Spinal cord repair strategies: Schwann cells, neurotrophic factors, and biodegradable polymers
Martin Oudega and Sandrine E. Gautier ( USA and Belgium )
Injury to the adult mammalian spinal cord leads to permanent loss of controlled neurological function. Endogenous repair mechanisms fail to reestablish functional synoptic connections. Moreover, neurological outcome usually gets worse in time, due to neurodestructive processes inherent to the adult spinal cord. Surgical repair strategies need to focus on replacing damaged/ lost nervous tissue, promoting axonal regeneration and reestablishing functional synaptic contacts. This review will discuss the current understanding of the potential beneficial role of Schwann cells, neurotrophic factors, biodegradable polymers or combinations thereof in spinal cord injury. Replacement, of injured spinal tissue with a Schwann cell graft promotes axonal regeneration and myelination. Neurotrophic factors initiate and/or enhance events that are crucial for functional recovery, such as cell survival and axonal regeneration. Biodegradable polymers can be used as a scaffold for cell implantation and/or as a drug delivery vehicle. The complex nature of spinal cord injury demands a combinatorial restorative approach. For the future, the challenge will be to combine individual growth-promoting properties such that neurological recovery in spinal cord injured humans can be achieved.
Biomed Rev 1999; 10: 75-88.
Received 2 October 1999 and accepted 3 December 1999.
Correspondence and reprint requests to Dr Martin Oudega, The Miami Project to Cure Paralysis, University of Miami School of Medicine, P.O. Box 016960 , R-48, Miami , FL 33136, USA. Tel: 1 305 243 6226, Fax: 1 3052434427.