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Tremendous efforts have been made to ameliorate and improve locomotor function after spinal cord injury (SCI) by the transplantation of various types of stem cells. In our study we compared the use of non-neurogenic stem cells – bone marrow stromal cells (MSCs), an immortalized stem cell line (SPCs) derived from human fetal spinal cord tissue or human induced pluripotent stem cell-derived neural precursors (iPS-NPs) – for the treatment of a balloon-induced spinal cord compression lesion. Suspensions of stem cells were implanted into the lesion one week after SCI, while the control groups were injected with saline. Locomotor and sensitivity tests were performed weekly for two months. Animals transplanted with any cell type displayed significant motor and sensory improvement compared to the controls. Morphometric evaluation showed that the white matter was spared in all grafted animals when compared to controls, while the gray matter was spared only in animals implanted with MSCs or iPS-NPs. Two months post-implantation (PI), all types of grafted cells survived in the lesion; however, MSCs, unlike iPS-NPs and SPCs, did not differentiate nor communicate with the host tissue. Compared to SPCs, which partially filled the lesion cavity, iPS-NPs interacted more with the host tissue. Besides differentiating into MAP2-, 5TH- and Dcx-positive neurons, iPS-NPs differentiated into CNPase+ oligodendrocytes. A few cells expressed ChAT, while others were DARPP32+ . SPCs expressed mainly GFAP; however, already at two months PI we found 25% of the cells to be positive for Nkx 6.1, and at four months PI the cells were positive for ChAT and Islet2, motor neuron-specific markers. qPCR revealed the increased expression of rat and human neurotrophin genes as well as human motor neuron-specific genes. Based on staining for GAP43, SPCs cells supported endogenous neurite sprouting and regeneration. Another important therapeutic goal is treating chronic SCI, possibly by a combination of stem cells and bridging scaffolds. Hydrogel bridges seeded with MSCs were implanted into SCI one month after injury. The implanted rats were behaviorally tested, then sacrificed 6 months PI and the spinal cord lesions histologically evaluated. The hydrogels adhered well to the surrounding tissue and completely filled the post-traumatic cavity. MSCs survived in the hydrogel, and neurofilaments, blood vessels and Schwann cells infiltrated the implant. Combined therapy also prevented tissue atrophy, while behavioral analysis showed an improvement in rats with combined treatment, compared with the control group. Our results demonstrate that the transplantation of neurogenic as well as non-neurogenic stem cells into the lesioned rat spinal cord improves functional outcome by providing trophic support to the spared axons in the injured tissue. Neurogenic stem cells have the ability to interact with the host tissue and differentiate into a more mature phenotype, such as motor neurons. Treatment of chronic spinal cord injury will require a combination of cell therapy and lesion bridging. Supported by IAA500390902, GA CR: P304/12/1370, GA CR: P108/10/1560.
The use of nanotechnology in cell therapy and tissue engineering offers promising future perspectives for treatment of brain and spinal cord injury. Stem cells have been shown to selectively target injured brain and spinal cord tissue and improve functional recovery. To allow cell detection, nanoparticles based on a superparamagnetic iron-oxide core or gadolinium complexes can be used to label transplanted cells. MRI is then a suitable method for the in vivo tracking of grafted cells in the host organism. In addition, nanoparticles based on a perovskite core can be used for tumor thermoablation. To improve MR imaging and labeling efficiency when compared to commercial contrast agents, superparamagnetic iron-oxide nanoparticles can be modified with different coatings (Poly-L-lysin, D-mannose, polydimethylacrylamid). CNS, and particularly spinal cord, injury is accompanied by tissue damage and the formation of physical and biochemical barriers that prevent axons from regenerating. One aspect of nanomedicine is the development of biologically compatible nanofiber or polymer scaffolds that mimic the structure of the extracellular matrix and can serve as a permissive bridge for axonal regeneration or as a drug-delivery system. These scaffolds, when implanted into acute or chronic spinal cord injury, provide a suitable environment not only for axonal ingrowth, but also for the growth of blood vessels and Schwann cells myelinating the axons. The incorporation of biologically active epitopes and/ or the utilization of these scaffolds as stem cell carriers may further enhance their therapeutic efficacy. Supported by AV0Z50390703, GACR203/06/1242, 1M0538, LC554 and IAA 500390902.
Spinal cord injury leads to a robust inflammatory response that is an unfavorable environment for stem cell implantation. In this study, we evaluated the effect of combined therapy of curcumin and mesenchymal stem cells (MSC) on behavioral recovery and tissue sparing, glial scar formation, axonal sprouting and inflammatory responses in a rat experimental model of spinal cord injury (SCI). Balloon‑induced compression lesion was performed at thoracic (Th8‑9) spinal level. Out of the four groups studied, two groups received curcumin on the surface of the spinal cord immediately after SCI and then once a week for 3 weeks together with an intraperitoneal daily curcumin injection for 28 days. The other two groups received saline. Seven days after SCI, human MSC were intrathecally implanted in one curcumin and one saline group. Both curcumin and curcumin combined with MSC treatment improved locomotor ability in comparison to the saline treated animals. The combined treatment group showed additional improvement in advanced locomotor performance. The combined therapy facilitated axonal sprouting, and modulated expression of pro‑regenerative factors and inflammatory responses, when compared to saline and single treatments. These results demonstrate that preconditioning with curcumin, prior to the MSC implantation could have a synergic effect in the treatment of experimental SCI
Currently, there is no effective strategy for the treatment of spinal cord injury (SCI). A combination of biomaterials and stem cell therapy seems to be a promising approach to increase regenerative potential after SCI. We evaluated the use of a cell-polymer construct based on a combination of the conditionally immortalized spinal progenitor cell line SPC-01_GFP3, derived from human fetal spinal cord tissue, with a serotonin-modified poly(2-hydroxyethyl methacrylate) hydrogel (pHEMA-5HT). We compared the effect of treatment with a pHEMA-5HT hydrogel seeded with SPC-01_GFP3 cells, treatment with a pHEMA-5HT only and no treatment on functional outcome and tissue reconstruction in hemisected rats. Prior to transplantation the cell-polymer construct displayed a high potential to support the growth, proliferation and differentiation of SPC-01 cells in vitro. One month after surgery, combined hydrogel-cell treatment reduced astrogliosis and tissue atrophy and increased axonal and blood vessel ingrowth into the implant; however, two months later only the ingrowth of blood vessels remained increased. SPC-01_GFP3 cells survived well in vivo and expressed advanced markers of neuronal differentiation. However, a majority of the transplanted cells migrated out of the lesion and only rarely remained in the hydrogel. No differences among the groups in motor or sensory recovery were observed. Despite the support of the hydrogel as a cell carrier in vitro, and good results in vivo one month postsurgery, there was only a small effect on long term recovery, mainly due to the limited ability of the hydrogels to support the in vivo growth and differentiation of cells within the implant. Further modifications will be necessary to achieve stable long term improvement in functional outcome.
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