Integrative emphases on intimate intrinsic propensity/ pathological processes–causes of self recovery limits and also subtle related targets for neuroprotection/ pleiotropicity/ multimodal actions by accessible therapeutic approaches–in spinal cord injuries

摘要

>Background: The last two decades have come up with some important progresses in the genetic, immune, histochemical and bio (nano)–technological domains, that have provided new insight into cellular/ molecular mechanisms, occurring in the central nervous system (CNS) – including in spinal cord – injuries. >Methods: In previous works, emerging from our theoretical and practical endeavors in the field, we have thoroughly described the principal intimate propensity and the pathophysiological processes – representing intrinsic limitations for self–recovery after SCI, and, at the same time, subtle targets for neuroprotection/ recovery – and reviewed the main related worldwide–published reports. The aim of this paper is to emphasize the connections between such main aspects and some feasible integrative solutions, including the ones for clinical practice. >Results: Consequently, we stress upon some therapeutic suggestions regarding this subject matter by systematizing the most up to date and efficient ones – obviously, within major limits, according to the very low capacities of CNS/ spinal cord (SC) to post–injury self preserve and recover. Moreover, we also talk about accessible drugs, respectively those being already in clinical use (but at present, mainly used to treat other conditions, including the neurological ones) and hence, with relatively well known, determined effects and/or respectively, restrictions.>Discussions: The recent advances in the knowledge on the basic components of the afore mentioned CNS/ SC propensity for self destroying and inefficient endogenous repair mechanisms in the actual new context, will hopefully be, from now on, more effectively correlated with revolutionary – mostly still experimental – treatments, especially by using stem cells within tissue engineering, including, if needed, more advanced/ courageous approaches, based on somatic cell nuclear transfer (SCNT). >Conclusions: This paper contains the scientific motivated highlighting of some already available drugs, ‘neuroprotective’ (and not only) properties too, which enable practitioners with (although not yet capable to cure – but anyway) more efficient therapeutic means, to approach the extremely difficult and still painfully disappointing domain, of spinal cord injury (SCI).