"Neuroprotection and neuronal regeneration strategies for spinal cord injury; focus on the endogenous mechanisms that promote axonal regeneration in the central nervous system"

Abstract

In the present bibliographic review, we present strategies to enhance neuroprotection and nerve regeneration after spinal cord injury (SCI). Injury can occur at any level of the spinal cord and the severity of the symptoms varies depending on the location and severity of the damage. One of the main reasons that there is still no cure for SCI is the poor ability of the adult CNS to regenerate and restore function after injury. The failure of central axons to regenerate after damage is attributed to the presence of a growth inhibitory extrinsic environment and the loss of intrinsic growth capacity of these axons. This study focuses on the intrinsic regulators of neural repair of the CNS and summarizes the most important findings to date, regarding the pharmacological targeting of these factors. Intrinsic influences of neural repair include signaling pathways such as the cyclic AMP, PI3K, RhoA and JAK kinases. The endogenous ability of central neurons to regenerate is also affected by the structural elements of the cytoskeleton, namely tubulin and actin. Finally, the epigenetic regulation of molecules and transcription factors such as KLF, Sox11, LPAR1, etc. as well as the axonal transport of mitochondria appear to have a neuroprotective effect and induce axonal regeneration after SCI. Pharmacological targeting of the above intrinsic factors, in combination with the regulation of extracellular signals that inhibit regeneration, rehabilitation treatments already used in clinical practice and new experimental techniques currently being tested, may lead to a successful treatment for spinal cord injury.

PAPANIKOLAOU Irini