Spinal Cord Injury – Stem Cell Treatments

Spinal cord injuries (SCIs) are sustained by around 12,000 Americans each year, adding to over 1,250,000 patients already living with disabilities due to spinal cord trauma. Common causes of spinal cord injury include falls, gunshot wounds, sports injuries, and car accidents. Most injuries are bruises to the cord, with actual nerve severance less common but usually much more severe. Trauma to the spine, especially where there are pre-existing problems of stenosis or degeneration, can fracture or displace vertebrae and cause bone or disc material to adversely impact the nerve fibers in the spinal cord. Neurological deficits then occur, whether temporary or permanent, and include problems with locomotor function, sensation, and incontinence (bowel and/or bladder).

Stem Cells to Prevent Severe SCI?

Functional deficits from spinal cord injury are largely due to damage or severance of axons, demyelination, and loss of neurons and glia. The initial trauma causes damage to the spinal cord tissue and subsequent ischaemia, anoxia, and free-radical formation then cause further degeneration of the patients’ condition. Routine stem cell therapy to cure spinal cord injury is a long way away, with only a handful of early-stage studies showing some degree of efficacy. Key strategies for researchers working with stem cells and patients with SCI include rapid treatment following initial trauma to prevent further axonal generation and even reverse the damage incurred by the mechanical insult itself. There appears to be significant promise for those treatments which surround damaged areas of the spinal cord with healthy stem cells as this appears to inhibit the progress of such injuries.

Stem Cells for SCI Scarring

Those suffering a spinal cord injury usually develop a post-lesion scar barrier which prevents axonal regeneration making researchers optimistic that early treatment that stops this scarring from occurring may then allow functional recovery as axonal regrowth occurs. Indeed, researchers have now devised biocompatible hydrogels which may be inserted following spinal cord injury to prevent this barrier forming and actually encourage the regeneration of neurons and their axons, glia, and other tissues (Hejcl, et al, 2008).

The potential to use hydrogels and scaffolds to bridge the cavity created by a spinal cord injury and infuse these with stem cells was investigated by Teng (et al, 2002). They found evidence of a protective effect which reduced further loss of axons and helped restore some function in animal models. Other problems exist however, such as inhibitors of myelin repair, and the loss in adult neurons of the ability to overcome inhibitory cues. What this means is that a spinal cord injury is often self-perpetuating, with damaged regions unable to repair themselves and inhibiting the repair of adjacent sections over time. Initiating treatment immediately after spinal cord trauma can help preserve more tissue and is extremely important in enhancing functional recovery.

Clinical Trials Underway for SCI

The first human trial of stem cell treatment for spinal cord injury treated its first patient in late 2010 with human embryonic stem cell-derived oligodendrocyte progenitor cells and other stem cell trials for spinal cord injury have followed; results of treatment are eagerly awaited.

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