There are approximately 265,000 Americans who are living with spinal cord injuries, with resurfacing cases of 11,000 and 12,500 each year. However, since over 20% of injuries do not get reported, this may be an underestimate. Spinal cord injuries, especially those that cause paralysis, can be extremely devastating for patients. People suffering from paralysis may be vulnerable to certain health conditions such as skin infections, obesity, and life-threatening respiratory infections. The fact that the mind and body are connected becomes evident in people suffering from spinal cord injuries. When the body is physically dysfunctional in certain areas, the mind seems to mirror the effects too, but in terms of mental health issues. Depression and anxiety are very common in people dealing with the challenges of living with a spinal cord injury, and maybe exacerbated. Some medications also have the ability to change the way the brain processes certain neurotransmitters, increasing vulnerability to mental illnesses. Contusions in the spinal cord may also lead to other changes in physical capabilities such as difficulty controlling bladder or bowels, difficulty with sexual function and fertility, phantom pain radiating from site of injuring to elsewhere, and breathing difficulties and sleep apnea. People with spinal cord injuries may also face discrimination in the workplace, household, and schools, which is an additional stress on their mental health.
In the article, The effect of a nanofiber-hydrogel composite on neural tissue repair and regeneration in the contused spinal cord, Oudega et al engineered an injectable nanofiber-hydrogel composite (NHC) which could provide mechanical strength and porosity due to it’s interfacial abilities. They investigated “the mechanical support of NHC and its effects on neural tissue generation by assessing the presence of macrophages, blood vessels, axons, and neural-like cells.” in an adult rat model of spinal contusion. They hypothesized that the NHC should provide mechanical support to the spinal cord segment that is damaged, and it should also create a microenvironment allowing the infiltration of endogenous cells, which is necessary for nervous tissue to generate and repair itself. One of the main results of this study show that there was a growth of M2 macrophages in the contused areas. The researchers concluded that NHC is able to mechanically support the contused spinal cord and support “pro-regenerative macrophage polarization, angiogenesis, axon growth, and neurogenesis in the injured tissue without any exogenous factors or cells” (Oudega et al., 2020).
The article, Growth Cocktail Helps Restore Spinal Connections in the Most Severe Injuries by Emily Willingham, talks about research done based on the fact that a certain type of nerve cell, aids the signaling restoration in spinal cords that are partially damaged. These cells can also restore limited walking ability even when direct connections to the brain are damaged. Michael Sofroniew, one of the senior authors of the study and his colleagues used this idea and wanted to see if they could create an area of complete spinal injury in their experimental animals and use propriospinal neurons. If these neurons could flourish into this area of injury, then they might be able to follow the same idea. Their attempts using only propriospinal cells failed, so they then turned to adding laminin which is a set of chemicals that promote nerve cell growth and trigger production of a structural protein, along with chemicals that help in placement of regenerating axons. Laminin acts as a support protein in tissue engineering. They called this the trifecta of axon growth factors. This current study was finally successful – enough of the neuron fibers were accumulated to bridge the gap in the spinal contusion. The axons could also fully pass electrical signals. The results of this study led to the generation of the future goal of figuring out how to use their three-part protocol and apply it in patient care. Sofroniew said that their protocol is just the first step to a longer process and that this treatment may not be applicable for other kinds of spinal cord neurons. Their three-pronged method, he said, could be applied to other neurons to try and bring to reality the ability to restore certain functions, such as control of stepping. Although they were able to bridge the gap, they think that it is just the first step. The experimental animals did not regain their locomotion abilities all of a sudden when the gap was bridged. This is mainly because the axons that have been regenerated need communication pathways around the injury, so that the restored signals can flow through the brain and spinal cord. This could be brought about by rehabilitation, training of the new axons to perform their new duties, combined with their three-pronged relationship. The experimenters plan to take their spinal cord injury repair protocol and add it to different types of rehabilitation. The team’s current goal is to see if they can use rehabilitation training to “reboot the whole system”.
If the results of both studies could be applied in patient care, it could have the potential to change the lives of millions of people around the world who are suffering from severe spinal cord injuries. They could potentially regain many of the physical bodily functions that were lost or weakened due to their injuries. These studies also open doors for further studies on specific areas which may also aid in specialized patient care.
Works Cited:
SpinalCord.com. (n.d.). Life after a spinal cord injury. SpinalCord.com. Retrieved March 4, 2022, from https://www.spinalcord.com/life-after-a-spinal-cord-injury
Li, X., Zhang, C., Haggerty, A. E., Yan, J., Lan, M., Seu, M., Yang, M., Marlow, M. M., Maldonado-Lasunción, I., Cho, B., Zhou, Z., Chen, L., Martin, R., Nitobe, Y., Yamane, K., You, H., Reddy, S., Quan, D.-P., Oudega, M., & Mao, H.-Q. (2020). The effect of a nanofiber-hydrogel composite on Neural Tissue Repair and regeneration in the contused spinal cord. Biomaterials, 245, 119978.
https://doi.org/10.1016/j.biomaterials.2020.119978 Willingham, E. (2018, August 30). Growth cocktail helps restore spinal connections in the most severe injuries. Scientific American. Retrieved March 4, 2022, from https://www.scientificamerican.com/article/growth-cocktail-helps-restore-spinal-connections-in-the-most-severe-injuries/ URL: https://restoration-of-spinal-connections.blogspot.com/2022/03/restoration-of-spinal-connections-in.html
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