Regenerative therapy for central nervous system trauma

Abstract

Functional regeneration and not merely structural restoration is important in the central nervous system (CNS) following loss of tissue due to trauma. Spontaneous regeneration in the CNS is poor due to a number of reasons, mainly the presence of inhibitory factors. This chapter will start with a review some of the mechanisms of this inhibition, which form the basis of strategies to promote regeneration in the CNS. Degradation of inhibitors such as chondroitin sulfate proteoglycans in the glial scar at the site of spinal cord injury by application of chondroitinase ABC promotes regeneration of corticospinal tract axons in experimental animals. Inhibitors of axonal regeneration in myelin include Nogo, myelin-associated glycoprotein, and oligodendrocyte myelin glycoprotein. These can be blocked with antibodies or peptides to facilitate regeneration. Developments in nanobiotechnology and nanomedicines also show potential for CNS repair. However the experimental work in CNS regeneration has not yet been translated into clinical use. Combination of approaches, including stem cell transplantation with nanoscaffolds, supplemented with pharmacological enhancement of regeneration and physical therapies are promising for functional regeneration of the CNS following trauma.