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Review
. 2020 Sep 22:10:112.
doi: 10.1186/s13578-020-00475-3. eCollection 2020.

Treatment of spinal cord injury with mesenchymal stem cells

Ling Ling Liau  1 , Qi Hao Looi  2 , Wui Chuen Chia  2 , Thayaalini Subramaniam  3 , Min Hwei Ng  3 , Jia Xian Law  3
Affiliations
Review

Treatment of spinal cord injury with mesenchymal stem cells

Ling Ling Liau et al. Cell Biosci. .

Abstract

Background: Spinal cord injury (SCI) is the damage to the spinal cord that can lead to temporary or permanent loss of function due to injury to the nerve. The SCI patients are often associated with poor quality of life.

Results: This review discusses the current status of mesenchymal stem cell (MSC) therapy for SCI, criteria to considering for the application of MSC therapy and novel biological therapies that can be applied together with MSCs to enhance its efficacy. Bone marrow-derived MSCs (BMSCs), umbilical cord-derived MSCs (UC-MSCs) and adipose tissue-derived MSCs (ADSCs) have been trialed for the treatment of SCI. Application of MSCs may minimize secondary injury to the spinal cord and protect the neural elements that survived the initial mechanical insult by suppressing the inflammation. Additionally, MSCs have been shown to differentiate into neuron-like cells and stimulate neural stem cell proliferation to rebuild the damaged nerve tissue.

Conclusion: These characteristics are crucial for the restoration of spinal cord function upon SCI as damaged cord has limited regenerative capacity and it is also something that cannot be achieved by pharmacological and physiotherapy interventions. New biological therapies including stem cell secretome therapy, immunotherapy and scaffolds can be combined with MSC therapy to enhance its therapeutic effects.

Keywords: Mesenchymal stem cells; Nerve regeneration; Spinal cord injury; Stem cell therapy.

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Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Stem cell therapy for SCI. Human embryonic stem cells, bone marrow-derived mesenchymal stem cells, adipose-derived mesenchymal stem cells, umbilical cord-derived mesenchymal stem cells and induced pluripotent stem cells can be used for the treatment of SCI
Fig. 2
Fig. 2
Changes to the injured spinal cord at the molecular and cellular level. Mechanical trauma to the spinal cord will cause bleeding, oedema, disruption in blood supply, inflammation, disruption of blood-spinal cord barrier, electrolyte shifts, oxidative stress, lipid peroxidation, cell necrosis and release of toxic substances by the damaged cells
Fig. 3
Fig. 3
Mechanisms of action of MSCs in ameliorate SCI. MSC transplantation promotes the spinal cord regeneration by differentiating into neural and glial cells, secrete paracrine factors and microvesicles, reduce inflammation and oxidative stress, promote survival of remaining neurons and angiogenesis as well as inhibit gliosis
Fig. 4
Fig. 4
Factors affect the efficacy of MSC therapy to treat SCI. These factors can be categorized as patients factors that include severity of the injury, level of cord injury and mechanism of primary injury as well as treatment factors such as cell source, route of cell administration, timing of cell administration, number of cell administration, number of cells administered and cell preparation method. ADSCs—adipose tissue-derived mesenchymal stem cells, SVF—stromal vascular fraction, BMSCs—bone marrow-derived mesenchymal stem cells, BMMCs—bone marrow mononuclear cells, AIS—ASIA (American Spinal Injury Association) Impairment Scale
Fig. 5
Fig. 5
Routes of MSC administration. MSCs have been transplanted to the SCI patients via the intravenous, intraspinal and intrathecal route
See this image and copyright information in PMC

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