Adipose-derived stem cell therapy for spinal cord injuries: Advances, challenges, and future directions

• Published in: Regenerative therapy Vol. 26; pp. 508 - 519
• Main Authors: Shimizu, Yusuke, Ntege, Edward Hosea, Takahara, Eisaku, Matsuura, Naoki, Matsuura, Rikako, Kamizato, Kota, Inoue, Yoshikazu, Sowa, Yoshihiro, Sunami, Hiroshi
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2024; Japanese Society for Regenerative Medicine; Elsevier
• Subjects: Adipose-derived stem cells; Cell therapy; Functional recovery; Neuroregeneration; Paralysis; Review; Spinal cord injury; lncRNAs; OECs; SVF; Cell therapy; BBB; OLCs; CNS; Adipose-derived stem cells; Spinal cord injury; DS; iPSCs; MSCs; ADSCs; ASIA; TGF-β; EPSPs; Paralysis; EVs; BDNF; BM-MSCs; VEGF; NLCs; AIS; RA; BMP4; Functional recovery; GDNF; SCI; Neuroregeneration
• ISSN: 2352-3204; 2352-3204
• DOI: 10.1016/j.reth.2024.07.007

Spinal cord injury (SCI) has limited treatment options for regaining function. Adipose-derived stem cells (ADSCs) show promise owing to their ability to differentiate into multiple cell types, promote nerve cell survival, and modulate inflammation. This review explores ADSC therapy for SCI, focusing on its potential for improving function, preclinical and early clinical trial progress, challenges, and future directions. Preclinical studies have demonstrated ADSC transplantation's effectiveness in promoting functional recovery, reducing cavity formation, and enhancing nerve regrowth and myelin repair. To improve ADSC efficacy, strategies including genetic modification and combination with rehabilitation are being explored. Early clinical trials have shown safety and feasibility, with some suggesting motor and sensory function improvements. Challenges remain for clinical translation, including optimizing cell survival and delivery, determining dosing, addressing tumor formation risks, and establishing standardized protocols. Future research should focus on overcoming these challenges and exploring the potential for combining ADSC therapy with other treatments, including rehabilitation and medication. •ADSCs are a promising regenerative therapy for spinal cord injury and paralysis.•ADSCs promote neuroregeneration through differentiation, secretion, and immunomodulation.•Preclinical studies have demonstrated the efficacy of ADSC transplantation in SCI animal models.•Early clinical trials have shown preliminary safety and feasibility of ADSC therapy in patients with SCI.•Future research should focus on optimizing ADSC therapy and exploring combinatorial approaches.