创伤性脊髓损伤的神经再生和神经保护疗法取得进展

Gregor Fischer, Linda Bättig, M. Stienen, Armin Curt, Michael G. Fehlings, Nader Hejrati
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摘要

创伤性脊髓损伤(SCIs)仍然是医疗保健领域的一个主要问题,在全球的发病率不断上升。为应对这一日益严峻的医疗挑战,科学界已将大量注意力投入到开发神经保护和神经再生策略上,以改善脊髓损伤患者的预后和生活质量。本综述旨在对目前正在研究的最新神经再生和神经保护疗法进行最新、最全面的概述。这些策略包括神经药理学干预、细胞疗法以及生物材料支架和神经调节疗法等其他有前景的策略。此外,综述还讨论了急性期临床管理的重要性,包括血液动力学管理以及手术时机和技术方面的作用,这些都是减轻 SCI 后继发性损伤的关键因素。总之,本综述强调了为提高患者的治疗效果和生活质量而不断进行的科学研究,重点是即将出台的创伤性 SCI 治疗策略。每一部分都提供了与临床医生相关的临床前和患者试验的基本知识,同时强调了这些疗法的病理生理学原理。
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Advancements in neuroregenerative and neuroprotective therapies for traumatic spinal cord injury
Traumatic spinal cord injuries (SCIs) continue to be a major healthcare concern, with a rising prevalence worldwide. In response to this growing medical challenge, considerable scientific attention has been devoted to developing neuroprotective and neuroregenerative strategies aimed at improving the prognosis and quality of life for individuals with SCIs. This comprehensive review aims to provide an up-to-date and thorough overview of the latest neuroregenerative and neuroprotective therapies currently under investigation. These strategies encompass a multifaceted approach that include neuropharmacological interventions, cell-based therapies, and other promising strategies such as biomaterial scaffolds and neuro-modulation therapies. In addition, the review discusses the importance of acute clinical management, including the role of hemodynamic management as well as timing and technical aspects of surgery as key factors mitigating the secondary injury following SCI. In conclusion, this review underscores the ongoing scientific efforts to enhance patient outcomes and quality of life, focusing on upcoming strategies for the management of traumatic SCI. Each section provides a working knowledge of the fundamental preclinical and patient trials relevant to clinicians while underscoring the pathophysiologic rationale for the therapies.
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