Therapeutical Strategies for Spinal Cord Injury and a Promising Autologous Astrocyte-Based Therapy Using Efficient Reprogramming Techniques

Abstract

Spinal cord injury (SCI) is a traumatic event resulting in disturbances to normal sensory, motor, or autonomic functions, which ultimately impacts a patient's physical, psychological, and social well-being. Until now, no available therapy for SCI can effectively slow down or halt the disease progression. Compared to traditional treatments, e.g., medication, surgery, and functional electrical stimulation, stem cell replacement therapy shows high potential for repair and functional plasticity. Thus, stem cell therapy may provide a promising strategy in curative treatment of SCI, specifically when considering the requirement of neuron replenishment in the spinal cord after distinct acute injuries. However, the therapeutic application of neural stem cells (NSCs) still faces enormous challenges, such as ethical issues, possible inflammatory reactions, graft rejection, and tumor formation. Therefore, it is of vital interest to identify more suitable sources of cells with stem cell potential, which might potentially be harnessed for local neural repair. Due to abovementioned possible drawbacks, these cells should be autologous. Reprogramming of astrocytes to generate the desired neuronal cell types would open the door to autologous cell transplantation and treatment of SCI without possible severe side effects. In this paper, we review the relevant therapeutic strategies for SCI, and conversion of astrocyte into NSCs, suggesting this procedure as a possible treatment option.

Effects of high-frequency transcranial magnetic stimulation on functional performance in individuals with incomplete spinal cord injury: study protocol for a randomized controlled trial

“…Individuals with iSCI show clinical symptoms which are associated with reduced quality of life and functional independence [ 60 , 61 ]. The CNS may be able to recover naturally after injury due to plasticity mechanisms and reorganization of residual neural pathways [ 5 ].…”

The emerging role of long non‐coding RNA in spinal cord injury

“…After SCI, permanent neuronal loss is a major obstacle and will result in functional disfigurement, so enhancing the survival of neurons is critical for recovery in patients with SCI [36]. It is really difficult to avoid the neuronal loss happened; however, during the secondary injury after SCI, genes expression can be regulated to promote posttraumatic spinal neuron survival, and regulation of lncRNAs is an important way [37,38].…”

Drug delivery, cell-based therapies, and tissue engineering approaches for spinal cord injury

“…are all exploited for their pluripotent differentiation ability to replace neuronal lineage cells, enhance axonal regeneration and restore inter-neuron communications (116). Stem cell-based therapy is promising, yet potential side effects and safety concerns do exist, such as ethical issues, immunological rejection, and tumor formation (117). Cell transplantation can also act as a vehicle for gene delivery.…”