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Promising Advances in Targeted Cellular Based Therapies: Treatment Update in Spinal Cord Injury

George M Ghobrial, Christopher J Haas, Christopher M Maulucci, Angelo Lepore, Itzhak Fischer and James S Harrop

Spinal Cord Injury (SCI) affects approximately 10,000 people per year in North America. Over the last twenty years, significant advances have been made in the understanding the pathophysiology of traumatic spinal cord injuries. In addition there have been concurrent advances in embryonic stem cells (ESCs) and the various pathways of their differentiation into neural stem cells (NSCs) and progenitors. It is hoped that these advancing fields can be merged. The administration of ESCs and NSC cells will reconstitute the architecture of the injured spinal cord as well as spinal cord tracts. Thus, this would result in improved anatomical recovery and plasticity allowing for improved neurologic function and locomotion. The authors provide a brief overview of recent publications to illustrate the various approaches to the treatment of SCI with cellular based therapies, including both pluripotent stem cells and neural-committed lineages. Considerable advances have been made in the field. While there is a growing body of laboratory evidence in the literature to support translating cellular therapies into the clinical setting, there are no definitive answers on the efficacy of cellular based therapies in the clinical setting. A variety of cellular therapies have been implemented in novel clinical trials including OECs, fetal-derived NSCs, and Schwann cells. Further refinement of these methods should be made in the future to limit patient morbidity.