Supervisors info:
Βλάμης Ιωάννης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μπενέτος Ιωάννης, Ακαδημαϊκός Υπότροφος, Ιατρική Σχολή, ΕΚΠΑ
Ευαγγελόπουλος Δημήτριος, Ακαδημαϊκός Υπότροφος, Ιατρική Σχολή, ΕΚΠΑ
Summary:
The current study assesses the modern therapeutic approaches that are being tested at the level of clinical trials, for the treatment of Spinal Cord Injury (SCI) and aim at the recovery of functionality, through the mechanisms of neuroprotection, neuroregeneration and neuromodulation.
Initially, the pathophysiology of SCI is briefly described, specifically the primary and secondary phase of injury, as well as the factors that cause inhibition of neurogenesis.
The physiological therapeutic approaches tested at the clinical trial level, which aim at neuroprotection of cells at the site of injury, are then discussed. These include body hypothermia, drainage of the CSF and regulation of the mean blood pressure to specific levels.
The next chapter presents the pharmaceutical approaches that are researched, regarding their possible neuroprotective and neurorestorative role in SCI. Methylprednisolone, minocycline, riluzole, naloxone, tirilazade, nimodipine, fibroblastic growth factor, granulocyte colony stimulating factor, Rho-rock inhibitors and Anti-Nogo-A antibodies are discussed.
In the next chapter, the cellular approaches in SCI are presented. Special interest is given on stem cell therapy, one of the most promising therapeutic approaches in SCI. All used cell types, the possible mechanisms by which they act when transplanted after SCI and the clinical studies published from 1/1/2017 to 31/3/2022 in the PubMed database are analyzed. Furthermore, the delivery of stem cells combined with scaffolds based on biomaterials is discussed. Finally, the research approach of SCI treatment with the use of extracellular vesicles is presented.
The last chapter of the study presents the research efforts which aim at neuromodulation through the application of electrical or magnetic stimulation. The epidural and transcutaneous spinal electrical stimulation, the transcranial electrical and magnetic stimulation as well as the application of machine brain interface technologies are discussed.
Keywords:
Spinal cord injury, Neuromodulation, Neuroprotection, Neuroregeneration, Stem cell therapies
