Science and technology have been advancing at an astonishing rate during the first two decades of the 21st century. Advancements in the fields of biology and medicine continue to improve our understanding of the limits of the human body and brain, and new research in the fields of neuroscience and psychology are prominent examples of how far we have come scientifically as a species. An area of research that has been gaining incredible insights and breakthroughs is that of repairing damage to the spinal cord, a very difficult area to tackle in regards to sever damage and rehabilitation and recovery further down the road.
Damage to the spinal cord can be more often than not fatal, and when a patient survives, their way of life is often drastically altered for the worst. However, research in animal models, primarily mice and rats, has yielded exciting results regarding the new techniques and methodologies that can help repair injured contused spinal cords, such as in the article “The effect of a nanofiber-hydrogel composite on neural tissue repair and regeneration in the contused spinal cord” by Martin Oudega and colleagues (March 2020). In this study, Oudega et al. investigated the effects of a nanofiber hydrogel composite to repair neural tissue that had been contused, or damaged, in adult rats. The composite was composed of a “thiol modified HA hydrogel phase” (Oudega et al., 2020) bound to PCL (electrospun polycapractalone) fibers. The HA hydrogel was used by the researchers due to its natural biocompatibility with the spinal cord and surrounding areas, as well as the composites overall ability to mimic the surrounding extracellular matrix (ECM) They were primarily observing the composites ability to provide mechanical strength and renewed nourishment after binding and integrating successfully with the area of the spinal cord that was damaged. Ultimately, they were able to determine that the nanofiber hydrogel composite “provided mechanical support to the contused spinal cord and supported pro-regenerative macrophage polarization, angiogenesis, axon growth, and neurogenesis in the injured tissue without any exogenous factors or cells” (Oudega et al. 2020).
More recently, as of November 2021, another major study was published by researchers and reported on by US News, from the Simpson Querrey Institute for BioNanotechnology at Northwestern University and Dr. Jeremy Steinberger, director of minimally invasive spine surgery at the Mount Sinai Health System in New York. As stated by the study lead, Samuel Stupp, their study aimed to observe the effects of an injectable therapy comprised of liquid nanofibers in the form a gel that had the ability to mesh with the damaged region of the spinal cord in adult mice. Ultimately, Stupp et al. also had promising findings in their results from the study – they found that the nanofiber gel was successful in facilitating regeneration in the severed nerves in the lab mice, with little scarring. They place emphasis on the minimal amount of scar tissue left after the nanofiber gel had run its course - "The scar is actually what causes permanent paralysis. Even though the neurons are still alive at the site where they were severed, the body produces this scar, which is a physical barrier. The axons cannot regenerate because they have a big hard scar in front of them” (Thompson, 2021). Similar to the study conducted by Oudega et al. in 2020, this study also targeted the smooth integration of the injected material with the damage site of interest in the spinal cord, as well as the high rates of regeneration with minimal scarring – both essential to healing the contusions, and for providing future support for more funding for this research – especially in humans.
Nevertheless, despite these promising results, caution must be exercised, and optimism curbed, as success in animal trials in the lab do not always translate over to success in human subjects, as emphasized by Dr. Steinberger. However, the results are still promising, and Stupp and his colleagues are attempting to take the next step and present their findings to the FDA to apply for human clinical trials. As stated previously, breakthroughs like the research described in both Oudega et al. (2020) and Stupp et al. (2021) are incredibly promising and inspiring, especially when spinal cord injuries are becoming increasingly common - According to US News, “Nearly 300,000 Americans live with a spinal cord injury today, the researchers said in background notes. Less than 3% with complete injury ever recover basic physical functions (Thompson, 2021).
Citations:
Thompson, D. (2021, November 12). Mouse study points to possible breakthrough against spinal ... U.S. News & World Report. Retrieved March 4, 2022, from https://www.usnews.com/news/health-news/articles/2021-11-12/mouse-study-points-to-possible-breakthrough-against-spinal-cord-injury
Samuel Stupp, PhD, founding director, Simpson Querrey Institute for BioNanotechnology, Northwestern University, Evanston, Ill.; Jeremy Steinberger, MD, assistant professor, neurosurgery, orthopedics and rehabilitation medicine, and director, minimally invasive spine surgery, Mount Sinai Health System, New York City; Science, Nov. 12, 2021
The effect of a nanofiber-hydrogel composite on neural tissue repair and regeneration in the contused spinal cord Xiaowei Lia,b,c,1,2 , Chi Zhanga,b,c,d,1 , Agnes E. Haggertye,1 , Jerry Yana,c,f , Michael Lana,c,f , Michelle Seua,g , Mingyu Yanga,b,c , Megan M. Marlowe , Inés Maldonado-Lasuncióne,h,i,j,k , Brian Choa,g , Zhengbing Zhoua,b,c , Long Chena,b,c , Russell Martina,b,c , Yohshiro Nitobee,l , Kentaro Yamanee,m, Hua Youn , Sashank Reddyg , Da-Ping Quand,∗ , Martin Oudegai,j,k,n,o,∗∗, Hai-Quan Maoa,b,c,f,∗∗∗
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