Introduction
The spinal cord injury (SCI) has been known for decades as one of the profoundest and most intractable neurological disorders. Injury to pathways in the spinal cord disrupts messages from the brain to the body, and it can lead to permanent paralysis. Until recently, the goal of treatment has instead been stabilization and rehabilitation, rather than actual repair.
Recently, accounts in Japan of stem cell transplanted spinal cord injury patients have drawn worldwide interest. In early clinical investigations, transplanted stem cells were reported to support the rebuilding of damaged neural pathways, with some patients showing partial recovery of strength and voluntary movement over time.
How Could ### Stem CellsHelp?
Based on their nature, stem cells, such as the iPSCs or neural stem cells, have the potential to:
- Differentiate into neurons and glial cells
- Promote axonal regeneration
- Reduce inflammation
- Support remyelination
- Restore disrupted neural signalling
Experimental models have shown that stem cell transplantation may promote functional recovery by providing a conducive environment for nerve regeneration.
Why This Is Significant
Regeneration is insufficient after injury to the adult central nervous system. But if stem cell–based therapies can be used to reliably and substantially regain motor function, it could represent a fundamentally different way of thinking about curing spinal injuries as opposed to managing them.
But caution is in order. The majority of the current data are derived from phase 2 trials that included relatively small numbers of patients. Larger, controlled clinical studies are required to confirm safety, long-term efficacy, sustainability of improvement and risk of adverse effects, including pathological cell growth or immune reactions.
Balancing Hope with Evidence
Regenerative medicine breakthroughs frequently transition from successful laboratory trials to cautious clinical optimism. Even though these preliminary findings are encouraging, spinal cord restoration is still one of neurology’s most difficult problems.
If further proven, stem cell therapy could revolutionize the way spinal injuries are treated and pave the way for the treatment of other neurodegenerative diseases that were previously thought to be incurable.
Do you believe that regenerative medicine will soon redefine what we consider to be “permanent” neurological impairment if stem cell therapy can partially restore neuronal circuits in spinal cord injury?
MBH/PS