Shen Yingbo, Cao Xinyue, Lu Minhui, Gu Hongcheng, Li Minli, Posner David A
State Key Laboratory of Bioelectronics School of Biological Science and Medical Engineering Southeast University Nanjing China.
Molecular Immunity Unit Cambridge Institute of Therapeutic Immunology and Infectious Diseases Department of Medicine University of Cambridge Cambridge UK.
Smart Med. 2022 Dec 26;1(1):e20220017. doi: 10.1002/SMMD.20220017. eCollection 2022 Dec.
Both traumatic and non-traumatic spinal cord injuries (SCIs) can be categorized as damages done to our central nervous system (CNS). The patients' physical and mental health may suffer greatly because of traumatic SCI. With the widespread use of motor vehicles and increasingly aged population, the occurrence of SCI is more frequent than before, creating a considerable burden to global public health. The regeneration process of the spinal cord is hampered by a series of events that occur following SCI like edema, hemorrhage, formation of cystic cavities, and ischemia. An effective strategy for the treatment of SCI and functional recovery still has not been discovered; however, recent advances have been made in bioengineering fields that therapies based on cells, biomaterials, and biomolecules have proved effective in the repair of the spinal cord. In the light of worldwide importance of treatments for SCI, this article aims to provide a review of recent advances by first introducing the physiology, etiology, epidemiology, and mechanisms of SCI. We then put emphasis on the widely used clinical treatments and bioengineering strategies (cell-based, biomaterial-based, and biomolecule-based) for the functional regeneration of the spinal cord as well as challenges faced by scientists currently. This article provides scientists and clinicians with a comprehensive outlook on the recent advances of preclinical and clinical treatments of SCI, hoping to help them find keys to the functional regeneration of SCI.
创伤性和非创伤性脊髓损伤(SCI)均可归类为对我们中枢神经系统(CNS)造成的损害。创伤性SCI可能会给患者的身心健康带来极大影响。随着机动车的广泛使用以及人口老龄化加剧,SCI的发生率比以往更高,给全球公共卫生造成了相当大的负担。SCI后发生的一系列事件,如水肿、出血、囊腔形成和缺血,阻碍了脊髓的再生过程。目前尚未发现治疗SCI和促进功能恢复的有效策略;然而,生物工程领域最近取得了进展,基于细胞、生物材料和生物分子的疗法已被证明在脊髓修复中有效。鉴于SCI治疗在全球的重要性,本文旨在通过首先介绍SCI的生理学、病因学、流行病学和机制,对最近的进展进行综述。然后,我们重点介绍广泛使用的临床治疗方法以及用于脊髓功能再生的生物工程策略(基于细胞、基于生物材料和基于生物分子的策略),以及科学家目前面临的挑战。本文为科学家和临床医生提供了关于SCI临床前和临床治疗最新进展的全面展望,希望能帮助他们找到SCI功能再生的关键。