Bradshaw Katherine J, Leipzig Nic D
Department of Biomedical Engineering, Auburn Science and Engineering Center #275, The University of Akron, Akron, Ohio, USA.
Department of Chemical, Biomolecular, and Corrosion Engineering, The University of Akron, Akron, Ohio, USA.
Tissue Eng Part A. 2025 Feb;31(3-4):108-125. doi: 10.1089/ten.tea.2024.0194. Epub 2024 Nov 18.
Tissue engineering provides a path forward for emerging personalized medicine therapies as well as the ability to bring about cures for diseases or chronic injuries. Traumatic spinal cord injuries (SCIs) are an example of a chronic injury in which no cure or complete functional recovery treatment has been developed. In part, this has been due to the complex and interconnected nature of the central nervous system (CNS), the cellular makeup, its extracellular matrix (ECM), and the injury site pathophysiology. One way to combat the complex nature of an SCI has been to create functional tissue-engineered scaffolds that replace or replenish the aspects of the CNS and tissue/ECM that are damaged following the immediate injury and subsequent immune response. This can be achieved by employing the tissue-engineering triad consisting of cells, biomaterial(s), and environmental factors. Stem cells, with their innate ability to proliferate and differentiate, are a common choice for cellular therapies. Natural or synthetic biomaterials that have tunable characteristics are normally used as the scaffold base. Environmental factors can range from drugs to growth factors (GFs) or proteins, depending on if the idea would be to stimulate exogeneous or endogenous cell populations or just simply retain cells on the scaffold for effective transplantation. For functional regeneration and integration for SCI, the scaffold must promote neuroprotection and neuroplasticity. Tissue-engineering strategies have shown benefits including neuronal differentiation, axonal regeneration, axonal outgrowth, integration into the native spinal cord, and partial functional recovery. Overall, this review focuses on the background that causes SCI to be so difficult to treat, the individual components of the tissue-engineering triad, and how combinatorial scaffolds can be beneficial toward the prospects of future SCI recovery.
组织工程为新兴的个性化医学疗法提供了一条前进的道路，同时也具备治愈疾病或慢性损伤的能力。创伤性脊髓损伤（SCI）就是一种慢性损伤的例子，目前尚未开发出治愈方法或完全恢复功能的治疗手段。部分原因在于中枢神经系统（CNS）复杂且相互关联的性质、细胞组成、细胞外基质（ECM）以及损伤部位的病理生理学。应对SCI复杂性的一种方法是创建功能性组织工程支架，以替代或补充中枢神经系统以及在急性损伤和随后的免疫反应后受损的组织/细胞外基质的各个方面。这可以通过采用由细胞、生物材料和环境因素组成的组织工程三元组来实现。干细胞具有增殖和分化的固有能力，是细胞疗法的常见选择。具有可调节特性的天然或合成生物材料通常用作支架基础。环境因素可以从药物到生长因子（GFs）或蛋白质不等，这取决于其目的是刺激外源性或内源性细胞群体，还是仅仅将细胞保留在支架上以进行有效的移植。对于SCI的功能再生和整合，支架必须促进神经保护和神经可塑性。组织工程策略已显示出诸多益处，包括神经元分化、轴突再生、轴突生长、整合到天然脊髓以及部分功能恢复。总体而言，本综述重点关注导致SCI难以治疗的背景、组织工程三元组的各个组成部分，以及组合支架如何有利于未来SCI恢复的前景。
