Spinal Cord Injury

  • Condition

One of the principal and intriguing facts in regenerative medicine has been the use of stem cell therapy in conditions involving the nervous system, including Spinal Cord Injury (SCI). The most common scenario in human SCI, is contusion to the SC after spine facture or displacement, producing cell injury and death. After injury, the peripheral nervous system (PNS) presents challenges in cell survival due to the almost inexistent repairing characteristics of neurons, being this the primary injury. A cascade of biochemical reactions follow producing the secondary injury with the continuing cell death, cyst formation and glial scar tissue (Horner, 2000; Li, 2013). Cellular debris and components also promote modifications to the environment with the secretion of inhibitory factors that prevent and limit cell repair and growth, reducing the effectiveness of endogenous and exogenous healing. Therefore, when stem cell therapies are being considered, certain aspects should be evaluated in order to determine the better source of cells, the timing or the combination of several cellular and molecular factors to better target the problem in SCI.
It has been a challenge to obtain CNS progenitor cells in the past. Today, it is possible to obtain cells from certain sources including Olfactory Ensheathing Cells (OEC), Fetal tissue derived cells, and pluripotent stem cells, most commonly studied, Embryonic Stem Cells (ESC) and recently also Induced Pluripotent Stem cells (iPS).
Since the previously mentioned are still in preclinical stages, we focus on a source already in clinical stages, fetal derived neural stem cells (NSCs)  which are considered multipotent due to their limited capacity to differentiate only into neurons and supportive cells of the nervous system.
In a murine preclinical setting, an SCI was caused and followed with NSCs intrathecal application (Cheng et al. 2002)

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References

  • Cheng I., Mayle RE, Cox CA, Park DY, Smith RL, Corcoran-Swhwartz I, Ponnusamy KE, Oshtory R, Smuck MW, Mitra R, Kharazi AI, et al. Functional assessment of the acute local and distal transplantation of human neural stem cells after spinal cord injury. The Spine Journal 2012;12:1040-1044.
  • Dlouhy B.J., Awe O., Rao R. C., Kirby P. A. et al. Autograft-derived spinal cord mass following olfactory mucosal cell transplantation in a spinal cord injury patient. Case Report. Journal of Neurosurgery: Spine, 2014; 21(4): 618-622.
  • Horner PJ, Gage FH. Regenerating the damaged central nervous system. Nature 2000; 407(6807):963–970
  • Li J., Lepski G. Cell Transplantation for Spinal Cord Injury: A systematic Review. BioMed Res International 2013; Article ID 786475, 1-32.
  • Salewski R., Emrani H., Fehlings M.G. Neural Stem/Progenitor Cells for Spinal Cord Regeneration. Intech 2013;11: http:/dx.doi.org/10.5772/55054.

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