Spinal Cord Injury: Pathophysiology, Neural Stem Cell Treatment and Its Combination with Other Strategies

Abstract

Spinal cord injury is associated with the damage to neural circuits and disruption of neural pathways, leading to irreversible long-term complications in terms of physical and mental health. Traditional treatments mainly include surgical decompression and pharmacotherapy whereas none of them could attenuate or even alleviate long-term complications following SCI. This is largely due to complicated pathophysiological process in SCI which includes primary injury and secondary injury. Primary injury is defined as direct mechanical damage on the spinal cord in the initial time course of injury. Secondary injury occurs a few hours after primary injury and it could persist for longer time, promoting a catastrophe of degenerative pathophysiological process in spinal cord and related tissues. Although currently there is no effective cure strategies for SCI, some recent studies have shown that stem cell therapy combined with other strategies is able to enhance neurofunctional recovery and neural stem cell line is one of the stem cell lines which show convincing therapeutic effects (Huang, L., Fu, C., Xiong, F., He, C. & Wei, Q., 2021). Biomaterials can work as carriers which help deliver nutrient biomolecules to help NSC survive and differentiate to more functional cells or as scaffolds which provide structural bridges to lesion site for NSC migration and tissue regeneration (Vismara, I., Papa, S., Rossi, F., Forloni, G. & Veglianese, P., 2017). In addition, the basic principles of magnetic stimulation and electric stimulation are similar and they all involve producing electrical current on brain or spinal cord to modulate brain or spinal cord activity. It has been revealed that electric stimulation and repetitive magnetic stimulation is associated with neuroplasticity which may reduce inappropriate lateral sprouting resulting from NSC therapy, making them become potential complementary strategies to NSC therapy as well (Kricheldorff, J. et al., 2022).