Spinal Cord Repair: Bridging the Divide

Abstract

The normal spinal cord coordinates movement and sensation in the body. It is a complex organ containing nerve cells, supporting cells, and nerve fibers to and from the brain. The spinal cord is arranged in segments, with higher segments controlling movement and sensation in the upper parts of the body and lower segments controlling the lower parts of the body. Recent notable discoveries in the fields of neuroscience and cell biology have ensured that many more people survive injuries to the brain and spinal cord. The consequences of injury reflect this organization. Although these developments have been mirrored by significant strides in our understanding of the evolution and pathology of spinal injuries, complete repair of structure and hence function remain elusive. Most spinal cord injuries still cause lifelong disability, and continued research is critically needed. Here we review the molecular and cellular processes that occur during the evolution of an injury to the central nervous system. Throughout, we highlight several promising therapies aimed to restore the disrupted connections in the brain and spinal cord. These, used in combination with supportive care and rehabilitation strategies, may help patients to achieve significant long-term recovery.

The laser lesion of the mouse visual cortex as a model to study neural extracellular matrix remodeling during degeneration, regeneration and plasticity of the CNS

“…In agreement with this view, the degradation of CSPGs leads to an improved functional recovery of CNS lesions (Bradbury et al 2002;Fawcett 2006a, b;Fitch and Silver 2008;Massey et al 2008). The inhibitory properties of CSPGs and the potential application of the CSPG-degrading enzyme chondroitinase ABC as treatment have been extensively reviewed elsewhere (Fawcett 2009;Verma et al 2008). However, chondroitinase ABC-resistant inhibitors have also been reported (Siddiqui et al 2009).…”

A cortical astrocyte subpopulation inhibits axon growth in vitro and in vivo

“…The failure of neuron regeneration following injury in the adult mammalian CNS is considered to be the result of a decreased intrinsic regenerative capacity in affected neurons (14,15). The process is affected by numerous factors, including myelin-associated inhibitory factors (16,17), glial scars formed by damaged astrocytes and inhibitory molecules secreted by damaged astrocytes (18,19). …”

Estratégia terapêutica após contusão da medula espinhal: recuperação funcional e estabilidade cortical sensório-motora

“…No instante do impacto, fragmentos de ossos, material do disco vertebral e os ligamentos esmagam a medula espinhal, danificando as membranas das células neuronais, levando a uma lesão parcial (Verma et al, 2008). Esse impacto direto na medula espinhal desencadeia uma série de eventos celulares e moleculares em resposta à lesão.…”

“…Além disso, durante este período, importantes mudanças reativas ocorrem na morfologia e função das células da glia (Verma et al, 2008). Estudos mostram que 24 horas após a LM, 50% dos astrócitos e oligodendrócitos, presentes no local da lesão, morrem.…”

“…Entretanto, também existem muitas proteínas associadas à mielina (Nogo-A, MAG, OMgp), proteoglicana sulfato de condroitina e outras moléculas inibitórias, como a tenascina e a semaforina 3A que são parcialmente responsáveis pela inibição da regeneração após a LM (Bradbury e McMahon, 2006;Schwab, 2007;Blesch e Tuszynski, 2009;Verma et al, 2008).…”