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Current Concepts of Stem Cell Therapy for Chronic Spinal Cord Injury

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MDPI
DOI: 10.3390/ijms22147435

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chronic spinal cord injury; stem cells; glial scar; chondroitin sulfate proteoglycans; regenerative medicine; clinical trial

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Chronic spinal cord injury is a devastating condition with significant neurological deficits and socio-economic burdens. Symptomatic management is currently the main approach, but innovative regenerative strategies involving stem cells and other supportive drugs show promise in accelerating the pathway from bench to bedside. Future therapies targeting persistent barriers to regeneration, such as glial scarring and immunorejection, will likely require a combination of stem cells and synergistic approaches.
Chronic spinal cord injury (SCI) is a catastrophic condition associated with significant neurological deficit and social and financial burdens. It is currently being managed symptomatically with no real therapeutic strategies available. In recent years, a number of innovative regenerative strategies have emerged and have been continuously investigated in clinical trials. In addition, several more are coming down the translational pipeline. Among ongoing and completed trials are those reporting the use of mesenchymal stem cells, neural stem/progenitor cells, induced pluripotent stem cells, olfactory ensheathing cells, and Schwann cells. The advancements in stem cell technology, combined with the powerful neuroimaging modalities, can now accelerate the pathway of promising novel therapeutic strategies from bench to bedside. Various combinations of different molecular therapies have been combined with supportive scaffolds to facilitate favorable cell-material interactions. In this review, we summarized some of the most recent insights into the preclinical and clinical studies using stem cells and other supportive drugs to unlock the microenvironment in chronic SCI to treat patients with this condition. Successful future therapies will require these stem cells and other synergistic approaches to address the persistent barriers to regeneration, including glial scarring, loss of structural framework, and immunorejection.

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