Stem Cell Scaffolds for the Treatment of Spinal Cord Injury—A Review

Abstract

Spinal cord injury (SCI) is a profoundly debilitating yet common central nervous system condition resulting in significant morbidity and mortality rates. Major causes of SCI encompass traumatic incidences such as motor vehicle accidents, falls, and sports injuries. Present treatment strategies for SCI aim to improve and enhance neurologic functionality. The ability for neural stem cells (NSCs) to differentiate into diverse neural and glial cell precursors has stimulated the investigation of stem cell scaffolds as potential therapeutics for SCI. Various scaffolding modalities including composite materials, natural polymers, synthetic polymers, and hydrogels have been explored. However, most trials remain largely in the preclinical stage, emphasizing the need to further develop and refine these treatment strategies before clinical implementation. In this review, we delve into the physiological processes that underpin NSC differentiation, including substrates and signaling pathways required for axonal regrowth post-injury, and provide an overview of current and emerging stem cell scaffolding platforms for SCI.

Social Determinants of Health Impact Spinal Cord Injury Outcomes in Low- and Middle-Income Countries: A Meta-Epidemiological Study

“…47 Many of these natural polymer scaffolds are abundant in nature, and dissemination strategies to equip LMICs with these options for SCI treatment should be considered as clinical translational studies progress. 47 Similar approaches may be considered for transcutaneous neuromodulation, which has been demonstrated as a low-cost, noninvasive treatment for SCI symptoms, particularly neurogenic lower urinary tract dysfunction. 48 As previously mentioned, telemedicine for SCI patients in LMICs has shown an ability to improve quality of life, functional scores, and depression scores.…”

Selective cargo sorting in stem cell‐derived small extracellular vesicles: impact on therapeutic efficacy for intervertebral disc degeneration

“…MSCs have been utilised in the therapeutic management of diverse diseases, encompassing musculoskeletal disorders, neurodegenerative diseases, shock, and tumors 31–33 . MSCs are commonly employed for the repair of tissues or organs through cell transplantation 34 . They serve as scaffolds to provide viable cells or bioactive molecules.…”

Improving Efficiency of Direct Pro-Neural Reprogramming: Much-Needed Aid for Neuroregeneration in Spinal Cord Injury

“…Currently, cutting-edge approaches to neural regeneration and functional restoration post-SCI are multi-pronged and propose using various combinations of supportive TES with cell therapies (Figure 1), including cell therapy utilizing induced pluripotent stem cells (iPSCs) or directly reprogrammed neural precursor/progenitor cells (drNPCs), electrical epidural stimulation, and the application of bio-active compounds modulating molecular pathways critical for tissue regeneration and its normal functioning [25][26][27]. TES transplanted to the lesion site provide mechanical support to the tissue, can be used as a drug delivery system, might have conductive properties, and guides cell differentiation, proliferation and migration.…”

“…This brings to our discussion another tool of post-SCI neuroregenerative therapy-TES. Indeed, in the past few years there seems to have been a steady increase in reports focusing on TES for successful neuroregeneration [117], including SC incorporating TES for SCI treatment (as comprehensively reviewed in [27]). Such TES should meet several requirements: briefly, they have to be biodegradable (allowing for their substitution with tissue), bio-compatible, and bio-mimetic, i.e., recapitulating key properties of the neural tissue, for example, conductivity [29].…”