Nagoshi Narihito, Sugai Keiko, Okano Hideyuki, Nakamura Masaya
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
Department of Physiology, Keio University School of Medicine, Tokyo, Japan.
Spine Surg Relat Res. 2023 Sep 4;8(1):22-28. doi: 10.22603/ssrr.2023-0135. eCollection 2024 Jan 27.
Spinal cord injury (SCI) is a devastating injury that causes permanent neurological dysfunction. To develop a new treatment strategy for SCI, a clinical trial of transplantation of human-induced pluripotent stem cell-derived neural precursor cells (NPCs) in patients in the subacute phase of SCI was recently initiated. The formation of synaptic connections with host neural tissues is one of the therapeutic mechanisms of cell transplantation, and this beneficial efficacy has been directly demonstrated using a chemogenetic tool. This research focuses on the establishment of cell therapy for chronic SCI, which is more challenging owing to cavity and scar formation. Thus, neurogenic NPC transplantation is more effective in forming functional synapses with the host neurons. Furthermore, combinatory rehabilitation therapy is useful to enhance the efficacy of this strategy, and a valid rehabilitative training program has been established for SCI animal models that received NPC transplantation in the chronic phase. Therefore, the use of regenerative medicine for chronic SCI is expected to increase.
脊髓损伤(SCI)是一种导致永久性神经功能障碍的毁灭性损伤。为了开发一种针对脊髓损伤的新治疗策略,最近启动了一项在脊髓损伤亚急性期患者中移植人诱导多能干细胞衍生神经前体细胞(NPCs)的临床试验。与宿主神经组织形成突触连接是细胞移植的治疗机制之一,并且已经使用化学遗传学工具直接证明了这种有益效果。本研究重点在于建立针对慢性脊髓损伤的细胞治疗方法,由于空洞和瘢痕形成,这一治疗更具挑战性。因此,神经源性NPC移植在与宿主神经元形成功能性突触方面更有效。此外,联合康复治疗有助于提高该策略的疗效,并且已经为在慢性期接受NPC移植的脊髓损伤动物模型建立了有效的康复训练方案。因此,预计再生医学在慢性脊髓损伤治疗中的应用将会增加。