Spinal cord injury (SCI) is a distressing incident with abrupt onset of the motor as well as sensory dysfunction, and most often, the injury occurs as result of high-energy or velocity accidents as well as contact sports and falls in the elderly. The key challenges associated with nerve repair are the lack of self-repair as well as neurotrophic factors and primary and secondary neuronal apoptosis, as well as factors that prevent the regeneration of axons locally. Neurons that survive the initial traumatic damage may be lost due to pathogenic activities like neuroinflammation and apoptosis. Implanted stem cells are capable of differentiating into neural cells that replace injured cells as well as offer local neurotrophic factors that aid neuroprotection, immunomodulation, axonal sprouting, axonal regeneration, and remyelination. At the microenvironment of SCI, stem cells are capable of producing growth factors like brain-derived neurotrophic factor and nerve growth factor which triggers neuronal survival as well as axonal regrowth. Although stem cells have proven to be of therapeutic value in SCI, the major disadvantage of some of the cell types is the risk for tumorigenicity due to the contamination of undifferentiated cells prior to transplantation. Local administration of stem cells via either direct cellular injection into the spinal cord parenchyma or intrathecal administration into the subarachnoid space is currently the best transplantation modality for stem cells during SCI.

中文翻译：

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阐明干细胞在脊髓损伤修复中的关键神经免疫调节作用


脊髓损伤（SCI）是一种令人痛苦的事件，会突然出现运动和感觉功能障碍，最常见的是，损伤是由于高能量或速度事故以及老年人的接触运动和跌倒造成的。与神经修复相关的关键挑战是缺乏自我修复以及神经营养因子和原发性和继发性神经元凋亡，以及局部阻止轴突再生的因素。在最初的创伤性损伤中幸存下来的神经元可能会因神经炎症和细胞凋亡等致病活动而丢失。植入的干细胞能够分化成替代受损细胞的神经细胞，并提供有助于神经保护、免疫调节、轴突萌芽、轴突再生和髓鞘再生的局部神经营养因子。在脊髓损伤的微环境中，干细胞能够产生脑源性神经营养因子和神经生长因子等生长因子，从而触发神经元存活和轴突再生。尽管干细胞已被证明在 SCI 中具有治疗价值，但某些细胞类型的主要缺点是由于移植前未分化细胞的污染而存在致瘤风险。通过直接细胞注射到脊髓实质或鞘内注射到蛛网膜下腔来局部施用干细胞是目前 SCI 期间干细胞的最佳移植方式。