Spinal Cord Damage - Promising Breakthroughs
Science
and technology have been advancing at an astonishing rate during the first two
decades of the 21st century. Advancements in the fields of biology
and medicine continue to improve our understanding of the limits of the human
body and brain, and new research in the fields of neuroscience and psychology
are prominent examples of how far we have come scientifically as a species. An
area of research that has been gaining incredible insights and breakthroughs is
that of repairing damage to the spinal cord, a very difficult area to tackle in
regards to sever damage and rehabilitation and recovery further down the road.
Damage
to the spinal cord can be more often than not fatal, and when a patient survives,
their way of life is often drastically altered for the worst. However, research
in animal models, primarily mice and rats, has yielded exciting results regarding
the new techniques and methodologies that can help repair injured contused
spinal cords, such as in the article “The effect of a nanofiber-hydrogel
composite on neural tissue repair and regeneration in the contused spinal cord”
by Martin Oudega and colleagues (March 2020). In this study, Oudega et al. investigated
the effects of a nanofiber hydrogel composite to repair neural tissue that had
been contused, or damaged, in adult rats. The composite was composed of a “thiol
modified HA hydrogel phase” (Oudega et al., 2020) bound to PCL (electrospun
polycapractalone) fibers. The HA hydrogel was used by the researchers due to its
natural biocompatibility with the spinal cord and surrounding areas, as well as
the composites overall ability to mimic the surrounding extracellular matrix
(ECM) They were primarily observing the composites ability to provide mechanical
strength and renewed nourishment after binding and integrating successfully
with the area of the spinal cord that was damaged. Ultimately, they were able
to determine that the nanofiber hydrogel composite “provided mechanical support
to the contused spinal cord and supported pro-regenerative macrophage
polarization, angiogenesis, axon growth, and neurogenesis in the injured tissue
without any exogenous factors or cells” (Oudega et al. 2020).
More recently,
as of November 2021, another major study was published by researchers and
reported on by US News, from the Simpson Querrey Institute for BioNanotechnology
at Northwestern University and Dr. Jeremy Steinberger, director of minimally
invasive spine surgery at the Mount Sinai Health System in New York. As stated
by the study lead, Samuel Stupp, their study aimed to observe the effects of an
injectable therapy comprised of liquid nanofibers in the form a gel that had
the ability to mesh with the damaged region of the spinal cord in adult mice. Ultimately,
Stupp et al. also had promising findings in their results from the study – they
found that the nanofiber gel was successful in facilitating regeneration in the
severed nerves in the lab mice, with little scarring. They place emphasis on
the minimal amount of scar tissue left after the nanofiber gel had run its
course - "The scar is actually what causes permanent paralysis. Even
though the neurons are still alive at the site where they were severed, the
body produces this scar, which is a physical barrier. The axons cannot
regenerate because they have a big hard scar in front of them” (Thompson, 2021).
Similar to the study conducted by Oudega et al. in 2020, this study also
targeted the smooth integration of the injected material with the damage site
of interest in the spinal cord, as well as the high rates of regeneration with minimal
scarring – both essential to healing the contusions, and for providing future
support for more funding for this research – especially in humans.
Nevertheless,
despite these promising results, caution must be exercised, and optimism
curbed, as success in animal trials in the lab do not always translate over to
success in human subjects, as emphasized by Dr. Steinberger. However, the
results are still promising, and Stupp and his colleagues are attempting to
take the next step and present their findings to the FDA to apply for human clinical
trials. As stated previously, breakthroughs like the research described in both
Oudega et al. (2020) and Stupp et al. (2021) are incredibly promising and
inspiring, especially when spinal cord injuries are becoming increasingly
common - According to US News, “Nearly 300,000 Americans live with a spinal
cord injury today, the researchers said in background notes. Less than 3% with
complete injury ever recover basic physical functions (Thompson, 2021).
Citations:
Thompson, D. (2021, November 12). Mouse study points
to possible breakthrough against spinal ... U.S. News & World Report.
Retrieved March 4, 2022, from
https://www.usnews.com/news/health-news/articles/2021-11-12/mouse-study-points-to-possible-breakthrough-against-spinal-cord-injury
Samuel Stupp, PhD, founding director, Simpson Querrey
Institute for BioNanotechnology, Northwestern University, Evanston, Ill.; Jeremy
Steinberger, MD, assistant professor, neurosurgery, orthopedics and
rehabilitation medicine, and director, minimally invasive spine surgery, Mount
Sinai Health System, New York City; Science, Nov. 12, 2021
The effect of a nanofiber-hydrogel composite on neural
tissue repair and regeneration in the contused spinal cord Xiaowei Lia,b,c,1,2
, Chi Zhanga,b,c,d,1 , Agnes E. Haggertye,1 , Jerry Yana,c,f , Michael Lana,c,f
, Michelle Seua,g , Mingyu Yanga,b,c , Megan M. Marlowe , Inés
Maldonado-Lasuncióne,h,i,j,k , Brian Choa,g , Zhengbing Zhoua,b,c , Long
Chena,b,c , Russell Martina,b,c , Yohshiro Nitobee,l , Kentaro Yamanee,m, Hua Youn
, Sashank Reddyg , Da-Ping Quand,∗
, Martin Oudegai,j,k,n,o,∗∗,
Hai-Quan Maoa,b,c,f,∗∗∗
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