Andriot Theo, Ghosh Mousumi, Pearse Damien D
The Miami Project to Cure Paralysis and Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
The Neuroscience Program, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Int J Mol Sci. 2025 Aug 16;26(16):7922. doi: 10.3390/ijms26167922.
Spinal cord injury (SCI) remains a devastating neurological condition characterized by loss of sensory, motor and autonomic function. Despite decades of research, no FDA-approved regenerative therapies currently exist to restore lost function following SCI. Schwann cells (SCs) support axon regeneration, remyelination, and neuroprotection after SCI, with their therapeutic potential validated in clinical trials demonstrating safe and feasible transplantation in humans. Although SC transplantation has shown promising results, challenges remain, including modest graft survival, limited host integration, and restricted migration that collectively contribute to constrain efficacy. To address these limitations, biomaterial scaffolds have been explored as synergistic platforms to enhance SC delivery and function. When combined with natural or synthetic biomaterials such as hydrogels, nanofiber scaffolds, or ECM-mimetic matrices, SCs demonstrate improved survival, retention, spatial distribution, and regenerative activity. The intrinsic regenerative properties of SCs, first demonstrated in models of peripheral nerve injury, make them particularly well-suited for neural repair of the central nervous system (CNS) compared to other cell types and their effectiveness can be enhanced synergistically when combined with biomaterials. These constructs not only provide structural support but also modulate the lesion microenvironment, enhance axon growth and improve SC integration with host tissue. Combinatorial approaches incorporating biomaterials with SCs are emerging as next-generation strategies to optimize repair for clinical translation. This review focuses on current progress in SC-based therapies combined with biomaterials, highlighting key preclinical advances, clinical translation efforts, and the path forward toward effective regenerative interventions for SCI.
脊髓损伤（SCI）仍然是一种严重的神经系统疾病，其特征是感觉、运动和自主神经功能丧失。尽管经过数十年的研究，但目前尚无美国食品药品监督管理局（FDA）批准的用于恢复脊髓损伤后丧失功能的再生疗法。雪旺细胞（SCs）在脊髓损伤后支持轴突再生、髓鞘再生和神经保护，其治疗潜力在临床试验中得到验证，表明在人体中移植是安全可行的。尽管雪旺细胞移植已显示出有希望的结果，但挑战仍然存在，包括移植存活率低、宿主整合有限以及迁移受限，这些因素共同限制了疗效。为了解决这些局限性，生物材料支架已被探索作为增强雪旺细胞递送和功能的协同平台。当与水凝胶、纳米纤维支架或细胞外基质模拟物等天然或合成生物材料结合时，雪旺细胞表现出更好的存活率、留存率、空间分布和再生活性。雪旺细胞的内在再生特性最初在外周神经损伤模型中得到证明，与其他细胞类型相比，它们特别适合中枢神经系统（CNS）的神经修复，并且当与生物材料结合时，其有效性可以协同增强。这些构建体不仅提供结构支持，还能调节损伤微环境，促进轴突生长并改善雪旺细胞与宿主组织的整合。将生物材料与雪旺细胞结合的组合方法正在成为优化临床转化修复的下一代策略。本综述重点关注基于雪旺细胞的疗法与生物材料结合的当前进展，强调关键的临床前进展、临床转化努力以及实现脊髓损伤有效再生干预的未来方向。
