Stem cell therapy in spinal cord injury: Hollow promise or promising science?

Abstract

Spinal cord injury (SCI) remains one of the most physically, psychologically and socially debilitating conditions worldwide. While rehabilitation measures may help limit disability to some extent, there is no effective primary treatment yet available. The efficacy of stem cells as a primary therapeutic option in spinal cord injury is currently an area under much scrutiny and debate. Several laboratory and some primary clinical studies into the use of bone marrow mesenchymal stem cells or embryonic stem cell-derived oligodentrocyte precursor cells have shown some promising results in terms of remyelination and regeneration of damaged spinal nerve tracts. More recently,laboratory and early clinical experiments into the use of Olfactory Ensheathing Cells, a type of glial cell derived from olfactory bulb and mucosa have provided some phenomenal preliminary evidence as to their neuroregenerative and neural bridging capacity. This report compares and evaluates some current research into selected forms of embryonic and mesenchymal stem cell therapy as well as olfactory ensheathing cell therapy in SCI, and also highlights some legal and ethical issues surrounding their use. While early results shows promise, more rigorous large scaleclinical trials are needed to shed light on the safety, efficacy and long term viability of stem cell and cellular transplant techniques in SCI.

Stem Cells and Regenerative Medicine

“…[32] The Geron Company was founded in 1990 and started experiments on stem cells in 1998. [33] In May 2008, the American Food and Drug Administration rejected Geron's 21.000-page application, which halted embryonic stem cell research. [33] However, a few days after Barack Obama was president, the obstacle was removed and researches restarted.…”

“…[33] In May 2008, the American Food and Drug Administration rejected Geron's 21.000-page application, which halted embryonic stem cell research. [33] However, a few days after Barack Obama was president, the obstacle was removed and researches restarted. [34] The Geron Company underwent "specialized stem cell injections" in four of the eight patients that had been paralyzed by spinal cord injury in the Phase 1 study.…”

Stem Cells and Labeling for Spinal Cord Injury

“…The primary phase of SCI essentially involves the mechanical disruption of the normal architecture of the spinal cord, and is characterized by acute hemorrhage and ischemia [ 4 ]. The cumulative damage of neurons, astroglia, and oligodendroglia in and around the lesion site disrupts neural circuitry and leads to neurological dysfunction [ 5 ].…”

An allogenic therapeutic strategy for canine spinal cord injury using mesenchymal stem cells

“…SCI results in neural dysfunction, lifelong disability, and loss of independence. The primary damage caused by external forces is followed by secondary injury involving release of cytotoxic factors, edema, decreased blood flow, and accelerated apoptosis (Goel, ). The neuropathological outcome of SCI is complex, and therefore some challenging concepts like reducing neural cell death, regaining healthy neural cells, reducing scarring, stimulating axonal regeneration, and remodeling the injury niche need to be addressed (Mortazavi et al, ).…”