About this Research Topic
A spinal cord injury (SCI) disrupts axonal tracts and results in a permanent loss of bodily functions. Hence, the basic premise for repair of an injured spinal cord is simple: regrow and reconnect the severed axon tracts, or harness spared neural circuitry, so that signals from brain to the body, and vice versa, are restored. Perhaps unsurprisingly, research on the neurobiology of the spinal cord, the various and progressive pathologies after injury, and proposed experimental treatment strategies, have shown that achieving meaningful functional recovery is not that simple. The injured spinal cord is a complex environment and the difficulties preventing restoration of function and regeneration are numerous.
While a number of promising clinical trials are ongoing, we remain without therapeutic treatment that can improve or restore lost functions for any type of injury to the spinal cord. Nonetheless, continuous progress is made to understand details of the spinal cord’s neurobiology, pathology, and thus generate potential treatments. For example, we have found new cellular targets that reduce scar formation, found that various motor and sensory circuitry require different gene activation for repair, and discovered that the inflammatory reactions following SCI are multifaceted with both negative and positive effects on spinal cord repair. While experimentally assessing various therapeutic implementations, we have also discovered the challenges of implementing such strategies for differing types of SCI. For example, it is unclear how best to apply transplant treatments when there is cyst or dense scar formation at the injury site. In summary, SCI’s are diverse as are the treatments applied to them and their effects. Opinions vary in terms of what is the correct course of action for spinal cord injury repair. Further, our increasing understanding of SCI pathology in rodent models dwarfs our understanding of that in humans and remains an additional concern for selecting the appropriate treatment or treatment implementation.
For this Research Topic, we are interested in highlighting the diverse nature of SCI’s experimentally and within the clinical patient population and their (potential) role in functional outcome. What makes a treatment strategy suitable to address one or several injury-related challenges? Example of macroscopic injury-related challenges are spinal location, time after injury, size of injury, background factors (age, drug-use, autoimmune diseases, health, man/woman, etc), and injury-type (penetrating/non-penetrating etc). However, there are several other challenges related to cellular and molecular aspects of the injury, as well as the treatment strategies themselves. Overall, this topic aims to highlight the discoveries that have changed our understanding of the problem at hand, what has been successful, and what remain unanswered questions with regard to injury-related challenges to the treatment/repair of the spinal cord.
While a number of promising clinical trials are ongoing, we remain without therapeutic treatment that can improve or restore lost functions for any type of injury to the spinal cord. Nonetheless, continuous progress is made to understand details of the spinal cord’s neurobiology, pathology, and thus generate potential treatments. For example, we have found new cellular targets that reduce scar formation, found that various motor and sensory circuitry require different gene activation for repair, and discovered that the inflammatory reactions following SCI are multifaceted with both negative and positive effects on spinal cord repair. While experimentally assessing various therapeutic implementations, we have also discovered the challenges of implementing such strategies for differing types of SCI. For example, it is unclear how best to apply transplant treatments when there is cyst or dense scar formation at the injury site. In summary, SCI’s are diverse as are the treatments applied to them and their effects. Opinions vary in terms of what is the correct course of action for spinal cord injury repair. Further, our increasing understanding of SCI pathology in rodent models dwarfs our understanding of that in humans and remains an additional concern for selecting the appropriate treatment or treatment implementation.
For this Research Topic, we are interested in highlighting the diverse nature of SCI’s experimentally and within the clinical patient population and their (potential) role in functional outcome. What makes a treatment strategy suitable to address one or several injury-related challenges? Example of macroscopic injury-related challenges are spinal location, time after injury, size of injury, background factors (age, drug-use, autoimmune diseases, health, man/woman, etc), and injury-type (penetrating/non-penetrating etc). However, there are several other challenges related to cellular and molecular aspects of the injury, as well as the treatment strategies themselves. Overall, this topic aims to highlight the discoveries that have changed our understanding of the problem at hand, what has been successful, and what remain unanswered questions with regard to injury-related challenges to the treatment/repair of the spinal cord.
Keywords: Spinal cord injury, spinal cord repair, translational medicine, treatment strategy, secondary injury
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
