Emerging Repair, Regeneration, and Translational Research Advances for Spinal Cord Injury

Study Design. Literature review of basic scientific and clinical research in spinal cord injury (SCI). Objective. To provide physicians with an overview of the neurobiologic challenges of SCI, the current status of investigation for novel therapies that have been translated to human clinical trials, and the preclinical, scientific basis for each of these therapies. Summary of Background Data. An abundance of recent scientific and clinical research activity has revealed numerous insights into the neurobiology of SCI, and has generated an abundance of potential therapies. An increasing number of such therapies are being translated into human SCI trials. Clinicians who attend to SCI patients are increasingly asked about potential treatments and clinical trials. Methods. Published data review of novel treatments that are either currently in human clinical trials for acute SCI or about to initiate clinical evaluation. Results. A number of treatments have bridged the "translational gap" and are currently either in the midst of human SCI trials, or are about to begin such clinical evaluation. These include minocycline, Cethrin, anti-Nogo antibodies, systemic hypothermia, Riluzole, magnesium chloride in polyethylene glycol, and human embryonic stem cell derived oligodendrocyte progenitors. A systematic review of the preclinical literature on these specific therapies reveals promising results in a variety of different SCI injury models. Conclusion. The SCI community is encouraged by the progression of novel therapies from "bench to bedside" and the initiation of clinical trials for a number of different treatments. The task of clinical evaluation, however, is substantial, and many years will be required before the actual efficacy of the treatments currently in evaluation will be determined.