Tissue Engineering Approaches to Modulate the Inflammatory Milieu following Spinal Cord Injury.
Tissue Engineering Approaches to Modulate the Inflammatory Milieu following Spinal Cord Injury.
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DOI：
10.1159/000446646
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Shea LD
中科院分区：
文献类型：
--
作者：
Dumont CM;Margul DJ;Shea LD
组织工程策略在促进脊髓损伤(SCI)后的愈合和再生方面显示出了良好的前景；然而，这些策略受到炎症和免疫反应的限制。先天和获得性免疫反应细胞的渗透以及随之而来的炎症会导致邻近损伤的继发性损害，增加瘢痕形成，并为受损神经元的再生提供有效的抑制环境。虽然通常情况下，随之而来的炎症与有限的再生有关，但免疫反应是关闭血脑屏障、最大限度减少损伤扩散和启动愈合的关键因素。本文综述了已开发的调节免疫反应的策略，以适应允许神经元、神经胶质细胞和实质再生的抗炎环境。我们的重点是使用生物材料、生物活性分子、基因疗法、纳米颗粒和干细胞来调节免疫反应，并说明未来治疗的概念。目前对脊髓损伤的临床治疗仅限于全身低温或甲基强的松龙，这两种疗法都是通过系统减轻免疫反应的影响而起作用的，但疗效不大。在这里，我们讨论新出现的研究策略，通过直接针对免疫反应的特定方面来进一步加强这些临床治疗。
Tissue engineering strategies have shown promise in promoting formation of healing and regeneration after spinal cord injury (SCI); however, these strategies are limited by inflammation and the immune response. Infiltration of cells of the innate and adaptive immune responses and the inflammation that follows cause secondary damage adjacent to the injury, increased scarring, and a potently inhibitory environment for regeneration of damaged neurons. While typically the inflammation that ensues is associated with limited regeneration, the immune response is a crucial element in the closing of the blood brain barrier, minimizing the spread of injury, and initiating healing. This review summarizes the strategies that have been developed to modulate the immune response towards an anti-inflammatory environment that is permissive to regeneration of neurons, glia, and parenchyma. We focus on the use of biomaterials, biologically active molecules, gene therapy, nanoparticles, and stem cells to modulate the immune response, and illustrate concepts for future therapies. Current clinical treatments for SCI are limited to systemic hypothermia or methylprednisolone, which both act by systemically mitigating the effects immune response but have marginal efficacy. Herein we discuss emerging research strategies to further enhance these clinical treatments by directly targeting specific aspects of the immune response.
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