Citation

Chio JCT, Punjani N, Hejrati N, Zavvarian MM, Hong J, Fehlings M. Antioxid. Redox Signal. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Mary Ann Liebert Publishers)

DOI

10.1089/ars.2021.0120

PMID

unavailable

Abstract

SIGNIFICANCE: Traumatic spinal cord injury (SCI) causes significant disruption of neuronal, glial, vascular and extracellular elements. The spinal cord extracellular matrix (ECM) comprises structural and communication proteins involved in reparative and regenerative processes after SCI. In the healthy spinal cord, the ECM helps maintain spinal cord homeostasis. After SCI, the damaged ECM limits plasticity and contributes to inflammation through expression of damage-associated molecules such as proteoglycans. Recent Advances: Considerable insights have been gained by characterizing the origins of the gliotic and fibrotic scars, which reduce the spread of injury but also limit neuroregeneration. These properties likely limit the success of therapies used to treat SCI patients. The ECM, which is a major contributor to the scars and normal physiological functions of the spinal cord, represents an exciting therapeutic target to enhance recovery post-SCI. Critical Issue: Various ECM-based pre-clinical therapies have been developed. These include disrupting scar components, inhibiting activity of extracellular matrix metalloproteinases and maintaining iron homeostasis. Biomaterials have also been explored. However, the majority of these treatments have not experienced successful clinical translation. This could be due to the ECM and scars' polarizing roles. FUTURE DIRECTIONS: This review surveys the complexity involved in spinal ECM modifications, discusses new ECM-based combinatorial strategies, and explore biomaterials evaluated in clinical trials which hope to introduce new treatments that enhance recovery after SCI. These topics will incorporate oxidative species, which are both beneficial and harmful in reparative and regenerative processes after SCI, and not often assessed in pertinent literature.

Language: en