Michael G Fehlings, MD, PhD, spoke with Spine Universe about the study outcomes and potential clinical implications for patients with chronic spinal cord injury.
Chronic injury of the spinal cord results in the formation of a harsh injury microenvironment that is inhibitory to neural repair and regeneration; this is seen particularly with the creation of the glial scar formed by astrocytes surrounding the site of injury, explained senior author Michael G. Fehlings, MD, PhD, Professor of Neurosurgery and Co-Director of the Spine Program at the University of Toronto in Ontario, Canada. As part of the glial scarring process, inhibitory chondroitin sulfate proteoglycans (CSPGs) are deposited into the extracellular matrix, reducing the ability of axons to regenerate and repair following transplantation with exogenous NSCs Dr. Fehlings and colleagues noted in their paper.
“While stem cells show considerable promise as a potential therapeutic option for spinal cord injury, NSCs alone are not sufficient to enable repair and regeneration of the injured spinal cord unless one deals with these critical impediments to regeneration,” Dr. Fehlings told SpineUniverse.
“In this study, we showed that if we pre-treated the chronically injured spinal cord with an enzyme called ChABC, which degrades CSPGs in the extracellular matrix of the glial scar, it unlocks the potential for plasticity of the chronically injured spinal cord,” Dr. Fehlings explained.
H. Suzuki H, Ahuja CS, Salewski RP, et al. Neural stem cell mediated recovery is enhanced by Chondroitinase ABC pretreatment in chronic cervical spinal cord injury. PLoS One. 2017;12(8):e0182339.
Findings Point to Possible Major Therapeutic Intervention for Chronic Spinal Cord Injuries Via Stem Cell Injections Article
Lead author Ivan Cheng, MD, and Michael G. Fehlings, MD, PhD, comment
Cheng I, Githens M, Smith RL, et al. Local versus distal transplantation of human neural stem cells following chronic spinal cord injury. Spine J. 2016;16(6):764-769.