• Open Access

Regenerative medicine for the treatment of spinal cord injury: more than just promises?

Authors

  • Ana Paula Pêgo,

    Corresponding author
    1. INEB – Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
    2. Universidade do Porto, Faculdade de Engenharia (FEUP) and Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
    • Correspondence to: Ana Paula PÊGO, INEB – Instituto de Engenharia Biomédica, Universidade do Porto Rua do Campo Alegre, 823, 4150-180 Porto, Portugal.

      Tel.: +351 226074900

      Fax: +351 226094567

      E-mail: apego@ineb.up.pt

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  • Sarka Kubinova,

    1. Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague 4, Czech Republic
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  • Dasa Cizkova,

    1. Institute of Neurobiology – Slovak Academy of Sciences, Center of Excellence for Brain Research, Kosice, Slovakia
    2. University of Veterinary Medicine and Pharmacy, Kosice, Slovakia
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  • Ivo Vanicky,

    1. Institute of Neurobiology – Slovak Academy of Sciences, Center of Excellence for Brain Research, Kosice, Slovakia
    2. University of Veterinary Medicine and Pharmacy, Kosice, Slovakia
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  • Fernando Milhazes Mar,

    1. Nerve Regeneration Group, IBMC – Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
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  • Mónica Mendes Sousa,

    1. Nerve Regeneration Group, IBMC – Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
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  • Eva Sykova

    1. Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague 4, Czech Republic
    2. Department of Neuroscience, 2nd Medical Faculty, Charles University, Prague 5, Czech Republic
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Abstract

Spinal cord injury triggers a complex set of events that lead to tissue healing without the restoration of normal function due to the poor regenerative capacity of the spinal cord. Nevertheless, current knowledge about the intrinsic regenerative ability of central nervous system axons, when in a supportive environment, has made the prospect of treating spinal cord injury a reality. Among the range of strategies under investigation, cell-based therapies offer the most promising results, due to the multifactorial roles that these cells can fulfil. However, the best cell source is still a matter of debate, as are clinical issues that include the optimal cell dose as well as the timing and route of administration. In this context, the role of biomaterials is gaining importance. These can not only act as vehicles for the administered cells but also, in the case of chronic lesions, can be used to fill the permanent cyst, thus creating a more favourable and conducive environment for axonal regeneration in addition to serving as local delivery systems of therapeutic agents to improve the regenerative milieu. Some of the candidate molecules for the future are discussed in view of the knowledge derived from studying the mechanisms that facilitate the intrinsic regenerative capacity of central nervous system neurons. The future challenge for the multidisciplinary teams working in the field is to translate the knowledge acquired in basic research into effective combinatorial therapies to be applied in the clinic.

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