Schwann cell and olfactory ensheathing cell implantation for repair of the contused spinal cord.
A contusion injury to the spinal cord results in impaired neurological functions due to neuronal death, and axonal damage and demyelination. In time, a fluid-filled cyst forms at the site of the initial impact. There are no effective endogenous repair mechanisms and, consequently, injury-induced functional deficits are permanent. One aspect of spinal cord repair is that severed descending and ascending axons need to regenerate beyond the site of injury towards the denervated spinal regions where they can become part of axonal circuits involved in motor and sensory function. Implantation of cells into the injured cord has been studied extensively as a means to promote axonal regeneration in the injured spinal cord. Depending on the overall damage, different cell types may be appropriate in different types of injury. To accomplish axonal regeneration in the contused spinal cord, the strengths and limitations of two glial cell types in particular will be discussed; Schwann cells and olfactory ensheathing cells. It is known that with these implants, axonal regeneration is frustrated by the presence of a glial scar surrounding the contused area. I will review current approaches aimed at overcoming this axonal growth inhibitory scar. Future studies need to focus on identifying interventions that, in combination with cellular implants, will elicit substantial axonal growth beyond the contusion injury, which may then be the basis for biologically significant functional recovery.
Oudega
M
M
International Center for Spinal Cord Injury, Kennedy Krieger Institute and the Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. oudega@kennedykrieger.org
D001369:Axons / Q000502:physiology; D002921:Cicatrix / Q000503:physiopathology; D003288:Contusions / Q000601:surgery*; D003711:Demyelinating Diseases / Q000503:physiopathology; D006801:Humans; D009186:Myelin Sheath / Q000502:physiology; D009416:Nerve Regeneration / Q000502:physiology; D009457:Neuroglia / Q000502:physiology / Q000637:transplantation*; D009830:Olfactory Bulb / Q000166:cytology / Q000601:surgery; D020127:Recovery of Function / Q000502:physiology; D012583:Schwann Cells / Q000637:transplantation; D013119:Spinal Cord Injuries / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology