The known-unknowns in spinal cord injury, with emphasis on cell-based therapies – a review with suggestive arenas for research

Abstract

Introduction: In spite of extensive research, the progress toward a cure in spinal cord injury (SCI) is still elusive, which holds good for the cell- and stem cell-based therapies. We have critically analyzed seven known gray areas in SCI, indicating the specific arenas for research to improvise the outcome of cell-based therapies in SCI.

Areas covered: The seven, specific known gray areas in SCI analyzed are: i) the gap between animal models and human victims; ii) uncertainty about the time, route and dosage of cells applied; iii) source of the most efficacious cells for therapy; iv) inability to address the vascular compromise during SCI; v) lack of non-invasive methodologies to track the transplanted cells; vi) need for scaffolds to retain the cells at the site of injury; and vii) physical and chemical stimuli that might be required for synapses formation yielding functional neurons.

Expert opinion: Further research on scaffolds for retaining the transplanted cells at the lesion, chemical and physical stimuli that may help neurons become functional, a meta-analysis of timing of the cell therapy, mode of application and larger clinical studies are essential to improve the outcome.

Keywords::

• cell therapies
• gray areas
• known-unknowns
• spinal cord injury
• stem cells

Acknowledgments

The authors acknowledge M/s Chennai Cell Cluster (CCC) for technical advice, Ms. Eiko Amemiya, II Department of Surgery, Yamanashi University, Faculty of Medicine, Chuo, Japan for her secretarial assistance and Loyola ICAM College of Engineering Technology (LICET) and Loyola Institute of Frontier Energy (LIFE) for their non-financial support to the research work.

Declaration of interest

The authors have no competing interests to declare and have received no funding in preparation of the manuscript.

Notes

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