Combinatorial therapies for spinal cord injury repair

Abstract

Spinal cord injuries have profound detrimental effects on individuals, regardless of whether they are caused by trauma or non-traumatic events. The compromised regeneration of the spinal cord is primarily attributed to damaged neurons, inhibitory molecules, dysfunctional immune response, and glial scarring. Unfortunately, currently, there are no effective treatments available that can fully repair the spinal cord and improve functional outcomes. Nevertheless, numerous pre-clinical approaches have been studied for spinal cord injury recovery, including using biomaterials, cells, drugs, or technological-based strategies. Combinatorial treatments, which target various aspects of spinal cord injury pathophysiology, have been extensively tested in the last decade. These approaches aim to synergistically enhance repair processes by addressing various obstacles faced during spinal cord regeneration. Thus, this review intends to provide scientists and clinicians with an overview of pre-clinical combinatorial approaches that have been developed toward the solution of spinal cord regeneration as well as update the current knowledge about spinal cord injury pathophysiology with an emphasis on the current clinical management.

Figure 1

Representation of an injured spinal cord, with the respective pathophysiological events occurring after injury. Created with BioRender.com.

Figure 2

Concept of combined therapies for spinal cord injuries involves the integration of various approaches. Cells and scaffolds may be utilized independently or in conjunction with pharmacological agents and additional biomolecules like growth factors and exosomes. Furthermore, technological methods can be synergistically employed with biomolecules or cells to address spinal cord injury. Created with Microsoft PowerPoint.