Abstract
Stem cell therapy is a potential treatment for spinal cord injury (SCI), and a variety of different stem cell types have been evaluated in animal models and humans with SCI. No consensus exists regarding the type of stem cell, if any, that will prove to be effective therapeutically. Most data suggest that no single therapy will be sufficient to overcome all the biological complications caused by SCI. Rationales for therapeutic use of stem cells for SCI include replacement of damaged neurons and glial cells, secretion of trophic factors, regulation of gliosis and scar formation, prevention of cyst formation, and enhancement of axon elongation. Most therapeutic approaches that use stem cells involve implantation of these cells into the spinal cord. The attendant risks of stem cell therapy for SCI—including tumor formation, or abnormal circuit formation leading to dysfunction—must be weighed against the potential benefits of this approach. This Review will examine the biological effects of SCI, the opportunities for stem cell treatment, and the types of stem cells that might be used therapeutically. The limited information available on the possible benefits of stem cell therapy to humans will also be discussed.
Key Points
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Strategies for the therapeutic use of stem cells and their derivatives in spinal cord injury (SCI) include cell replacement, trophic support and facilitation of axon regeneration
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Stem cell transplantation, either alone or in combination with other treatments, has produced functional improvements in animal models of SCI
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Caution must be exercised when evaluating the successes of stem cell therapy for SCI, and when developing these therapies for appropriate clinical trials
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The existing data from clinical trials have shown some stem cell transplants to be safe, but with very limited or no therapeutic efficacy
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Future strategies for stem cell therapies include the use of induced pluripotent stem cells, as well as the modulation of endogenous progenitor cell populations
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Sahni, V., Kessler, J. Stem cell therapies for spinal cord injury. Nat Rev Neurol 6, 363–372 (2010). https://doi.org/10.1038/nrneurol.2010.73
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DOI: https://doi.org/10.1038/nrneurol.2010.73
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