The role of mesenchymal stromal cells in spinal cord injury, regenerative medicine and possible clinical applications

Abstract

Diseases of the central nervous system still remain among the most challenging pathologies known to mankind, having no or limited therapeutic possibilities and a very pessimistic prognosis. Advances in stem cell biology in the last decade have shown that stem cells might provide an inexhaustible source of neurons and glia as well as exerting a neuroprotective effect on the host tissue, thus opening new horizons for tissue engineering and regenerative medicine. Here, we discuss the progress made in the cell-based therapy of spinal cord injury. An emphasis has been placed on the application of adult mesenchymal stromal cells (MSCs). We then review the latest and most significant results from in vitro and in vivo research focusing on the regenerative/neuroprotective properties of MSCs. We also attempt to correlate the effect of MSCs with the pathological events that are taking place in the nervous tissue after SCI. Finally, we discuss the results from preclinical and clinical trials involving different routes of MSC application into patients with neurological disorders of the spinal cord.

Keywords: ALS; AMSCs; BDNF; BMSC; CNS; CST; Cell-based therapy; Clinical trials; ESCs; GDNF; GRP; GVHD; IGF-1; MN; MRI; MSC; MV; NF; NGF; NMJ; NPCs; NTF; Neuroprotection; OMgp; PNN; Regeneration; SC; SCI; SOD1; Stem cells; VEGF; adipose-derived MSCs; amyotrophic lateral sclerosis; bone marrow MSC; brain-derived neurotrophic factor; central nervous system; corticospinal tracts; embryonic stem cells; glia derived neurotrophic factor; glial restricted precursors; graft-versus-host disease; hNSC; hUCB; human neural stem/progenitor cells; human umbilical cord blood; iPSCs; induced pluripotent cells; insulin growth factor-1; magnetic resonance imaging; mesenchymal stromal cells; microvesicles; motoneurones; neural growth factor; neural progenitor cells; neurofilament; neuromuscular junction; neurotrophic factors; oligodendrocytemyelin glycoprotein; perineuronal nets; spinal cord; spinal cord injury; superoxide dismutase 1 gene; vascular endothelial growth factor.