Supervisors info:
Βλάμης Ιωάννης , Αναπληρωτής Καθηγητής, Ιατρική Σχολή , ΕΚΠΑ
Ευαγγελόπουλος Δημήτριος-Στέργιος, Ακαδημαϊκός υπότροφος, Ιατρική Σχολή , ΕΚΠΑ
Μπενέτος Ιωάννης, Ακαδημαϊκός υπότροφος, Ιατρική Σχολή , ΕΚΠΑ
Summary:
Abstract
Introduction
Spinal cord injury (SCI) often leads to catastrophic neurological deficits that dramatically reduce a person's quality of life. Despite decades of efforts to develop effective methods of management, there is still an urgent need for novel treatment that promotes functional recovery after SCI. Stem cells have attracted particular interest as a potential source for cell regeneration therapy after SCI. The purpose of this study is to review the action of hematopoietic stem cells (HSCs) in the pathophysiological mechanisms of SCI.
Materials and methods
A literature review was conducted based on the Pubmed internet database, following the PRISMA Guidelines. Article titles were searched with the use of the keywords: ("hematopoietic stem cells" OR "HSCs") AND ("spinal cord injury"). The search included only animal and clinical studies evaluating the action of hematopoietic stem cells in the pathophysiological mechanisms of SCI. Studies published in non-English language, reviews, case reports and study protocols were excluded.
Results
Initially, 39 studies were identified after primary search on Pubmed electronic database. After screening of titles and abstracts, 21 articles were excluded. Among the remaining 18 studies, 9 were rejected as review articles. After checking the references list of the included studies, 13 more studies were added, leaving 22 studies for final analysis. There were 10 clinical studies and 12 animal studies.
Conclusions
The exact mechanism of functional recovery enhancement induced by HSC transplantation has not yet been clarified. HSCs may secrete neurotrophic growth factors, such as angiopoietin-1, which can enhance restoration of the spinal cord and improve functional outcome. The transplanted HSCs may integrate with the host cells in the injured spinal cord tissue, modulating immune and inflammatory reactions. Moreover, they have been associated with axon regeneration and remyelination along with a reduction of glial scar. HSC transplantation has shown promising results in the treatment of SCI, having the potential to repair the injured spinal cord and to enhance functional recovery. However, most studies are experimental and further human studies are needed to fully elucidate the role of HSC in SCI.
Key Words: "hematopoietic stem cells", “HSCs”, “spinal cord injury”
