Targeting Remyelination in Spinal Cord Injury: Insights and Emerging Therapeutic Strategies

Abstract

Introduction: Spinal cord injury (SCI) is a severe neurological disease characterized by significant motor, sensory, and autonomic dysfunctions. SCI is a major global disability cause, often resulting in long-term neurological impairments due to the impeded regeneration and remyelination of axons. A SCI interferes with communication between the brain and the spinal cord networks that control neurological functions. Recent advancements in understanding the molecular and cellular mechanisms of remyelination have opened novel therapeutic interventions.

Method: This review systematically sourced articles related to spinal chord injury, remyelination, regeneration and pathophysiology from major medical databases, including Scopus, PubMed, and Web of Science.

Results: This review discusses the efficacy of targeted therapy in enhancing myelin repair after SCI by identifying key molecules and signaling pathways. This explores the effectiveness of specific pharmacological agents and biological factors in promoting oligodendrocyte precursor cell proliferation, differentiation, and myelin sheath formation using in vitro and in vivo models. Targeted therapies have shown promising results in improving remyelination, providing hope for functional recovery in SCI patients.

Conclusions: This review demonstrates challenges and future perspectives in translating findings into clinical practice, emphasizing safety profiles, delivery method optimization, and combinatory therapy potential. This review also supports the possibility of targeted remyelination therapies as a promising strategy for SCI treatment, paving the way for future clinical applications.

Keywords: neurological impairments; regeneration; remyelination; spinal cord injury.

FIGURE 1

The pathophysiology of SCI leads to sensory, motor, and autonomic dysfunction, resulting in paralysis or altered sensation. Primary and secondary injury mechanisms contribute to tissue damage and neurological deficits, complicating both treatment and recovery processes.

FIGURE 2

Mesenchymal stem cell transplantation aids functional and anatomical recovery in SCI patients by reducing inflammation and glial scar formation.

FIGURE 3

The function and limitations of current SCI treatments. Current treatments for SCI, including surgical interventions, pharmacotherapy, etc., have limitations, including incomplete function restoration, complications, and high costs.

FIGURE 4

This process discusses demyelination and remyelination following SCI. SCI leads to demyelination, a loss of myelin sheath that impairs nerve function. Enhancing remyelination mechanisms could provide therapeutic intervention.