Advances in Biomaterial‐Based Spinal Cord Injury Repair

Abstract

Spinal cord injury (SCI) often leads to the loss of motor and sensory functions and is a major challenge in neurological clinical practice. Understanding the pathophysiological changes and the inhibitory microenvironment is crucial to enable the identification of potential mechanisms for functional restoration and to provide guidance for the development of efficient treatment and repair strategies. To date, the implantation of specifically functionalized biomaterials in the lesion area has been shown to help promote axon regeneration and facilitate neuronal circuit generation by remolding SCI microenvironments. Moreover, structural and functional restoration of the spinal cord through the transplantation of naive spinal cord tissue grafts from adult donors, artificial spinal cord-like tissue developed from tissue engineering, and 3D printing will open up new avenues for SCI treatment. This review focuses on the dynamic pathophysiological changes in SCI microenvironments, biomaterials for SCI repairs, strategies for restoring spinal cord structure and function, experimental animal models, regenerative mechanisms, and clinical studies for SCI repair. The current status, recent advances, challenges, and prospects of scaffold-based SCI repair from basic to clinical settings are summarized and discussed, to provide a reference that will help to guide the future exploration and development of spinal cord regeneration strategies.

Magnesium Oxide/Poly(l‐lactide‐co‐ε‐caprolactone) Scaffolds Loaded with Neural Morphogens Promote Spinal Cord Repair through Targeting the Calcium Influx and Neuronal Differentiation of Neural Stem Cells

“…However, the degradation products were acidic and detrimental to nerve repair. [26] Fortunately, this problem could be solved by the MgO nanoparticles used in this study. The MgO nanoparticles modified the acidic microenvironment of SCI and neutralized the acidic products generated by polymer degradation.…”

The immune microenvironment and tissue engineering strategies for spinal cord regeneration

“…or synthetic biodegradable biomaterials (polyglycolic acid, polylactic acid, polylactic acid-glycolic acid and polyepsilon-caprolactone., etc.) mimic the natural structure of the spinal cord for neuron proliferation, migration and differentiation ( Chen et al, 2017 ; Varone et al, 2017 ; Shen et al, 2022a ). Moreover, neurotrophic factor (NT-3), brain-derived neurotrophic factor (BDNF), basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) can be used alone or in combination to improve the survival of neurons and promote axonal regeneration ( Li et al, 2009 , 2019 ; He et al, 2011 ; Han et al, 2015 ; Chen et al, 2018 ; Wang X. L. et al, 2018 ; Shang et al, 2019 ).…”

Biomaterial-Mediated Factor Delivery for Spinal Cord Injury Treatment

“…Obviously, SCI has a grave impact on the quality of life of the patients, and incurs heavy costs from both social and healthcare points of view [ 6 , 7 , 8 ]. From a pathophysiological perspective, the trauma starts with an acute phase (primary mechanical injury) as a consequence of compressive, stretching, or contusive trauma [ 9 , 10 , 11 , 12 , 13 ]. This phase is then followed by a multifactorial process (also known as secondary injury) that aggravates the tissue damage and, thus, worsens the condition of the patient [ 14 ], leading finally to variable motor dysfunction, chronic pain syndrome, and many other permanent and critical outcomes.…”