Department of Physiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Cells. 2021 Oct 6;10(10):2676. doi: 10.3390/cells10102676.
Every year, 0.93 million people worldwide suffer from spinal cord injury (SCI) with irretrievable sequelae. Rehabilitation, currently the only available treatment, does not restore damaged tissues; therefore, the functional recovery of patients remains limited. The pathophysiology of spinal cord injuries is heterogeneous, implying that potential therapeutic targets differ depending on the time of injury onset, the degree of injury, or the spinal level of injury. In recent years, despite a significant number of clinical trials based on various types of stem cells, these aspects of injury have not been effectively considered, resulting in difficult outcomes of trials. In a specialty such as cancerology, precision medicine based on a patient's characteristics has brought indisputable therapeutic advances. The objective of the present review is to promote the development of precision medicine in the field of SCI. Here, we first describe the multifaceted pathophysiology of SCI, with the temporal changes after injury, the characteristics of the chronic phase, and the subtypes of complete injury. We then detail the appropriate targets and related mechanisms of the different types of stem cell therapy for each pathological condition. Finally, we highlight the great potential of stem cell therapy in cervical SCI.
每年,全球有 93 万人患有脊髓损伤(SCI),且不可逆转。目前,康复是唯一可用的治疗方法,但无法修复受损组织;因此,患者的功能恢复仍然有限。脊髓损伤的病理生理学是异质的,这意味着潜在的治疗靶点因损伤发生时间、损伤程度或损伤的脊髓水平而异。近年来,尽管有大量基于各种类型干细胞的临床试验,但这些损伤方面并未得到有效考虑,导致试验结果不佳。在癌症学等专业领域,基于患者特征的精准医学带来了无可争议的治疗进展。本综述的目的是促进 SCI 领域的精准医学发展。在这里,我们首先描述了 SCI 的多方面病理生理学,包括损伤后的时间变化、慢性期的特征以及完全损伤的亚型。然后,我们详细介绍了每种病理状况下不同类型干细胞治疗的适当靶点和相关机制。最后,我们强调了干细胞治疗在颈段 SCI 中的巨大潜力。
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