Neurotrophic factors, cellular bridges and gene therapy for spinal cord injury

Injury to the adult mammalian spinal cord results in extensive axonal degen eration, variable amounts of neuronal loss, and often severe functional def icits. Restoration of controlled function depends on regeneration of these axons through an injury site and the formation of functional synaptic conne ctions. One strategy that has emerged for promoting axonal regeneration aft er spinal cord injury is the implantation of autologous Schwann cells into sites of spinal cord injury to support and guide axonal growth. Further, mo re recent experiments have shown that neurotrophic factors can also promote axonal growth, and, when combined with Schwann cell grafts, can further am plify axonal extension after injury. Continued preclinical development of t hese approaches to neural repair may ultimately generate strategies that co uld be tested in human injury.