Regeneration of spinal cord injury (SCI) : What we know so far By: Kendra Michaud
INTRODUCTION BACKGROUND/IMPACT Neerumalla, Dr. Ravali. Spinal Cord Injury - Causes, Symptoms, Diagnosis, Treatment & Prevention. Medindia, The Medindia Medical Review Team, 6 Mar. 2017, www.medindia.net/patientinfo/spinal-cordinjury.htm. SCI is damage to the spinal cord or spinal nerves Yearly 250,000-500,000 people are affected, high disability and death rate The promising research on combining mesenchymal stem cells with scaffolds in clinical studies to treat SCI
What happens with a SCI Normal axonal regeneration Trauma (primary injury) > inflammation > increases cytokines > more degeneration (secondary injury) > forms a cystic cavity > forms a glial scar > the scar prevents natural regeneration of axon 2 days after injury, then 2 weeks, chronic after 6 months They are hoping to reduce the inflammation and prevent scars, to help treat SCI. They have a medication, methyl prednisolone, that if injected 6-8 hours after a trauma, can reduce inflammation.
COMBINING MSC S AND SCAFFOLDS Mesenchymal stem cells either promote or differentiate to replace. But this method hasn t had a high rate of success. Scaffolds increase survival rate of stem cells. There are hydrogels and nanofiber classifications for scaffolds. The stem cells can t make it to engraftment, and so they can t produce healthy blood stem cells. Both MSC and scaffolds have to comply with certain restrictions outlined for use in biomedical applications
RESTRICTIONS Stem cells must be accessible, non-invasive, large quantity of cells, plasticity, differentiable, immunologically inert, and must not cause ethical problems What Ate the Benefits of Stem Cell Therapy? Dr Christopher Vertullo : Knee Surgeon, Gold Coast Australia, www.kneesurgeon.net.au/stem-cell-therapy/.
RESTRICTIONS Scaffolds in regenerative medicine are immunologically inert, biodegradable, have mechanical strength, and matrix properties. Ahmed Ali, Bachelor pharmacy,master molecular pharmacology,master Public health Follow. Drug Release in Tissue Engineering. LinkedIn SlideShare, 4 June 2014, www.slideshare.net/ahmedali562114/drug-release-in-tissue-engineering.
MESENCHYMAL STEM CELLS VS. STEM CELLS Best cells to use are Schwann cells and neural progenitor cells. Schwann cells release growth factor, and neural progenitor cells differentiate into neurons or glial cells But their ethical issues prevent them from being tested. Since donor has to be dead. So that is why mesenchymal stem cells were used.
BONE MARROW-DERIVED MESENCHYMAL STEM CELLS Have shown to increase survival, mobility, and the stem cells stayed where they needed to be for differentiation, for rats with SCI, when combined with fibrin scaffolding. When combined to 3D collagen scaffold, it lowered the inflammation cytokines.
ENDOMETRIAL STEM CELLS One study showed a regenerative potential for EnSCs, in preventing the cystic cavity from forming, when combined with electro-spun PCL scaffolds.
CONCLUSION BMSC s have shown great promise when combined with scaffolding in aiding axonal regeneration. EnSC s have only had one promising study and could use more testing. Other kinds of MSC should be continued to be tested
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