Cell Therapies for Spinal Cord Injury: Trends and Challenges of Current Clinical Trials

医学 脊髓损伤 临床试验 细胞疗法 嗅鞘神经胶质 脊髓 重症监护医学 干细胞 内科学 病理 中枢神经系统 精神科 遗传学 生物 嗅球
作者
Richard Bartlett,Sarah Cunningham Burley,Mina Ip,James G. Phillips,David Choi
出处
期刊:Neurosurgery [Oxford University Press]
卷期号:87 (4): E456-E472 被引量:20
标识
DOI:10.1093/neuros/nyaa149
摘要

Cell therapies have the potential to revolutionize the treatment of spinal cord injury. Basic research has progressed significantly in recent years, with a plethora of cell types now reaching early-phase human clinical trials, offering new strategies to repair the spinal cord. However, despite initial enthusiasm for preclinical and early-phase clinical trials, there has been a notable hiatus in the translation of cell therapies to routine clinical practice. Here, we review cell therapies that have reached clinical trials for spinal cord injury, providing a snapshot of all registered human trials and a summary of all published studies. Of registered trials, the majority have used autologous cells and approximately a third have been government funded, a third industry sponsored, and a third funded by university or healthcare systems. A total of 37 cell therapy trials have been published, primarily using stem cells, although a smaller number have used Schwann cells or olfactory ensheathing cells. Significant challenges remain for cell therapy trials in this area, including achieving stringent regulatory standards, ensuring appropriately powered efficacy trials, and establishing sustainable long-term funding. However, cell therapies hold great promise for human spinal cord repair and future trials must continue to capitalize on the exciting developments emerging from preclinical studies.
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