The leading edge: Emerging neuroprotective and neuroregenerative cell-based therapies for spinal cord injury.
The leading edge: Emerging neuroprotective and neuroregenerative cell-based therapies for spinal cord injury.
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DOI：
10.1002/sctm.19-0135
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发表时间：
2020-12
影响因子：
6
通讯作者：
Fehlings MG
中科院分区：
文献类型：
--
作者：
Ahuja CS;Mothe A;Khazaei M;Badhiwala JH;Gilbert EA;van der Kooy D;Morshead CM;Tator C;Fehlings MG
脊髓损伤（SCI）与全球数百万个人和家庭的巨大身体，社会和经济成本有关。专业医疗和外科护理的快速提供降低了死亡率;然而，长期功能恢复仍然有限。基于细胞的疗法代表了一种令人兴奋的SCI神经保护和神经再生策略。本文总结了迄今为止最有前途的临床前和临床细胞方法，包括间充质干细胞，神经干细胞，少突胶质细胞祖细胞，雪旺细胞和嗅鞘细胞的移植，以及激活内源性多能细胞库的策略。在整个过程中，我们强调基于细胞的治疗的基本生物学，脊髓损伤的病理生理学的关键特征，以及每种方法的优势和局限性。我们还重点介绍了全球范围内已完成和正在进行的临床试验及其结果的双向转化。然后，我们提供了一个关键的辅助策略，如营养因子的支持，以优化移植物的存活和分化，工程生物材料，以提供一个支持支架，电场刺激迁移，和新的方法来降解胶质瘢痕的概述。我们还讨论了启动细胞疗法临床试验时的重要考虑因素，例如临床级细胞系规模扩大，细胞储存和运输以及将细胞输送到人体中的物流。最后，我们展望了基于细胞的SCI治疗的未来以及该领域跨学科合作的机会。
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.
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影响因子：
3.7
作者：
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DOI：
10.1523/jneurosci.2980-06.2006
发表时间：
2006-10-18
期刊：
The Journal of neuroscience : the official journal of the Society for Neuroscience
影响因子：
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作者：
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影响因子：
5.3
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