One of the most disastrous inabilities is Spinal cord injury (SCI), with reports of 29.5 cases in a million per year! A majority of patients are young people in the age group of 20 to 29 years. Major causes of SCI are sports or violence, accidents involving vehicles, and injuries due to industries. The Spinal cord injuries may lead to paralysis, as well as disability and huge medical expenditures to manage them.
SCI may be of two types:
primary or secondary: Primary injury involves external causes such as contusion or damage or compression. There can be secondary causes such as chain reactions following primary injury. The damage is seen due to the production of free radicles, inflammation as well as cell death, known as apoptosis in the spinal cord. Severe forms of the damage are associated with complications of respiratory or cardiac issues, pain, ulcers, and infections.
There are several treatment options for SCI such as surgery, medicines or rehabilitation but none have given the sure shot cure. Surgery in the form of surgical decompression has been associated with complications such as meningitis while certain corticosteroids have been used in few preclinical and clinical studies. The field of stem cells has garnered much interest for the treatment of SCI: this goal can be traced back to the ability of stem cells to differentiate into other types of cells of the body. An added feature of stem cells is the ability to make molecules that can protect damaged nerve cells such as cytokines or growth factors. The transplantation of certain progenitor cells derived from human embryonic stem cells (hESC) has shown repairing and restoration of nervous functions with minimum damage, promote cell growth and minimize the inflammatory responses.
A 2012 study used Mesenchymal stem cells isolated from bone marrow to show improvement in muscle function in 60% of the test subjects. The researchers are also investigating if the use of multiple injections as well as the use of additional materials such as growth factors can help the therapy.
Another report published in 2015 showed that the injected neural stem cells (NSC) can differentiate into cells of the nervous system when these cells were injected into lesions in mice with spinal cord injury. A study published in 2011 used Induced pluripotent stem cells (iPSC) that are stem cells derived from other cells of the body by the administration of key factors. These cells increased sensitivity to mechanical stress. However, the use of iPSCs has certain challenges that need to be resolved.
Studies have revealed the presence of neural stem cells in the damaged nervous system that can show a possibility of regeneration. In a very famous clinical trial that concluded in October 2016, nearly 30 patients in the age group of 20 and 64 years underwent autologous stem cell therapy to treat an injury in the spinal cord. For this, within a fortnight of injury, their bone marrow fluid was collected and mesenchymal stem cells were extracted and cultivated to be injected intravenously into the patients. The injected stem cells were observed to accumulate more and led to regenerated tissues in the injured areas of the spinal cord!
They are therapeutic approaches with great potential as these cells can be mobilized to damaged areas. The use of stem cell-derived progenitors can lower the disability associated with SCI. The results from clinical and experimental studies have shown promise of stem cells with SCI, and more trials are the need of the hour.