TRANSLATION OF LABORATORY RESEARCH INTO CLINICAL PRACTICE

摘要

There are very many interventions that have been shown to improve histological and/or functional outcome after SCI in experimental rodents. These findings have of course engendered a great deal of optimism that it might be possible to translate the experimental interventions into clinical therapies. However, there are many steps that must be made to fill this gap1, but the key data relate to four issues: 1. Will the interventions used successfully in rodents also promote recovery in 'higher' mammals(notably primates)? This question centres on the differences in anatomy between species, especially the dominance of corticospinal tract function over motor control in humans. 2. There is a size difference between experimental rodents and other species;the necessary 'scaling up' may vary in complexity depending on whether dealing with an administered drug or cell transplantation. 3. Experimental lesions are designed to be homogenous (see also point 4 below), whereas all clinical classification schemeswill inherently permit a degree of (often unknowable) heterogeneity. 4. There is a difference between defining a statistical difference to prove a principle and finding an effect that is medically relevant.