Khan Shahidul Islam, Ahmed Nazmin, Ahsan Kamrul, Abbasi Mahmud, Maugeri Rosario, Chowdhury Dhiman, Bonosi Lapo, Brunasso Lara, Costanzo Roberta, Iacopino Domenico Gerardo, Umana Giuseppe Emmanuele, Chaurasia Bipin
Spine Surgery Unit, Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Bangladesh.
Department of Neurosurgery, Ibrahim Cardiac Hospital and Research Institute, Shahbag, Dhaka 1000, Bangladesh.
Brain Sci. 2023 Dec 9;13(12):1697. doi: 10.3390/brainsci13121697.
Spinal cord injury (SCI) is a devastating neurological disorder that has a substantial detrimental impact on a person's quality of life. The estimated global incidence of SCI is 40 to 80 cases per million people and around 90% of cases are traumatic. Various etiologies can be recognized for SCI, and post-traumatic SCI represents the most common of these. Patients worldwide with SCI suffer from a persistent loss of motor and sensory function, which affects every aspect of their personal and social lives. Given the lack of effective treatments, many efforts have been made to seek a cure for this condition. In recent years, thanks to their ability to regenerate tissue and repair lost or damaged cells, much attention has been directed toward the use of stem cells (embryonic, induced pluripotent, mesenchymal, hematopoietic), aimed at restoring the functional integrity of the damaged spinal cord and improving a functional recovery including sensory and motor function. In this paper, we offer an overview of the benefits and drawbacks of stem cell therapy for SCI based on clinical evidence. This report also addresses the characteristics of various stem cell treatments, as well as the field's likely future. Each cell type targets specific pathological characteristics associated with SCI and demonstrates therapeutic effects via cell replacement, nutritional support, scaffolds, and immunomodulation pathways. SCI accompanied by complex pathological processes cannot be resolved by single treatment measures. Stem cells are associated with the adjustment of the expression of neurotrophic factors that help to achieve better nutrition to damaged tissue. Single-cell treatments have been shown in some studies to provide very minor benefits for SCI in multiple preclinical studies and a growing number of clinical trials. However, SCI damage is complex, and many studies are increasingly recognizing a combination approach such as physical therapy, electrical stimulation, or medication therapy to treatment.
脊髓损伤（SCI）是一种毁灭性的神经系统疾病，对人的生活质量有重大不利影响。全球脊髓损伤的估计发病率为每百万人40至80例，约90%的病例为创伤性。脊髓损伤有多种病因，创伤后脊髓损伤是其中最常见的。世界各地的脊髓损伤患者持续存在运动和感觉功能丧失，这影响到他们个人和社会生活的方方面面。由于缺乏有效的治疗方法，人们为治愈这种疾病付出了许多努力。近年来，由于干细胞（胚胎干细胞、诱导多能干细胞、间充质干细胞、造血干细胞）具有组织再生和修复丢失或受损细胞的能力，人们对其应用给予了极大关注，旨在恢复受损脊髓的功能完整性并改善包括感觉和运动功能在内的功能恢复。在本文中，我们基于临床证据概述了干细胞疗法治疗脊髓损伤的利弊。本报告还讨论了各种干细胞治疗的特点以及该领域可能的未来发展。每种细胞类型针对与脊髓损伤相关的特定病理特征，并通过细胞替代、营养支持、支架和免疫调节途径发挥治疗作用。伴有复杂病理过程的脊髓损伤无法通过单一治疗措施解决。干细胞与神经营养因子表达的调节有关，有助于为受损组织提供更好的营养。在一些研究中，单细胞治疗在多项临床前研究和越来越多的临床试验中对脊髓损伤显示出非常微小的益处。然而，脊髓损伤的损害很复杂，许多研究越来越认识到采用物理治疗、电刺激或药物治疗等联合方法进行治疗。
