[Transplants as a therapy after spinal cord injury].
This review describes shortly phenomena that take place in different parts of central nervous system (CNS) after the spinal cord injury: 1/ due to axotomy many of neurones present outside the cavity of lesion (even those of supraspinal origin) can atrophy or die as an effect of necrosis or apoptosis; 2/ at the injury site itself, the primary and secondary effects lead to increased cell loss and the scar or cyst formation that are the mechanical barrier for regenerating axons; 3/ due to abolished conduction across the injury site the spinal cord circuitry below the lesion is deprived of supraspinal inputs. Then this review presents the new therapeutic strategies that were developed recently to obtain at least partial recovery of motor functions after spinal cord injury. The cell body can be rescued by applying various factors that increase intrinsic neural repair (e.g. neurotrophins or anti-apoptotic agents). To enhance the axonal regrowth through the lesion cavity, the scar and cyst formation can be reduced by constructing the bridges using e.g. the Schwann cells, fetal tissue, stem cells, olfactory ensheating glial cells, or by application of macrophages. To induce partial restoration of some functions that are controlled by neural circuitry below the lesion the various methods for enhancing the plasticity in segmental circuitry were developed (e.g. rehabilitation by locomotor training or intraspinal transplantation of monoaminergic cells). As a consequence of the great unpredictability of effects obtained after injury at different parts of the spinal cord the various strategies for repair need to be coordinated for optimal recovery.
Sławińska
Urszula
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Pracownia Plastyczności Układu Nerwowo-Mieśniowego Instytut Biologii Doświadczalnej im. Marcelego Nanckiego PAN 02-093 Warszawa. ulaslaw@nencki.gov.pl
D000818:Animals; D017690:Cell Transplantation; D016332:Fetal Tissue Transplantation; D006801:Humans; D008264:Macrophages / Q000637:transplantation; D009043:Motor Activity; D009416:Nerve Regeneration; D009830:Olfactory Bulb / Q000637:transplantation; D020127:Recovery of Function; D012583:Schwann Cells / Q000637:transplantation; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000601:surgery*; D033581:Stem Cell Transplantation