Zhang Wen-Jun, Zhang Jun
Rehabilitation Medicine Department, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang City, Jiangxi Province, China.
Emergency Department, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang City, Jiangxi Province, China.
Int J Surg. 2025 Aug 1;111(8):5325-5336. doi: 10.1097/JS9.0000000000002548. Epub 2025 Jun 4.
Spinal cord injury (SCI) can lead to sensory, motor, and autonomic dysfunction, and even accompanied by persistent pathological pain, seriously affecting the psychosomatic health of patients. At present, there are no effective treatment methods. In recent years, cell transplantation replacement therapy has entered people's field of vision. Functional bioactive cells are transplanted into the host to exert the characteristics of biotherapy so as to repair the injured nerve and repair the function. Neural stem cells (NSCs) are a kind of pluripotent stem cells, which have been well applied in nerve injury repair and tissue engineering regeneration. In preclinical and animal models, NSCs transplantation can well repair SCI and repair part of the function. The therapeutic functions of NSCs include differentiation into neurons, promoting axonal regeneration and myelination, neuroprotection, immunoregulation, and improving the local inflammatory microenvironment of SCI, replacing injured neurons. it is beneficial to the repair and reconstruction of neural network after SCI. NSCs have also achieved some encouraging results in clinical trials of SCI. Transplantation of NSCs into patients with SCI is a safe and feasible treatment, which can partially restore the sensory and motor function of the patients, without obvious side effects. At present, NSCs are in the primary exploration stage in clinical trials, and there are many problems and challenges in their extensive development and application in clinical trials. Therefore, we comprehensively discussed the application of NSCs in clinical trials of SCI and the existing problems and challenges, so as to provide useful information for the application of NSCs in SCI in the future.
脊髓损伤(SCI)可导致感觉、运动和自主神经功能障碍,甚至伴有持续性病理性疼痛,严重影响患者的身心健康。目前,尚无有效的治疗方法。近年来,细胞移植替代疗法进入了人们的视野。将功能性生物活性细胞移植到宿主体内,发挥生物治疗特性,以修复受损神经并恢复功能。神经干细胞(NSCs)是一种多能干细胞,已在神经损伤修复和组织工程再生中得到很好的应用。在临床前和动物模型中,NSCs移植能够很好地修复SCI并恢复部分功能。NSCs的治疗功能包括分化为神经元、促进轴突再生和髓鞘形成、神经保护、免疫调节、改善SCI局部炎症微环境、替代受损神经元,这有利于SCI后神经网络的修复和重建。NSCs在SCI的临床试验中也取得了一些令人鼓舞的成果。将NSCs移植到SCI患者体内是一种安全可行的治疗方法,可部分恢复患者的感觉和运动功能,且无明显副作用。目前,NSCs在临床试验中尚处于初步探索阶段,其在临床试验中的广泛开展和应用存在诸多问题和挑战。因此,我们全面探讨了NSCs在SCI临床试验中的应用以及存在的问题和挑战,以便为NSCs未来在SCI中的应用提供有用信息。