A recent study published in the journal Engineering delves into the application of tissue engineering in spinal cord injury (SCI) repair, presenting a comprehensive review of the latest research and potential treatment strategies.
SCI is a severe condition that affects the central nervous system, often leading to permanent loss of sensation and motor function. Current treatments, such as surgical decompression and drug therapy, can only alleviate symptoms to a certain extent, making it crucial to explore new therapeutic approaches. Tissue engineering, an interdisciplinary field integrating life science, material science, engineering technology, and clinical medicine, offers new possibilities.
The researchers first focused on biomaterials. SCI can cause an inflammatory storm and the formation of scar tissue, which hinders axon regeneration. Biomaterials play a vital role in SCI treatment by creating a new microenvironment at the injury site. For example, biodegradable materials like hydrogels have shown great potential. Cai et al. fabricated a GelMA-MXene hydrogel with a grooved configuration, which enhanced hind-limb motor function recovery in rats with SCI. Wang et al. designed an anisotropic Fe3S4 ferromagnetic fluid hydrogel that promoted axon regeneration and functional recovery.
Cells also play a significant role in SCI repair. Stem cells, such as bone-marrow-derived mesenchymal stem cells (MSCs), umbilical cord-derived MSCs, and adipose-derived stem cells (ADSCs), have been widely studied. They can differentiate into various cell types and secrete cytokines to promote nerve regeneration. For instance, Liu et al. used 3D printing technology to create a neural scaffold for the survival and differentiation of neural stem cells (NSCs) into neurons, improving the hind-limb motor function of rats with SCI.
In addition, the decellularized extracellular matrix (dECM) and exosomes have emerged as promising candidates. dECM can provide a conducive environment for nerve regeneration, while exosomes have therapeutic potential. Zhu et al. developed an HA hydrogel patch that can release exosomes and methylprednisolone, enhancing functional and electrophysiological performance in rats with SCI.
The study also explored other active factors, small molecules, and RNA. Delivering neurotrophic factors, such as NT3, can facilitate the restoration of structure and function. Wang et al. found that NT3-chitosan promoted neuron regeneration and reconstructed the damaged neural network.
Creating a regenerative microenvironment is crucial for SCI repair. Combining biomaterials with cells or active factors can enhance nerve regeneration. Yuan et al. designed a DNA hydrogel to carry NSCs, restoring hind-limb function in rats. Song et al. fabricated an IGF-1 bioactive supramolecular nanofiber hydrogel that promoted the survival and differentiation of NSCs.
Although significant progress has been made, the researchers noted that further research is needed to validate the safety and efficacy of these treatment strategies. They emphasized the importance of coordinated efforts from experts in various disciplines and global collaborative innovation to translate these findings into clinical applications. This research provides valuable insights into the future treatment of SCI, offering new hope for patients suffering from this debilitating condition.
The paper "Tissue Engineering and Spinal Cord Injury Repair," authored by Lai Xu, Songlin Zhou, Xiu Dai, Xiaosong Gu, Zhaolian Ouyang. Full text of the open access paper: https://doi.org/10.1016/j.eng.2024.12.027
