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Adult Bone Marrow Stem Cells and Biocompatible Polymers in SCI Repair, pp. 297-320 $100.00
Authors:  A. Hejčl, P. JendelovŠ and E. SykovŠ
Spinal cord injury (SCI) is a complex and dynamic process that will require multiple
approaches to yield successful therapy. Bone marrow stem cells and biomaterials
represent an important part of SCI neurotransplantation research in the last decade. The
behavior of rat and human mesenchymal stem cells (MSCs) grafted to the injured spinal
cord has been studied in terms of the cellsí participation in lesion repair, their
differentiation and their ability to promote functional recovery. The fate of MSCs has
been followed using cells labeled in culture with superparamagnetic iron-oxide
nanoparticles. The effects of implanted rat MSCs was compared with the implantation of
a freshly prepared mononuclear fraction of bone marrow cells (BMCs) or the injection of
granulocyte colony-stimulating factor. Lesioned animals grafted with MSCs, BMCs or
treated with G-CSF had significantly smaller lesions and better motor performance. The
transplantation of MSCs in animal models of chronic SCI (which result in cavity
formation) led to only modest improvement. Autologous BMC implantation was used in
a Phase I/II clinical trial in patients with SCI. Intra-arterial vs. intravenous administration
and groups of acute vs. chronic patients were compared. Implantation was safe; in
addition, 5 out of 6 patients with a subacute cervical lesion improved their function
following the administration of BMCs via a. vertebralis.
Various biomaterials, such as hydrogels and nanofibers, have been used to bridge
large pseudocystic cavities. Scaffolds may bridge the gap left after a population of cells
is lost and may also serve as carriers for stem cells, thus supporting tissue reconstruction. Hydrogels and nanofibers based on copolymers of 2-hydroxypropylmethacrylamide and
2-hydroxyethylmethacrylate were implanted in animals with SCI to provide a bridge
across the pseudocystic cavity and to serve as a scaffold for tissue regeneration. Various
physical and chemical modifications of these scaffolds, which were evaluated in vivo, are
discussed. Both therapeutic modalities, i.e. MSCs and hydrogels, can be applied together
to combine the advantages of both therapeutic approaches. Hydrogels were used as 3D
carriers for stem cells and implanted into acute spinal cord lesions. Various hydrogels are
suitable as carriers of MSCs and/or other stem cells, as the cells survived in the hydrogels
for several months. Further, these hydrogel constructs (hydrogel+MSCs) were also tested
in an animal model of chronic SCI. The hydrogel constructs seeded with MSCs created a
successful bridge, preventing tissue atrophy and improving functional outcome. 

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Adult Bone Marrow Stem Cells and Biocompatible Polymers in SCI Repair, pp. 297-320