Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, Kentucky, USA.
Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Top Spinal Cord Inj Rehabil. 2023 Fall;29(Suppl):23-43. doi: 10.46292/sci23-00044S. Epub 2023 Nov 17.
Regenerating the injured spinal cord is a substantial challenge with many obstacles that need to be overcome to achieve robust functional benefits. This abundance of hurdles can partly explain the limited success when applying regenerative intervention treatments in animal models and/or people. In this article, we elaborate on a few of these obstacles, starting with the applicability of animal models and how they compare to the clinical setting. We then discuss the requirement for combinatorial interventions and the associated problems in experimental design, including the addition of rehabilitative training. The article expands on differences in lesion sizes and locations between humans and common animal models, and how this difference can determine the success or failure of an intervention. An additional and frequently overlooked problem in the translation of interventions that applies beyond the field of neuroregeneration is the reporting bias and the lack of transparency in reporting findings. New data mandates are tackling this problem and will eventually result in a more balanced view of the field. Finally, we will discuss strategies to negotiate the challenging course of successful translation to facilitate successful translation of regeneration promoting interventions.
修复受损的脊髓是一项重大挑战，需要克服许多障碍才能实现强大的功能益处。这些大量的障碍部分解释了在动物模型和/或人群中应用再生干预治疗的有限成功。在本文中，我们详细阐述了其中的一些障碍，首先是动物模型的适用性以及它们与临床环境的比较。然后，我们讨论了组合干预的要求以及实验设计中的相关问题，包括康复训练的加入。文章还扩展了人类和常见动物模型之间病变大小和位置的差异，以及这种差异如何决定干预的成败。除神经再生领域外，干预措施的另一个经常被忽视的问题是报告偏差和报告结果缺乏透明度。新的数据要求正在解决这个问题，并最终将对该领域有更平衡的看法。最后，我们将讨论成功转化的策略，以促进再生促进干预的成功转化。
