Tissue Engineering and Pharmacological Approaches for the Treatment of Spinal Cord Injuries


Book Description

The World Health Organization (WHO) estimated the number of spinal cord injuries to be between 250,000 and 500,000 new cases every year, with an increasing incidence over the years. In the USA alone, about 282,000 persons are living with SCI. All these cases suffer from loss of sensory and motor functions to some degree, and there is no definitive treatment until now that can restore these functions. Moreover, one-third of these patients experience insidious damage to the neural tissues and a decline in the quality of their lives due to the development of post-traumatic intraspinal cystic lesions. The strategies for restoring neurological functions are long-term solutions, retrospective, and require the synergy of different therapeutic approaches. Along with these strategies, simple proactive strategies are required to prevent SCI complications. Molecular mechanisms involved in spinal cord development and disease seem very promising targets for both strategies, yet they are mostly unclear. Better exploitation of these molecular mechanisms can help researchers find definitive solutions for urgent and long-term problems, even without a full understanding of them. Therefore, the primary objective of this study was to prove the utility of some of the mechanisms involved in spinal cord development and disease while attempting to explain how they work, when possible. The overall hypothesis of this work is that molecular mechanisms involved in the spinal cord development and disease can be exploited for improving the outcome of SCI treatment. First, the focus was on utilizing the molecular signaling and cues retained in the subcutaneous environment throughout adulthood for priming aNSPCs encapsulated in chitosan-based hydrogel and helping nascent neurons acquire region-specific identity based on the region of implantation of the bioscaffold. To investigate this hypothesis, I implanted three bioscaffolds in the subcutaneous tissues in the back of rats in the cervical, thoracic, and lumbar region for four, six, and eight weeks. After harvesting the scaffolds, the response of aNSPCs was evaluated using IHC and RT-qPCR. Evaluation of the cell response required isolating RNA from aNSPCs encapsulated in the chitosan hydrogel, which was proved to be challenging due to physicochemical interactions between chitosan and RNA. Therefore, I investigated the pH-dependent isolation of RNA from a chitosan-based hydrogel. This experiment hypothesized that pH manipulation of the homogenization solution could improve isolated RNA yield and quality. Second, a molecular mechanism implicated in the expansion of the cystic lesions after SCI was investigated. The upregulation of BGT-1 and its substrate betaine was associated with intraspinal cystic lesions. Therefore, I hypothesized that inhibition of BGT-1 in spinal cord tissues could counteract cystic cavity expansion after SCI. Along with this goal, micro-CT utility for an estimation of intraspinal cysts was investigated in comparison to conventional histology. A significant difference was found between histology and micro-CT when both were used to estimate the syrinx size. In this dissertation, I tried to demonstrate the nature of the Integrated Biosciences Ph.D. program, which cuts through across the boundaries of traditional departments and approaches a problem from different perspectives.




Engineering Approaches for Treatment of Spinal Cord Injuries


Book Description

Spinal cord injury (SCI) remains a global concern for which there is no cure. This special issue of Cells Tissues Organs presents possible engineering approaches to circumvent various aspects of SCI. It presents topics related to bioelectric medicine and ultrasound as well as their potential ability to interface with or regenerate neural tissue. Additionally, several biomaterial-related issues are presented, including hydrogel selection with a special emphasis on swelling and intraspinal pressure, the use of nanoparticle technology in the spinal cord, and fibrous materials for neural stem cell implantation and drug delivery. Two ground-breaking articles highlight the importance of considering oligodendrocyte response in engineering approaches and modulation of the inflammatory response following SCI. Engineering Approaches to Spinal Cord Injuries is of special interest to clinicians who wish to translate up-and-coming research areas to the clinic, basic researchers collaborating with engineers, and the engineers themselves. The reader will become aware of promising approaches that may in the future become vital to the treatment of SCI.




Pharmacological Approaches to the Treatment of Brain and Spinal Cord Injury


Book Description

Although there are over 400,000 people each year in the United States alone who suffer from traumatic injury to the central nervous system (CNS), no phar macological treatment is currently available. Considering the enormity of the problem in terms of human tragedy as well as the economic burden to families and societies alike, it is surprising that so little effort is being made to develop treatments for these disorders. Although no one can become inured to the victims of brain or spinal cord injuries, one reason that insufficient time and effort have been devoted to research on recovery is that it is a generally held medical belief that nervous system injuries are simply not amenable to treatment. At best, current therapies are aimed at providing symptomatic relief or focus on re habilitative measures and the teaching of alternative behavioral strategies to help patients cope with their impairments, with only marginal results in many cases. Only within the last decade have neuroscientists begun to make serious inroads into understanding and examining the inherent "plasticity" found in the adult CNS. Ten years or so ago, very few researchers or clinicians would have thought that damaged central neurons could sprout new terminals or that intact nerve fibers in a damaged pathway could proliferate to replace inputs from neurons that died as a result of injury.




Spinal Cord Injury (SCI) Repair Strategies


Book Description

Spinal Cord Injury (SCI) Repair Strategies provides researchers the latest information on potential regenerative approaches to spinal cord injury, specifically focusing on therapeutic approaches that target regeneration, including cell therapies, controlled drug delivery systems, and biomaterials. Dr. Giuseppe Perale and Dr. Filippo Rossi lead a team of authoritative authors in academia and industry in this innovative reference on the field of regenerative medicine and tissue engineering. This book presents all the information readers need to understand the current and potential array of techniques, materials, applications and their benefits for spinal cord repair. Covers current and future repair strategies for spinal cord injury repair Focuses on key research trends, clinics, biology and engineering Provides fundamentals on regenerative engineering and tissue engineering







Therapeutic Strategies to Spinal Cord Injury


Book Description

This book is a printed edition of the Special Issue "Therapeutic Strategies to Spinal Cord Injury" that was published in IJMS




Spinal Cord Injury Therapy


Book Description

Spinal cord injury (SCI) is one of the main pathologies causing significant loss of neurological function. Therefore, a variety of pharmacological and non-pharmacological therapies are the aims of several studies. To provide the best care, it is important to know and understand the therapeutic approaches that have shown important progress in this topic. This book contains eight chapters that are divided into three sections: Introduction, Pharmacological Therapies, and Non-Pharmacological Therapies. The authors of the chapters deal with the pathophysiology of SCI, the effect of antioxidant and immunosuppressive agents, stem cell-based therapies, the use of cultured cells for transference or transplantation, and the application of non-invasive modalities (transcutaneous electrical spinal cord stimulation, etc.) for SCI rehabilitation.




Indwelling Neural Implants


Book Description

Despite enormous advances made in the development of external effector prosthetics over the last quarter century, significant questions remain, especially those concerning signal degradation that occurs with chronically implanted neuroelectrodes. Offering contributions from pioneering researchers in neuroprosthetics and tissue repair, Indwel




Therapeutic Strategies to Spinal Cord Injury


Book Description

This Special Issue gathers eight research articles covering a broad range of strategies on how to combat spinal cord injuries, from searching for therapeutic target molecules, tackling inflammatory reactions, utilizing cell therapy or cell-based products, combined strategies for axonal plasticity assessment, and prevention of post-surgical epidural adhesions. Moreover, four reviews cover recent findings about the role of stress-activated protein kinases in SCI; progress in stem cell therapies; the mechanisms and benefits of activity-based physical rehabilitation therapies with adjuvant testosterone; and, finally, translational regenerative therapies for chronic spinal cord injury.




Biomaterials-Based Drug Delivery Systems for Treating Spinal Cord Injury


Book Description

Spinal cord injury occurs when the cord is subjected to physical trauma. Because spinal cord tissue exhibits limited regenerative capacity, injuries result in significant loss of motor, sensory, and autonomic function. In the hours to weeks following initial trauma, secondary injury mechanisms are triggered, exacerbating tissue damage. Because these mechanisms occur at delayed timepoints, they can theoretically can be targeted by therapeutic interventions. Although a wide range of molecules have been shown to attenuate secondary injury mechanisms in animal models of SCI, clinical translation of these strategies has been slow, in part due to difficulty in safely and effectively achieving therapeutic concentrations of the indicated molecules in injured spinal cord tissue. Biomaterials-based drug delivery systems offer unique opportunities to safely administer drugs to the injured spinal cord while avoiding any deleterious side effects associated with systemic drug administration. In the first part of this thesis, a novel drug delivery system was developed, characterized, and optimized to target endogenous progenitor differentiation with the goal of replacing oligodendrocytes lost during SCI progression. The drug delivery system was shown to safely provide local delivery of the thyroid hormone T3, a known inducer of oligodendrocyte differentiation that cannot be safely administered systemically at therapeutic doses. Local delivery of T3 stimulated oligodendrocyte differentiation, resulting in increased numbers of newly generated oligodendrocytes and improved myelination following SCI. In the second part of this thesis, drug delivery systems were developed to target the inflammatory response following SCI. Delivery systems were based on novel drug-loaded microparticles, which were extensively characterized to reveal mechanisms of formation and drug release, and shown to provide sustained release of a synthetic PEGylated peptide as well as a small molecule drug. These strategies highlight the promise of biomaterials-based drug delivery to expand the researcher's toolkit, allowing for the use of previously infeasible drugs, and to facilitate the translation of therapeutic strategies from neuroscience laboratories to viable clinical treatments.