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      Human Spinal Oligodendrogenic Neural Progenitor Cells Promote Functional Recovery After Spinal Cord Injury by Axonal Remyelination and Tissue Sparing

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          Abstract

          Cell transplantation therapy utilizing neural precursor cells (NPCs) is a conceptually attractive strategy for traumatic spinal cord injury (SCI) to replace lost cells, remyelinate denuded host axons and promote tissue sparing. However, the number of mature oligodendrocytes that differentiate from typical NPCs remains limited. Herein, we describe a novel approach to bias the differentiation of directly reprogrammed human NPCs (drNPCs) toward a more oligodendrogenic fate (oNPCs) while preserving their tripotency. The oNPCs derived from different lines of human NPCs showed similar characteristics in vitro. To assess the in vivo efficacy of this approach, we used oNPCs derived from drNPCs and transplanted them into a SCI model in immunodeficient Rowett Nude (RNU) rats. The transplanted cells showed significant migration along the rostrocaudal axis and proportionally greater differentiation into oligodendrocytes. These cells promoted perilesional tissue sparing and axonal remyelination, which resulted in recovery of motor function. Moreover, after transplantation of the oNPCs into intact spinal cords of immunodeficient NOD/SCID mice, we detected no evidence of tumor formation even after 5 months of observation. Thus, biasing drNPC differentiation along an oligodendroglial lineage represents a promising approach to promote tissue sparing, axonal remyelination, and neural repair after traumatic SCI. stem cells translational medicine 2018;7:806–818

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          Most cited references37

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          Epidemiology, demographics, and pathophysiology of acute spinal cord injury.

          Spinal cord injury occurs through various countries throughout the world with an annual incidence of 15 to 40 cases per million, with the causes of these injuries ranging from motor vehicle accidents and community violence to recreational activities and workplace-related injuries. Survival has improved along with a greater appreciation of patterns of presentation, survival, and complications. Despite much work having been done, the only treatment to date known to ameliorate neurologic dysfunction that occurs at or below the level of neurologic injury has been intravenous methylprednisolone therapy. Much research over the past 30 to 40 years has focused on elucidating the mechanisms of spinal cord injury, with the complex pathophysiologic processes slowly being unraveled. With a greater understanding of both primary and secondary mechanisms of injury, the roles of calcium, free radicals, sodium, excitatory amino acids, vascular mediators, and apoptosis have been elucidated. This review examines the epidemiology, demographics, and pathophysiology of acute spinal cord injury.
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            A systematic review of cellular transplantation therapies for spinal cord injury.

            Cell transplantation therapies have become a major focus in pre-clinical research as a promising strategy for the treatment of spinal cord injury (SCI). In this article, we systematically review the available pre-clinical literature on the most commonly used cell types in order to assess the body of evidence that may support their translation to human SCI patients. These cell types include Schwann cells, olfactory ensheathing glial cells, embryonic and adult neural stem/progenitor cells, fate-restricted neural/glial precursor cells, and bone-marrow stromal cells. Studies were included for review only if they described the transplantation of the cell substrate into an in-vivo model of traumatic SCI, induced either bluntly or sharply. Using these inclusion criteria, 162 studies were identified and reviewed in detail, emphasizing their behavioral effects (although not limiting the scope of the discussion to behavioral effects alone). Significant differences between cells of the same "type" exist based on the species and age of donor, as well as culture conditions and mode of delivery. Many of these studies used cell transplantations in combination with other strategies. The systematic review makes it very apparent that cells derived from rodent sources have been the most extensively studied, while only 19 studies reported the transplantation of human cells, nine of which utilized bone-marrow stromal cells. Similarly, the vast majority of studies have been conducted in rodent models of injury, and few studies have investigated cell transplantation in larger mammals or primates. With respect to the timing of intervention, nearly all of the studies reviewed were conducted with transplantations occurring subacutely and acutely, while chronic treatments were rare and often failed to yield functional benefits.
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              Allodynia limits the usefulness of intraspinal neural stem cell grafts; directed differentiation improves outcome.

              Several studies have reported functional improvement after transplantation of neural stem cells into injured spinal cord. We now provide evidence that grafting of adult neural stem cells into a rat thoracic spinal cord weight-drop injury improves motor recovery but also causes aberrant axonal sprouting associated with allodynia-like hypersensitivity of forepaws. Transduction of neural stem cells with neurogenin-2 before transplantation suppressed astrocytic differentiation of engrafted cells and prevented graft-induced sprouting and allodynia. Transduction with neurogenin-2 also improved the positive effects of engrafted stem cells, including increased amounts of myelin in the injured area, recovery of hindlimb locomotor function and hindlimb sensory responses, as determined by functional magnetic resonance imaging. These findings show that stem cell transplantation into injured spinal cord can cause severe side effects and call for caution in the consideration of clinical trials.
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                Author and article information

                Contributors
                michael.fehlings@uhn.on.ca
                Journal
                Stem Cells Transl Med
                Stem Cells Transl Med
                10.1002/(ISSN)2157-6580
                SCT3
                Stem Cells Translational Medicine
                John Wiley & Sons, Inc. (Hoboken, USA )
                2157-6564
                2157-6580
                07 August 2018
                November 2018
                : 7
                : 11 ( doiID: 10.1002/sct3.2018.7.issue-11 )
                : 806-818
                Affiliations
                [ 1 ] Division of Genetics and Development Krembil Research Institute, University Health Network Toronto Ontario Canada
                [ 2 ] Department of Orthopaedic Surgery Keio University School of Medicine Tokyo Japan
                [ 3 ] New World Laboratories Laval Quebec Canada
                [ 4 ] Institute of Medical Sciences, University of Toronto Toronto Ontario Canada
                [ 5 ] Department of Surgery and Spine Program University of Toronto Toronto Ontario Canada
                [ 6 ] Electron Microscope Laboratory Keio University School of Medicine Tokyo Japan
                Author notes
                [*] [* ]Correspondence: Michael G. Fehlings, M.D., Ph.D., FRCSC, FACS, University of Toronto, 399 Bathurst St, Toronto Western Hospital, Toronto, Ontario M5T 2S8, Canada. Telephone: 1‐416‐603‐5298, Fax: 1‐416‐603‐5298. E‐Mail: michael.fehlings@ 123456uhn.on.ca
                [†]

                Contributed equally.

                Author information
                http://orcid.org/0000-0002-5722-6364
                Article
                SCT312349
                10.1002/sctm.17-0269
                6216444
                30085415
                a6e2c216-da50-4ac3-8e1e-2acdcc877e86
                © 2018 The Authors stem cells translational medicine published by Wiley Periodicals, Inc. on behalf of AlphaMed Press

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 17 November 2017
                : 01 May 2018
                : 05 June 2018
                Page count
                Figures: 8, Tables: 0, Pages: 13, Words: 9387
                Funding
                Funded by: Krembil Foundation
                Funded by: Dezwirek Foundation
                Funded by: Canadian Institutes of Health Research (CIHR)
                Funded by: Industry Sponsored Collaborative Research Grant with New World Laboratories, Inc.
                Categories
                Tissue‐Specific Progenitor and Stem Cells
                Translational Research Articles and Reviews
                Tissue‐Specific Progenitor and Stem Cells
                Custom metadata
                2.0
                sct312349
                November 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.5.1 mode:remove_FC converted:05.11.2018

                stem cells,spinal cord injury,oligodendrogenic neural progenitor cells,remyelination,regeneration,oligodendrocytes

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