Spinal Cord Injury Introduction:

Spinal Cord Injury (SCI) is damage to any part of the Spinal Cord or nerves which results in severe neural dysfunction below the injury site. This damage can lead to lifelong disability and loss of independence . Patients with SCI express sensory, functional and autonomic deficits caused by neuronal and glial cell death, demyelination and axonal degeneration . Basically, the extremity of an injury relies on the section of the spinal cord that is affected. The severeness of the injury is often called “the completeness” and is divided into following:

Complete: it involves loss of all sensory and motor function below the spinal cord injury. Almost 50 % of all spinal cord injuries are complete.

Incomplete: In an incomplete SCI, some motor or sensory function remains below the affected area. In addition, Paralysis caused by spinal cord injury referred to as:

Quadriplegia: Also known as Tetraplegia, which occurs due to injuries in cervical region of spinal cord. This results in loss of muscles strength.

Paraplegia: This occurs due to injuries in the thoracic or lumbar areas of spinal cord which further results in paralysis of lower parts of body and legs .

According to the World Health Organisation (WHO) every year between 250 000 and 500 000 people suffers a SCI globally, majority of them are occurs due to falls or violence and road traffic crashes. People with a spinal cord injury are two to five times more likely to die prematurely compared to people without a spinal cord injury, with worse survival rates in low- and middle-income countries . According to the first global status report on road safety of the WHO, India has the highest number of deaths due to road traffic accidents, with 375 deaths and more than 1200 injuries per day due to road accidents in the country. Trauma is projected to be third largest killer in the developing world by 2020, with a large number of these injuries comprising of spine trauma and traumatic spinal cord injury.

Management of Spinal Cord Injury

There are four types of potential treatments for Spinal cord Injury :

• Neuroprotection
• Repair of the lesion site
• Recruiting preserved tissue
• Surgery

Usage of stem cell on spinal cord injury

Several studies have revealed that stem cells might provide a source of neural cells and also exerts neuroprotective effects after SCI . Among them, mesenchymal stem cells (MSCs) emerged as one of the most promising types of stem cells for the treatment of SCI for following reasons:

(i) Easy to isolate and cryopreserved

(ii) Viability and regeneration potential of MSCs stay maintained after cryopreservation at -80 °C

(iii) Express rapid replication along with high quality progenitor cells and high potential of multilineage differentiation

(iv) Negligible or no immunoreactivity and graft-versus-host reaction of transplanted allogeneic MSCs .

MSCs are ideally suited to approach various pathophysiological outcome of SCI . The major significant objective for therapeutic use of stem cells includes regeneration of axons, prevention of apoptosis and replacement of lost cells, specifically oligodendrocytes to promote the remyelination of spared axons . Various experimental studies demonstrated that MSCs strongly respond to inflammatory or chemotactic stimuli liberated from injured tissues including chemokines and several growth factors like hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF) and SDF-1α/CXCR4 axis . Studies specify that MSCs with improved migratory ability to the lesion site following SCI increase the antiapoptotic effects via upregulating the expression of stromal cell-derived factor-1 (SDF-1)/CXC chemokine receptor 4 (CXCR4) axis.

Consistently, the SDF-1α/CXCR4 axis increase cell migration toward injured tissues and promotes recovery after SCI via mediating bone marrow MSCs . Recent data indicated that MSC transplantation inhibits cavity formation occur due to SCI and resulted in following motor recovery after SCI. According to the preclinical experiments in SCI animal model indicating MSC transplantation in the improvement of functional recovery after SCI, number of clinical trials were performed which showed that the transplantation of such cells is safe and advantageous for some patients by using distinct transplantation procedures and cell application methods . In conclusion, number of clinical trials uses MSCs transplantation for the treatment of spinal cord injury, this approach needs continued exploration of basic scientific knowledge of spinal cord injury and proven therapeutic efficacy.

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References:

1. Jing Qu and Huanxiang Zhang. Roles of Mesenchymal Stem Cells in Spinal Cord Injury. Stem Cells International. 2017.
2. Ramalho BS, Almeida FM, Sales CM, et al. Injection of bone marrow mesenchymal stem cells by intravenous or intraperitoneal routes is a viable alternative to spinal cord injury treatment in mice. Neural Regen Res 2018;13:1046-1053.
3. American Association of Neurological Surgeons. Spinal Cord Injury. https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Cord-Injury
4. World Health Organisation. Spinal cord injury, 2013. http://www.who.int/news-room/fact-sheets/detail/spinal-cord-injury
5. Aleem IS, Marco DD, Brian D, et al. The Burden of Spine Fractures in India: A Prospective Multicentre Study. Global Spine Journal 2017;7(4):325-333.
6. Scholtes F, Brook G, Martin D. Spinal cord injury and its treatment: current management and experimental perspectives. Adv Tech Stand Neurosurg 2012;38:29-56. https://www.ncbi.nlm.nih.gov/pubmed/22592410
7. Melo FR, Bressan RB, Forner S et al. Transplantation of human skin-derived mesenchymal stromal cells improves locomotor recovery after spinal cord injury in rats. Cellular and Molecular Neurobiology 2016;37(5):1–7.
8. Lee MW, Yang MS, Park JS, et al. Isolation of mesenchymal stem cells from cryopreserved human umbilical cord blood. Int J Hematol 2005;81:126–130.
9. Kotobuki N, Hirose M, Takakura Y, et al. Cultured autologous human cells for hard tissue regeneration: preparation and characterization of mesenchymal stem cells from bone marrow. Artif Organs 2004;28:33–39.
10. Sekiya I, Larson BL, Smith JR, et al. Expansion of human adult stem cells from bone marrow stroma: conditions that maximize the yields of early progenitors and evaluate their quality. Stem Cells 2002;20:530–541.
11. Carrade DD, Affolter VK, Outerbridge CA, et al. Intradermal injections of equine allogeneic umbilical cord-derived mesenchymal stem cells are well tolerated and do not elicit immediate or delayed hypersensitivity reactions. Cytotherapy 2011;13:1180–1192.
12. Vawda R, Fehlings MG. Mesenchymal cells in the treatment of spinal cord injury: current & future perspectives. Curr Stem Cell Res Ther 2013;8:25–38.
13. Dasari VR, Veeravalli KK, Rao JS, at al. Mesenchymal Stem Cell Therapy for Apoptosis after Spinal Cord Injury. Advanced Understanding of Neurodegenerative Diseases 2011:365–394.
14. Dmitriev P, Kiseleva E, Kharchenko O et al. Dux4 controls migration of mesenchymal stem cells through the Cxcr4-Sdf1 axis. Oncotarget 2016;7(40):65090–65108.
15. Wang GD, Liu YX, Wang X, et al. The SDF-1/CXCR4 axis promotes recovery after spinal cord injury by mediating bone marrow-derived from mesenchymal stem cells. Oncotarget 2017;8(7):11629–11640.
16. Yousefifard M, Nasirinezhad F, Shardi Manaheji H, et al. Human bone marrow-derived and umbilical cord-derived mesenchymal stem cells for alleviating neuropathic pain in a spinal cord injury model. Stem Cell Research & Therapy 2016;7(1):36.
17. Miao X, Wu X, Shi W. Umbilical cord mesenchymal stem cells in neurological disorders: a clinical study. Indian Journal of Biochemistry & Biophysics 2015;52(2):140–146.

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