Immunosuppressive mechanisms for stem cell transplant survival in spinal cord injury

Abstract

Spinal cord injury (SCI) has been associated with a dismal prognosis-recovery is not expected, and the most standard interventions have been temporizing measures that do little to mitigate the extent of damage. While advances in surgical and medical techniques have certainly improved this outlook, limitations in functional recovery continue to impede clinically significant improvements. These limitations are dependent on evolving immunological mechanisms that shape the cellular environment at the site of SCI. In this review, we examine these mechanisms, identify relevant cellular components, and discuss emerging treatments in stem cell grafts and adjuvant immunosuppressants that target these pathways. As the field advances, we expect that stem cell grafts and these adjuvant treatments will significantly shift therapeutic approaches to acute SCI with the potential for more promising outcomes.

Keywords: CNS = central nervous system; FKBP = FK506 binding protein; MSC = mesenchymal stem cell; NPC = neural precursor cell; OPC = oligodendrocyte progenitor cell; SCI = spinal cord injury; SKP-SC = skin-derived precursor Schwann cell; TNF-α = tumor necrosis factor α; epSPC = ependymal stem/progenitor cell; glial scar; hESC = human embryonic stem cell; hSSC = human fetal spinal cord stem cell; iNOS = inducible nitric oxide synthase; iPSC = induced pluripotent stem cell; iPSC-NPC = iPSC-derived NPC; immunosuppressants; spinal cord injury; stem cell grafts.