Abstract
Spinal cord injury (SCI), which is much in the public eye, is still a refractory disease compromising the well-being of both patients and society. In spite of there being many methods dealing with the lesion, there is still a deficiency in comprehensive strategies covering all facets of this damage. Further, we should also mention the structure called the corticospinal tract (CST) which plays a crucial role in the motor responses of organisms, and it will be the focal point of our attention. In this review, we discuss a variety of strategies targeting different dimensions following SCI and some treatments that are especially efficacious to the CST are emphasized. Over recent decades, researchers have developed many effective tactics involving five approaches: (1) tackle more extensive regions; (2) provide a regenerative microenvironment; (3) provide a glial microenvironment; (4) transplantation; and (5) other auxiliary methods, for instance, rehabilitation training and electrical stimulation. We review the basic knowledge on this disease and correlative treatments. In addition, some well-formulated perspectives and hypotheses have been delineated. We emphasize that such a multifaceted problem needs combinatorial approaches, and we analyze some discrepancies in past studies. Finally, for the future, we present numerous brand-new latent tactics which have great promise for curbing SCI.
概要
本文根据脊髓不同传导束之间存在竞争以及其再 生需要的条件存在异质性, 得出优先关注皮质脊 髓束的结论。 同时, 旨在通过归纳目前治疗脊髓 损伤(特别是对皮质脊髓束)有效的各种策略, 寻找治疗脊髓损伤的最佳策略组合。 脊髓损伤的 恢复涉及众多方面的问题, 单一策略的失效(如 本文提及的SOX11 的过度表达反而对功能有害) 往往提示治疗方案需要综合其它方面的问题。 因 此, 有必要总结一下脊髓损伤治疗的几个关键方 面, 并梳理一套可能的治疗路线规划。 本文另一 目的在于对过去一些关键理论、假说、矛盾进行 总结, 并在此基础上进行新的综合和思考。
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Acknowledgements
We would like to thank Professor Cheng-zhen LIANG from Orthopedics Research Institute of Zhejiang University for his valuable opinions and suggestions. In addition, An-kai XU especially wishes to thank Qiu-ping DING, who has given him emotional support over past decades.
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Project supported by the National Natural Science Foundation of China (Nos. 81472504, 81401822, and 81572177), the Science and Technology Foundation of Zhejiang Province (No. 2016C33151), the Medical Science and Technology Project of Zhejiang Province of China (Nos. 2016146428, 2016KYA096, and 2017KY071), and the Zhejiang Provincial Natural Science Foundation of China (Nos. Y17H160033, LQ14H060002, and LY14H060004)
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Xu, AK., Gong, Z., He, YZ. et al. Comprehensive therapeutics targeting the corticospinal tract following spinal cord injury. J. Zhejiang Univ. Sci. B 20, 205–218 (2019). https://doi.org/10.1631/jzus.B1800280
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DOI: https://doi.org/10.1631/jzus.B1800280
Key words
- Spinal cord injury (SCI)
- Comprehensive strategy
- Corticospinal tract
- Neuroprotective
- Development
- Glial
- Transplantation
- Training
- Electrical stimulation