Combination cellular therapy as an effective approach for spinal cord injury

Spinal cord injury (SCI) is defined as a complete or partial disruption of structural and functional integrity of the spinal cord, mostly caused by trauma, resulting in paralysis, loss of sensation, and impaired function of autonomous nervous system (ANS). SCI is often associated with various morbidities, dependencies, and deprivations imposing many social and economic problems on individuals and society. Fallowing initial damage, a secondary cascade of injuries including neuronal or vascular deficiencies is occurred worsening the situation and finally creating a glial scar that is the main reason for lack of axon regeneration in this area. Indeed, formation of this inhibitory scar, endogenous nervous system weakness in regeneration, and existing of many inflammatory and apoptotic factors, all may complicate the repair process. The aim of most current treatment protocols, including administration of various medications is early neuroprotection and secondary injury prevention. However, cellular therapeutic approaches are expanding with no doubt in their potential for regeneration of SCI. Until now various cells like olfactory ensheathing cells (OECs), schwan cells (SCs), and mesenchymal stem cells (MSCs) have been applied for SCI with promising results. Although intralesional transplantation of these cells has shown significant advantages in preclinical and clinical studies, it seems their cotransplantation has more efficacy than individual application. In fact, since SCI is considered as a multifactorial disorder, there is a rational basis for combination cellular therapies with the potential to facing with different aspects of injury and synergically improving regeneration after SCI. So in this review we aim to discuss the results of co-application of these mentioned cells as efficient treatments for SCI.

Keywords:

SCI , Glial scar , Cell therapy , Combination therapy , Regeneration