细胞、诱导多能干细胞、嗅鞘细胞和雪旺细胞的试验。干细胞技术的进步，结合强大的神经成像方式，现在能够加速将有前景的新型治疗策略从实验室推向临床应用的进程。不同分子疗法的各种组合已与支持性支架相结合，以促进良好的细胞 - 材料相互作用。在本综述中，我们总结了一些关于使用干细胞和其他支持性药物的临床前和临床研究的最新见解，以解开慢性脊髓损伤中的微环境问题，从而治疗患有这种疾病的患者。未来成功的治疗将需要这些干细胞和其他协同方法来克服再生过程中持续存在的障碍，包括胶质瘢痕形成、结构框架丧失和免疫排斥反应。
