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World J Stem Cells. May 26, 2023; 15(5): 385-399
Published online May 26, 2023. doi: 10.4252/wjsc.v15.i5.385
Cell transplantation therapies for spinal cord injury focusing on bone marrow mesenchymal stem cells: Advances and challenges
Li-Yi Huang, Xin Sun, Hong-Xia Pan, Lu Wang, Cheng-Qi He, Quan Wei
Li-Yi Huang, Xin Sun, Hong-Xia Pan, Lu Wang, Cheng-Qi He, Quan Wei, Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu 610044, Sichuan Province, China
Author contributions: Huang LY, Sun X and Pan HX contributed equally to this work; Wei Q and He CQ designed the ideas and framework; Huang LY, Sun X and Pan HX wrote the manuscript; Wei Q revised the manuscript; and all authors have read and approve the final manuscript.
Supported by the National Key R&D Program of China, No. 2020YFC2008502.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Quan Wei, MD, PhD, Professor, Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital/West China School of Medicine, Sichuan University, No. 37 Guoxue Lane, Chengdu 610044, Sichuan Province, China. weiquan@scu.edu.cn
Received: January 12, 2023
Peer-review started: January 12, 2023
First decision: January 31, 2023
Revised: February 17, 2023
Accepted: March 21, 2023
Article in press: March 21, 2023
Published online: May 26, 2023
Processing time: 134 Days and 5.3 Hours
Abstract

Spinal cord injury (SCI) is a devastating condition with complex pathological mechanisms that lead to sensory, motor, and autonomic dysfunction below the site of injury. To date, no effective therapy is available for the treatment of SCI. Recently, bone marrow-derived mesenchymal stem cells (BMMSCs) have been considered to be the most promising source for cellular therapies following SCI. The objective of the present review is to summarize the most recent insights into the cellular and molecular mechanism using BMMSC therapy to treat SCI. In this work, we review the specific mechanism of BMMSCs in SCI repair mainly from the following aspects: Neuroprotection, axon sprouting and/or regeneration, myelin regeneration, inhibitory microenvironments, glial scar formation, immunomodulation, and angiogenesis. Additionally, we summarize the latest evidence on the application of BMMSCs in clinical trials and further discuss the challenges and future directions for stem cell therapy in SCI models.

Keywords: Spinal cord injury; Bone marrow derived mesenchymal stem cells; Neuroprotection; Axon; Myelin; Inhibitory microenvironment

Core Tip: In this work, we review the specific mechanism of bone marrow-derived mesenchymal stem cell (BMMSC) in spinal cord injury (SCI) repair mainly from the following aspects: Neuroprotection, neuronal circuit, axon sprouting and or regeneration, myelin regeneration, inhibitory microenvironment, glial scar formation, immunomodulation, and angiogenesis. Additionally, we also summarize the latest evidence on application of BMMSC in clinical trials and further discuss the challenges and future directions for stem cell therapy in SCI models.