SCI Treatment

The Future of SCI Treatment: Complementary Therapies

By Amaan Razi

    Traumatic spinal cord injuries have a myriad of causes and effects. In the United States, “published incidence rates for traumatic spinal-cord injury in the USA range between 28 and 55 per million people, with about 10 000 new cases reported every year” (McDonald & Sawosky 2002). McDonald & Sawosky also finds that “the estimated size of the population in the USA with traumatic spinal-cord injury is 183 000–230 000” (2002). Moreover, with such a high incidence rate, “total direct costs for all causes of SCI in the United States are $7.736 billion” (DeVivo 1997). Patients afflicted with SCI live difficult lives, are forced to pay mounting hospital fees, as well as deal with the physical negatives. Such physical effects include but are not limited to pain in the neck, head, or back, tingling/loss of sensation in extremities, and difficulty with balance and walking (AANS 2012). Due to the permanent nature of many of these afflictions, SCI-affected patients often have to deal with a lack of effective treatment.

    However, recent research progressions in neuroscience have found a new generation of promising treatments and therapies for SCI. One such treatment is outlined in the paper “The effect of a nanofiber-hydrogel composite on neural tissue repair and regeneration in the contused spinal cord” by Xiaowei et. Al.. In Xiaowei et Al.’s research, the primary focus was on nanofiber-hydrogels (NHC), and their effects on neural tissue repair. A rat with a spinal cord contusion was injected with NHC, and after 28 days, this paper found an increased width in the spinal cord, “2-fold higher M2/M1 macrophage ratio, 5-fold higher blood vessel density, 2.6-fold higher immature neuron presence, [and] 2.4-fold higher axon density” (Xiaowei et Al. 2020). However, while the composite has a high potential, it did not translate into functional recovery. Despite the lack of practical results, the gel itself has a high potential for SCI recovery treatment. 

    Another such promising treatment is described in the paper “Selective Modulation of A1 Astrocytes by Drug-Loaded Nano-Structured Gel in Spinal Cord Injury” by Vismara et Al. (2020). In this paper, researchers attempted to “formulate an effective therapy with maximum protective effects, but reduced side effects” (Vismara et Al. 2020) that utilizes the reparative properties of astrogliosis. Astrogliosis is a defense mechanism to CNS damage that “is associated with essential beneficial functions, but under specific circumstances can lead to harmful effects” (Sofroniew 2015). Vismara et Al. used a functionalized nanogel-based nanovector, selectively internalized in mouse or human astrocytes (2020). Using this nanogel, an anti-inflammatory drug known as Rolipram was administered, leading to a reversion in the “toxic effect of proinflammatory astrocytes on motor neurons in vitro, showing advantages over conventionally administered antiinflammatory therapy” (Vismara et Al. 2020). When tested on a mouse, this form of therapy leads to improved motor performance, however only in the early stages of recovery (Vismara et. Al 2020).

    While these two studies both use nanogels, they are utilized in very different ways. Xiaowei et Al.’s research uses the gel as a form of physical support, much like a steel beam to a skyscraper. Vismara et Al.’s usage is different, as it is utilized as a targeted vector for Rolipram to be delivered to astrocytes. With the field of neuroscience being as diverse and unknown as it is, it is interesting to see how these two studies in tandem may affect SCI. Using Vismara et Al.’s nanogel vector which has resulted in early-stage motor recovery as a “kickstarter”, while maintaining it with the physical rigidity provided by Xiaowei et Al.’s NHC could be a unique interaction to explore. If these two studies complement each others’ results, we could provide a feasible long-term treatment plan to the hundreds of thousands afflicted with SCI. Much like a highway being endlessly expanded, the field of neuroscience is a diverse web of concepts that we have yet to explore fully by any means. Comparing and combining experiments such as these can continue to provide us with more knowledge, and is an exciting prospect to consider. 

References :

American Association of Neurological Surgeons. Spinal cord injury facts. Retrieved March 3, 2022, from https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments

DeVivo, M. Causes and costs of spinal cord injury in the United States. Spinal Cord 35, 809–813 (1997). https://doi.org/10.1038/sj.sc.3100501

Li, Xiaowei, et al. "The effect of a nanofiber-hydrogel composite on neural tissue repair and regeneration in the contused spinal cord." Biomaterials 245 (2020): 119978. https://doi.org/10.1016/j.biomaterials.2020.119978-

McDonald, John W., and Cristina Sadowsky, “Spinal-cord injury”, The Lancet, Volume 359, Issue 9304, 2002, Pages 417-425, ISSN 0140-6736, https://doi.org/10.1016/S0140-6736(02)07603-1

Sofroniew, Michael V. “Astrogliosis.” Cold Spring Harbor perspectives in biology vol. 7,2 a020420. 7 Nov. 2014, https://doi:10.1101/cshperspect.a020420