Spinal Cord Regeneration

脊髓再生
  • 文章类型: Journal Article
    在人类和其他成年哺乳动物中,轴突再生是困难的神经元。因此,脊髓损伤(SCI)是一种破坏性事件,可导致运动和感觉功能的永久性丧失。此外,脊椎动物轴突再生的分子机制还不是很清楚,目前,对于SCI没有有效的治疗方法.与成年哺乳动物形成鲜明对比的是,许多非哺乳动物脊椎动物,如爬行动物,两栖动物,即使在完全SCI后,硬骨鱼和七叶鱼也可以自发恢复运动。近年来,下一代测序技术的快速发展为SCI提供了有价值的信息.在这次审查中,我们的目的是提供跨经典模型生物轴突再生过程的比较,重点关注在SCI后单个可识别的下降神经元再生中起重要作用的关键基因和信号通路。考虑到七匙鱼和斑马鱼特殊的进化位置和强大的再生能力,它们将是正在进行的脊髓再生研究的关键模式生物。在这些模型生物中详细研究SCI将有助于阐明跨物种神经元再生的分子机制。
    In humans and other adult mammals, axon regeneration is difficult in axotomized neurons. Therefore, spinal cord injury (SCI) is a devastating event that can lead to permanent loss of locomotor and sensory functions. Moreover, the molecular mechanisms of axon regeneration in vertebrates are not very well understood, and currently, no effective treatment is available for SCI. In striking contrast to adult mammals, many nonmammalian vertebrates such as reptiles, amphibians, bony fishes and lampreys can spontaneously resume locomotion even after complete SCI. In recent years, rapid progress in the development of next-generation sequencing technologies has offered valuable information on SCI. In this review, we aimed to provide a comparison of axon regeneration process across classical model organisms, focusing on crucial genes and signalling pathways that play significant roles in the regeneration of individually identifiable descending neurons after SCI. Considering the special evolutionary location and powerful regenerative ability of lamprey and zebrafish, they will be the key model organisms for ongoing studies on spinal cord regeneration. Detailed study of SCI in these model organisms will help in the elucidation of molecular mechanisms of neuron regeneration across species.
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  • 文章类型: Journal Article
    创伤性脊髓损伤(SCI)破坏脊髓血管系统,导致缺血,继发性损伤级联的放大和神经组织损失的加剧。恢复微血管的功能完整性以防止神经丢失和促进神经修复是SCI研究中的重要挑战和机遇。在这里,我们总结了SCI后血管损伤和修复的过程,并对目前针对脊髓微脉管系统的实验性治疗方法进行了全面概述,以减少缺血,从而促进神经修复和再生.使用PRISMA(系统评价和荟萃分析的首选报告项目)标准,对已发表的关于实验性SCI后促进血管修复的治疗方法的文献进行了系统评价。MEDLINE数据库PubMed,Embase,使用关键词“脊髓损伤”搜索OVIDMEDLINE,血管生成,\“\”血管生成诱导剂,\"\"组织工程,“和”啮齿动物主题。“通过搜索确定了总共111项研究。五个主要的治疗方法,以减少缺氧缺血和促进血管修复被确定为(1)血管生成因子的应用,(2)基因工程,(3)物理刺激,(4)细胞移植,(5)携带多种因子传递的生物材料。有不同的治疗方法具有减少缺氧缺血和促进实验性SCI后血管修复的潜力。值得注意的是,使用植入的生物材料和血管生成因子递送的组合方法似乎有望用于临床翻译。
    Traumatic spinal cord injury (SCI) disrupts the spinal cord vasculature resulting in ischemia, amplification of the secondary injury cascade and exacerbation of neural tissue loss. Restoring functional integrity of the microvasculature to prevent neural loss and to promote neural repair is an important challenge and opportunity in SCI research. Herein, we summarize the course of vascular injury and repair following SCI and give a comprehensive overview of current experimental therapeutic approaches targeting spinal cord microvasculature to diminish ischemia and thereby facilitate neural repair and regeneration. A systematic review of the published literature on therapeutic approaches to promote vascular repair after experimental SCI was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards. The MEDLINE databases PubMed, Embase, and OVID MEDLINE were searched using the keywords \"spinal cord injury,\" \"angiogenesis,\" \"angiogenesis inducing agents,\" \"tissue engineering,\" and \"rodent subjects.\" A total of 111 studies were identified through the search. Five main therapeutic approaches to diminish hypoxia-ischemia and promote vascular repair were identified as (1) the application of angiogenic factors, (2) genetic engineering, (3) physical stimulation, (4) cell transplantation, and (5) biomaterials carrying various factor delivery. There are different therapeutic approaches with the potential to diminish hypoxia-ischemia and promote vascular repair after experimental SCI. Of note, combinatorial approaches using implanted biomaterials and angiogenic factor delivery appear promising for clinical translation.
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  • 文章类型: Systematic Review
    临床前文献的系统评价和荟萃分析。
    为了评估基于生物材料的组合(BMC)策略对脊髓损伤(SCI)的治疗效果,在BMC策略的背景下,个体生物材料的影响,以及影响其疗效的因素。评估BMC策略中不同临床前测试范例的效果。
    我们对Embase进行了系统的文献检索,WebofScience和PubMed。所有对照临床前研究描述了SCI的体内或体外模型,该模型与至少一种其他再生策略(细胞,毒品,或两者)都包括在内。两位综述作者独立进行了研究选择,独立提取研究特征,并使用修改后的CAMARADES检查表评估研究质量。使用随机效应模型组合效应大小测量值,并使用tau2,I2和R2统计量的meta回归探索异质性。我们使用基于漏斗图的方法测试了小研究效果。
    包括134种出版物,测试超过100种不同的BMC策略。总的来说,与仅损伤对照组相比,BMC治疗的运动恢复改善25.3%(95%CI,20.3-30.3;n=102),体内轴突再生改善1.6SD(95%CI1.2-2SD;n=117).
    BMC策略可改善实验性SCI后的运动结果。我们的全面研究突出了当前知识的差距,并为未来的实验设计提供了基础。
    Systematic review and meta-analysis of preclinical literature.
    To assess the effects of biomaterial-based combination (BMC) strategies for the treatment of Spinal Cord Injury (SCI), the effects of individual biomaterials in the context of BMC strategies, and the factors influencing their efficacy. To assess the effects of different preclinical testing paradigms in BMC strategies.
    We performed a systematic literature search of Embase, Web of Science and PubMed. All controlled preclinical studies describing an in vivo or in vitro model of SCI that tested a biomaterial in combination with at least one other regenerative strategy (cells, drugs, or both) were included. Two review authors conducted the study selection independently, extracted study characteristics independently and assessed study quality using a modified CAMARADES checklist. Effect size measures were combined using random-effects models and heterogeneity was explored using meta-regression with tau2, I2 and R2 statistics. We tested for small-study effects using funnel plot-based methods.
    134 publications were included, testing over 100 different BMC strategies. Overall, treatment with BMC therapies improved locomotor recovery by 25.3% (95% CI, 20.3-30.3; n = 102) and in vivo axonal regeneration by 1.6 SD (95% CI 1.2-2 SD; n = 117) in comparison with injury only controls.
    BMC strategies improve locomotor outcomes after experimental SCI. Our comprehensive study highlights gaps in current knowledge and provides a foundation for the design of future experiments.
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  • 文章类型: Journal Article
    OBJECTIVE: To determine the molecular and cellular mechanisms of spinal cord regeneration in zebrafish.
    METHODS: Medical databases of PubMed and Scopus were searched with following key words: Zebrafish; spinal cord injuries; regeneration; recovery of function. The map of mechanisms was performed using Xmind software.
    RESULTS: Wnt/ß-catenin signaling, L1.1, L1.2, Major vault protein (MVP), contactin-2 and High mobility group box1 (HMGB1) had positive promoting effects on axonal re-growth while Ptena had an inhibitory effect. Neurogenesis is stimulated by Wnt/ß-catenin signaling as well as HMGB1, but inhibited by Notch signaling. Glial cells proliferate in response to fibroblast growth factor (FGF) signaling and Lysophosphatidic acid (LPA). Furthermore, fgf signaling pathway causes glia bridge formation in favor of axonal regeneration. LPA and HMGB1 in acute phase stimulate inflammatory responses around injury and suppress regeneration. LPA also induces microglia activation and neuronal death in addition to glia cell proliferation, but prevents neurite sprouting.
    CONCLUSIONS: This study provides a comprehensive review of the known molecules and mechanisms in the current literature involved in the spinal cord injury (SCI) regeneration in zebrafish, in a time course manner. A better understanding of the whole determining mechanisms for the SCI regeneration should be considered as a main goal for future studies.
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  • 文章类型: Journal Article
    Spinal cord injury (SCI) and amyotrophic laterals sclerosis (ALS) are devastating neurological conditions that affect individuals worldwide, significantly reducing quality of life, both for patients and their relatives.
    OBJECTIVE: The present review aims to summarize the multiple restorative approaches being developed for spinal cord repair, the use of different stem cell types and the current knowledge regarding stem cell therapy.
    METHODS: Review of the literature from the past 10 years of human studies using stem cell transplantation as the main therapy, with or without adjuvant therapies.
    CONCLUSIONS: The current review offers an overview of the state of the art regarding spinal cord restoration, and serves as a starting point for future studies.
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  • 文章类型: Journal Article
    Transplanted stem cells provide beneficial effects on regeneration/recovery after spinal cord injury (SCI) by the release of growth-promoting factors, increased tissue preservation, and provision of a permissive environment for axon regeneration. A rise in chemokine stromal cell-derived factor 1 (SDF-1/CXCL12) expression levels in central nervous system (CNS) injury sites has been shown to play a central role in recruiting transplanted stem cells. Although technically more challenging, it has been shown that after SCI few endogenous stem cells are recruited via SDF-1/CXCR4 signaling. Evidence is accumulating that increasing SDF-1 levels at the injury site (e.g., by exogenous application or transfection methods) further enhances stem cell recruitment. Moreover, SDF-1 might, in addition to migration, also influence survival, proliferation, differentiation, and cytokine secretion of stem cells. Here, we discuss the experimental data available on the role of SDF-1 in stem and progenitor cell biology following CNS injury and suggest strategies for how manipulation of the SDF-1 system could facilitate stem cell-based therapeutic approaches in SCI. In addition, we discuss challenges such as how to circumvent off-target effects in order to facilitate the transfer of SDF-1 to the clinic.
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  • 文章类型: Journal Article
    在动物研究中,将骨髓干细胞移植到脊髓病变中可增强轴突再生并促进功能恢复。有两种类型的成人骨髓干细胞;造血干细胞(HSC),和间充质干细胞(MSC)。已经广泛研究了HSCs和MSCs促进移植后脊髓修复的机制。这篇综述的目的是讨论这些机制;我们简要考虑有争议的话题HSC和MSC转分化为中枢神经系统细胞,组织保留,和MSC移植物在脊髓损伤(SCI)环境中的修复作用。然后,我们讨论了与SCI患者的HSC和MSC疗法的翻译有关的一些具体问题,并对迄今为止治疗SCI的当前骨髓细胞临床试验进行了全面的批评。
    Transplantation of bone marrow stem cells into spinal cord lesions enhances axonal regeneration and promotes functional recovery in animal studies. There are two types of adult bone marrow stem cell; hematopoietic stem cells (HSCs), and mesenchymal stem cells (MSCs). The mechanisms by which HSCs and MSCs might promote spinal cord repair following transplantation have been extensively investigated. The objective of this review is to discuss these mechanisms; we briefly consider the controversial topic of HSC and MSC transdifferentiation into central nervous system cells but focus on the neurotrophic, tissue sparing, and reparative action of MSC grafts in the context of the spinal cord injury (SCI) milieu. We then discuss some of the specific issues related to the translation of HSC and MSC therapies for patients with SCI and present a comprehensive critique of the current bone marrow cell clinical trials for the treatment of SCI to date.
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