Ana-Maria Oproescu and Victoria McCann
This is a summary of a literature review which combines the findings of many individual studies about drug and cell therapies for SCI and discusses the major developments and challenges in these areas of research. The review was published by researchers in the Department of Biomedical Engineering at the Cleveland Clinic and the Department of Orthopedics at the University of British Columbia, with ICORD researcher Dr. Brian Kwon.
For those living with SCI, treatment strategies are complicated by secondary injury to the nervous system. After the initial trauma to nervous tissue, damaged cells from the original site may lead to further damage by contributing to the formation of scars and swelling in the nervous system. This is given the term “secondary damage’ and includes other events such as demyelination (damage to a nerve’s protective covering), improper blood supply to various parts of the body, and damage to cell membranes and genetic information.
What are some of the current approaches to rehabilitation and therapy for people with SCI?
The authors review two different therapeutic approaches: neuroprotective and neuroregenerative. Neuroprotective strategies, such as drug-based therapies, focus on protecting the body from further injury caused by the original SCI. Neuroregenerative therapies, on the other hand, attempt to recover lost function caused by the SCI, and include cell-based and tissue-engineering approaches. While neuroprotective therapies may only be done within a limited time frame, neuroregenerative therapies may be done throughout one’s life. The authors identified the challenges and potential of several treatments.
|Drug Delivery (Neuroprotective)||
|Cell-Based Therapy (Neuroregenerative)||
|Tissue Engineering (Neuroregenerative)||
What could this mean for the future of SCI treatment?
The authors found that considering the dynamic nature of SCI symptoms, it is important that treatments and therapies take a combined approach. That is to say, the best results will likely be observed when both neuro-protection and neuro-regeneration are targeted within a single treatment.
A common issue with SCI research is that while results may appear promising in a lab setting, they fail to translate to people living with SCI. This review suggests that by establishing certain research guidelines to be met when planning a new therapy, researchers will ultimately be able to reduce the amount of time and effort spent on failed clinical trials. The authors write that more thorough testing procedures such as the use of multiple animal models, different injury models, and more effective drug delivery would prevent unfavorable results from discouraging researchers, patients, and community alike.
The authors are optimistic that one day targeted approaches will be available not only to promote injury repair through treatment, but also to facilitate self-repair of damage related to SCI.