Open AccessThe leading edge: Emerging neuroprotective and neuroregenerative cell‐based therapies for spinal cord injury
Author(s) -
Ahuja Christopher S.,
Mothe Andrea,
Khazaei Mohamad,
Badhiwala Jetan H.,
Gilbert Emily A.,
Kooy Derek,
Morshead Cindi M.,
Tator Charles,
Fehlings Michael G.
Publication year - 2020
Publication title -
stem cells translational medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.781
H-Index - 71
eISSN - 2157-6580
pISSN - 2157-6564
DOI - 10.1002/sctm.19-0135
Subject(s) - spinal cord injury , medicine , neuroscience , neuroprotection , cell therapy , olfactory ensheathing glia , mesenchymal stem cell , transplantation , progenitor cell , stem cell therapy , stem cell , neural stem cell , clinical trial , spinal cord , bioinformatics , pathology , biology , surgery , central nervous system , genetics , olfactory bulb
Spinal cord injuries (SCIs) are associated with tremendous physical, social, and financial costs for millions of individuals and families worldwide. Rapid delivery of specialized medical and surgical care has reduced mortality; however, long‐term functional recovery remains limited. Cell‐based therapies represent an exciting neuroprotective and neuroregenerative strategy for SCI. This article summarizes the most promising preclinical and clinical cell approaches to date including transplantation of mesenchymal stem cells, neural stem cells, oligodendrocyte progenitor cells, Schwann cells, and olfactory ensheathing cells, as well as strategies to activate endogenous multipotent cell pools. Throughout, we emphasize the fundamental biology of cell‐based therapies, critical features in the pathophysiology of spinal cord injury, and the strengths and limitations of each approach. We also highlight salient completed and ongoing clinical trials worldwide and the bidirectional translation of their findings. We then provide an overview of key adjunct strategies such as trophic factor support to optimize graft survival and differentiation, engineered biomaterials to provide a support scaffold, electrical fields to stimulate migration, and novel approaches to degrade the glial scar. We also discuss important considerations when initiating a clinical trial for a cell therapy such as the logistics of clinical‐grade cell line scale‐up, cell storage and transportation, and the delivery of cells into humans. We conclude with an outlook on the future of cell‐based treatments for SCI and opportunities for interdisciplinary collaboration in the field.