Traumatic central nervous system (CNS) injuries, including
spinal
cord injury and traumatic brain injury, are challenging enemies of
human health. Microglia, the main component of the innate immune system
in CNS, can be activated postinjury and are key participants in the
pathological procedure and development of CNS trauma. Activated microglia
can be typically classified into pro-inflammatory (M1) and anti-inflammatory
(M2) phenotypes. Reducing M1 polarization while promoting M2 polarization
is thought to be promising for CNS injury treatment. However, obstacles
such as the low permeability of the blood–brain barrier and
short retention time in circulation limit the therapeutic outcomes
of administrated drugs, and rational delivery strategies are necessary
for efficient microglial regulation. To this end, proper administration
methods and delivery systems like nano/microcarriers and scaffolds
are investigated to augment the therapeutic effects of drugs, while
some of these delivery systems have self-efficacies in microglial
manipulation. Besides, systems based on cell and cell-derived exosomes
also show impressive effects, and some underlying targeting mechanisms
of these delivery systems have been discovered. In this review, we
introduce the roles of microglia play in traumatic CNS injuries, discuss
the potential targets for the polarization regulation of microglial
phenotype, and summarize recent studies and clinical trials about
delivery strategies on enhancing the effect of microglial regulation
and therapeutic outcome, as well as targeting mechanisms post CNS
trauma.