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Sousa CS, Monteiro A, Salgado AJ, Silva NA. Combinatorial therapies for spinal cord injury repair. Neural Regen Res 2025; 20:1293-1308. [PMID: 38845223 DOI: 10.4103/nrr.nrr-d-24-00061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/02/2024] [Indexed: 07/31/2024] Open
Abstract
Spinal cord injuries have profound detrimental effects on individuals, regardless of whether they are caused by trauma or non-traumatic events. The compromised regeneration of the spinal cord is primarily attributed to damaged neurons, inhibitory molecules, dysfunctional immune response, and glial scarring. Unfortunately, currently, there are no effective treatments available that can fully repair the spinal cord and improve functional outcomes. Nevertheless, numerous pre-clinical approaches have been studied for spinal cord injury recovery, including using biomaterials, cells, drugs, or technological-based strategies. Combinatorial treatments, which target various aspects of spinal cord injury pathophysiology, have been extensively tested in the last decade. These approaches aim to synergistically enhance repair processes by addressing various obstacles faced during spinal cord regeneration. Thus, this review intends to provide scientists and clinicians with an overview of pre-clinical combinatorial approaches that have been developed toward the solution of spinal cord regeneration as well as update the current knowledge about spinal cord injury pathophysiology with an emphasis on the current clinical management.
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Affiliation(s)
- Carla S Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar - gualtar, Braga, Portugal
- ICVS/3B's Associate Lab, PT Government Associated Lab, Campus de Gualtar - gualtar, Braga, Portugal
| | - Andreia Monteiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar - gualtar, Braga, Portugal
- ICVS/3B's Associate Lab, PT Government Associated Lab, Campus de Gualtar - gualtar, Braga, Portugal
| | - António J Salgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar - gualtar, Braga, Portugal
- ICVS/3B's Associate Lab, PT Government Associated Lab, Campus de Gualtar - gualtar, Braga, Portugal
| | - Nuno A Silva
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar - gualtar, Braga, Portugal
- ICVS/3B's Associate Lab, PT Government Associated Lab, Campus de Gualtar - gualtar, Braga, Portugal
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2
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Hosseini SM, Borys B, Karimi-Abdolrezaee S. Neural stem cell therapies for spinal cord injury repair: an update on recent preclinical and clinical advances. Brain 2024; 147:766-793. [PMID: 37975820 DOI: 10.1093/brain/awad392] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/22/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023] Open
Abstract
Traumatic spinal cord injury (SCI) is a leading cause of lifelong disabilities. Permanent sensory, motor and autonomic impairments after SCI are substantially attributed to degeneration of spinal cord neurons and axons, and disintegration of neural network. To date, minimal regenerative treatments are available for SCI with an unmet need for new therapies to reconstruct the damaged spinal cord neuron-glia network and restore connectivity with the supraspinal pathways. Multipotent neural precursor cells (NPCs) have a unique capacity to generate neurons, oligodendrocytes and astrocytes. Due to this capacity, NPCs have been an attractive cell source for cellular therapies for SCI. Transplantation of NPCs has been extensively tested in preclinical models of SCI in the past two decades. These studies have identified opportunities and challenges associated with NPC therapies. While NPCs have the potential to promote neuroregeneration through various mechanisms, their low long-term survival and integration within the host injured spinal cord limit the functional benefits of NPC-based therapies for SCI. To address this challenge, combinatorial strategies have been developed to optimize the outcomes of NPC therapies by enriching SCI microenvironment through biomaterials, genetic and pharmacological therapies. In this review, we will provide an in-depth discussion on recent advances in preclinical NPC-based therapies for SCI. We will discuss modes of actions and mechanism by which engrafted NPCs contribute to the repair process and functional recovery. We will also provide an update on current clinical trials and new technologies that have facilitated preparation of medical-grade human NPCs suitable for transplantation in clinical studies.
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Affiliation(s)
- Seyed Mojtaba Hosseini
- Department of Physiology and Pathophysiology, Spinal Cord Research Centre, Rady Faculty of Health Sciences, University of Manitoba Winnipeg, Manitoba R3E 0J9, Canada
- Manitoba Multiple Sclerosis Research Center, Winnipeg, Manitoba R3E 0J9, Canada
| | - Ben Borys
- Department of Physiology and Pathophysiology, Spinal Cord Research Centre, Rady Faculty of Health Sciences, University of Manitoba Winnipeg, Manitoba R3E 0J9, Canada
| | - Soheila Karimi-Abdolrezaee
- Department of Physiology and Pathophysiology, Spinal Cord Research Centre, Rady Faculty of Health Sciences, University of Manitoba Winnipeg, Manitoba R3E 0J9, Canada
- Manitoba Multiple Sclerosis Research Center, Winnipeg, Manitoba R3E 0J9, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba R3E 3P4, Canada
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3
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Suzuki H, Imajo Y, Funaba M, Ikeda H, Nishida N, Sakai T. Current Concepts of Biomaterial Scaffolds and Regenerative Therapy for Spinal Cord Injury. Int J Mol Sci 2023; 24:ijms24032528. [PMID: 36768846 PMCID: PMC9917245 DOI: 10.3390/ijms24032528] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 02/03/2023] Open
Abstract
Spinal cord injury (SCI) is a catastrophic condition associated with significant neurological deficit and social and financial burdens. It is currently being managed symptomatically, with no real therapeutic strategies available. In recent years, a number of innovative regenerative strategies have emerged and have been continuously investigated in preclinical research and clinical trials. In the near future, several more are expected to come down the translational pipeline. Among ongoing and completed trials are those reporting the use of biomaterial scaffolds. The advancements in biomaterial technology, combined with stem cell therapy or other regenerative therapy, can now accelerate the progress of promising novel therapeutic strategies from bench to bedside. Various types of approaches to regeneration therapy for SCI have been combined with the use of supportive biomaterial scaffolds as a drug and cell delivery system to facilitate favorable cell-material interactions and the supportive effect of neuroprotection. In this review, we summarize some of the most recent insights of preclinical and clinical studies using biomaterial scaffolds in regenerative therapy for SCI and summarized the biomaterial strategies for treatment with simplified results data. One hundred and sixty-eight articles were selected in the present review, in which we focused on biomaterial scaffolds. We conducted our search of articles using PubMed and Medline, a medical database. We used a combination of "Spinal cord injury" and ["Biomaterial", or "Scaffold"] as search terms and searched articles published up until 30 April 2022. Successful future therapies will require these biomaterial scaffolds and other synergistic approaches to address the persistent barriers to regeneration, including glial scarring, the loss of a structural framework, and biocompatibility. This database could serve as a benchmark to progress in future clinical trials for SCI using biomaterial scaffolds.
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Multimodular Bio-Inspired Organized Structures Guiding Long-Distance Axonal Regeneration. Biomedicines 2022; 10:biomedicines10092228. [PMID: 36140328 PMCID: PMC9496454 DOI: 10.3390/biomedicines10092228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022] Open
Abstract
Axonal bundles or axonal tracts have an aligned and unidirectional architecture present in many neural structures with different lengths. When peripheral nerve injury (PNI), spinal cord injury (SCI), traumatic brain injury (TBI), or neurodegenerative disease occur, the intricate architecture undergoes alterations leading to growth inhibition and loss of guidance through large distance. In order to overcome the limitations of long-distance axonal regeneration, here we combine a poly-L-lactide acid (PLA) fiber bundle in the common lumen of a sequence of hyaluronic acid (HA) conduits or modules and pre-cultured Schwann cells (SC) as cells supportive of axon extension. This multimodular preseeded conduit is then used to induce axon growth from a dorsal root ganglion (DRG) explant placed at one of its ends and left for 21 days to follow axon outgrowth. The multimodular conduit proved effective in promoting directed axon growth, and the results may thus be of interest for the regeneration of long tissue defects in the nervous system. Furthermore, the hybrid structure grown within the HA modules consisting in the PLA fibers and the SC can be extracted from the conduit and cultured independently. This “neural cord” proved to be viable outside its scaffold and opens the door to the generation of ex vivo living nerve in vitro for transplantation.
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Fibrotic Scar in CNS Injuries: From the Cellular Origins of Fibroblasts to the Molecular Processes of Fibrotic Scar Formation. Cells 2022; 11:cells11152371. [PMID: 35954214 PMCID: PMC9367779 DOI: 10.3390/cells11152371] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/29/2022] [Accepted: 07/30/2022] [Indexed: 02/06/2023] Open
Abstract
Central nervous system (CNS) trauma activates a persistent repair response that leads to fibrotic scar formation within the lesion. This scarring is similar to other organ fibrosis in many ways; however, the unique features of the CNS differentiate it from other organs. In this review, we discuss fibrotic scar formation in CNS trauma, including the cellular origins of fibroblasts, the mechanism of fibrotic scar formation following an injury, as well as the implication of the fibrotic scar in CNS tissue remodeling and regeneration. While discussing the shared features of CNS fibrotic scar and fibrosis outside the CNS, we highlight their differences and discuss therapeutic targets that may enhance regeneration in the CNS.
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6
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Li JJ, Liu H, Zhu Y, Yan L, Liu R, Wang G, Wang B, Zhao B. Animal Models for Treating Spinal Cord Injury Using Biomaterials-Based Tissue Engineering Strategies. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:79-100. [PMID: 33267667 DOI: 10.1089/ten.teb.2020.0267] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Jiao Jiao Li
- School of Biomedical Engineering, Faculty of Engineering and IT, University of Technology Sydney, Ultimo, Australia
| | - Haifeng Liu
- Department of Orthopedics and Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
| | - Yuanyuan Zhu
- Department of Pharmacy, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
| | - Lei Yan
- Department of Orthopedics and Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
| | - Ruxing Liu
- Department of Orthopedics and Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
| | - Guishan Wang
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, China
| | - Bin Wang
- Department of Orthopedics and Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
- Department of Sports Medicine and Adult Reconstruction Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Bin Zhao
- Department of Orthopedics and Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
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7
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Sánchez-Torres S, Díaz-Ruíz A, Ríos C, Olayo MG, Cruz GJ, Olayo R, Morales J, Mondragón-Lozano R, Fabela-Sánchez O, Orozco-Barrios C, Coyoy-Salgado A, Orozco-Suárez S, González-Ruiz C, Álvarez-Mejía L, Morales-Guadarrama A, Buzoianu-Anguiano V, Damián-Matsumura P, Salgado-Ceballos H. Recovery of motor function after traumatic spinal cord injury by using plasma-synthesized polypyrrole/iodine application in combination with a mixed rehabilitation scheme. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2020; 31:58. [PMID: 32607849 DOI: 10.1007/s10856-020-06395-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
Traumatic spinal cord injury (TSCI) can cause paralysis and permanent disability. Rehabilitation (RB) is currently the only accepted treatment, although its beneficial effect is limited. The development of biomaterials has provided therapeutic possibilities for TSCI, where our research group previously showed that the plasma-synthesized polypyrrole/iodine (PPy/I), a biopolymer with different physicochemical characteristics than those of the PPy synthesized by conventional methods, promotes recovery of motor function after TSCI. The present study evaluated if the plasma-synthesized PPy/I applied in combination with RB could increase its beneficial effects and the mechanisms involved. Adult rats with TSCI were divided into no treatment (control); biopolymer (PPy/I); mixed RB by swimming and enriched environment (SW/EE); and combined treatment (PPy/I + SW/EE) groups. Eight weeks after TSCI, the general health of the animals that received any of the treatments was better than the control animals. Functional recovery evaluated by two scales was better and was achieved in less time with the PPy/I + SW/EE combination. All treatments significantly increased βIII-tubulin (nerve plasticity) expression, but only PPy/I increased GAP-43 (nerve regeneration) and MBP (myelination) expression when were analyzed by immunohistochemistry. The expression of GFAP (glial scar) decreased in treated groups when determined by histochemistry, while morphometric analysis showed that tissue was better preserved when PPy/I and PPy/I + SW/EE were administered. The application of PPy/I + SW/EE, promotes the preservation of nervous tissue, and the expression of molecules related to plasticity as βIII-tubulin, reduces the glial scar, improves general health and allows the recovery of motor function after TSCI. The implant of the biomaterial polypyrrole/iodine (PPy/I) synthesized by plasma (an unconventional synthesis method), in combination with a mixed rehabilitation scheme with swimming and enriched environment applied after a traumatic spinal cord injury, promotes expression of GAP-43 and βIII-tubulin (molecules related to plasticity and nerve regeneration) and reduces the expression of GFAP (molecule related to the formation of the glial scar). Both effects together allow the formation of nerve fibers, the reconnection of the spinal cord in the area of injury and the recovery of lost motor function. The figure shows the colocalization (yellow) of βIII-tubilin (red) and GAP-43 (green) in fibers crossing the epicenter of the injury (arrowheads) that reconnect the rostral and caudal ends of the injured spinal cord and allowed recovery of motor function.
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Affiliation(s)
- Stephanie Sánchez-Torres
- Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI. Av. Cuauhtémoc 330, Col. Doctores, México City, CP, 06720, México
- Doctorate in Biological and Health Sciences, Universidad Autónoma Metropolitana, Iztapalapa, Mexico City, CP, 09340, Mexico
- Proyecto Camina A.C. Research Center, Mexico City, CP, 14050, Mexico
| | - Araceli Díaz-Ruíz
- Departamento de Neuroquímica, Instituto Nacional de Neurología y Neurocirugía, Manuel Velasco Suárez S.S.A, Mexico city, CP, 14269, Mexico
| | - Camilo Ríos
- Departamento de Neuroquímica, Instituto Nacional de Neurología y Neurocirugía, Manuel Velasco Suárez S.S.A, Mexico city, CP, 14269, Mexico
| | - María G Olayo
- Departamento de Física, Instituto Nacional de Investigaciones Nucleares. Carretera Mexico-Toluca, km 36.5, Ocoyoacac, State of Mexico, CP, 52750, Mexico
| | - Guillermo J Cruz
- Departamento de Física, Instituto Nacional de Investigaciones Nucleares. Carretera Mexico-Toluca, km 36.5, Ocoyoacac, State of Mexico, CP, 52750, Mexico
| | - Roberto Olayo
- Departamento de Física, Universidad Autónoma Metropolitana, Mexico City, CP, 09340, Mexico
| | - Juan Morales
- Departamento de Física, Universidad Autónoma Metropolitana, Mexico City, CP, 09340, Mexico
| | - Rodrigo Mondragón-Lozano
- Proyecto Camina A.C. Research Center, Mexico City, CP, 14050, Mexico
- CONACyT-Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
| | - Omar Fabela-Sánchez
- Proyecto Camina A.C. Research Center, Mexico City, CP, 14050, Mexico
- Departamento de Ingeniería Eléctrica, Universidad Autónoma Metropolitana, San Rafael Atlixco 186, 09340, Iztapalapa, CDMX, México
- Catedrático CONACyT-Centro de Investigación en Química Aplicada, Enrique Reyna H. No. 140, San José de los Cerritos, Saltillo, Coahuila, 25294, México
| | - Carlos Orozco-Barrios
- Proyecto Camina A.C. Research Center, Mexico City, CP, 14050, Mexico
- CONACyT-Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
| | - Angélica Coyoy-Salgado
- Proyecto Camina A.C. Research Center, Mexico City, CP, 14050, Mexico
- CONACyT-Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
| | - Sandra Orozco-Suárez
- Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI. Av. Cuauhtémoc 330, Col. Doctores, México City, CP, 06720, México
| | - Cristian González-Ruiz
- Proyecto Camina A.C. Research Center, Mexico City, CP, 14050, Mexico
- Escuela Superior de Medicina-Instituto Politécnico Nacional, Mexico City, Mexico
| | - Laura Álvarez-Mejía
- Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI. Av. Cuauhtémoc 330, Col. Doctores, México City, CP, 06720, México
- Proyecto Camina A.C. Research Center, Mexico City, CP, 14050, Mexico
- Departamento de Física, Instituto Nacional de Investigaciones Nucleares. Carretera Mexico-Toluca, km 36.5, Ocoyoacac, State of Mexico, CP, 52750, Mexico
| | | | - Vinnitsa Buzoianu-Anguiano
- Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI. Av. Cuauhtémoc 330, Col. Doctores, México City, CP, 06720, México
| | - Pablo Damián-Matsumura
- Doctorate in Biological and Health Sciences, Universidad Autónoma Metropolitana, Iztapalapa, Mexico City, CP, 09340, Mexico
| | - Hermelinda Salgado-Ceballos
- Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI. Av. Cuauhtémoc 330, Col. Doctores, México City, CP, 06720, México.
- Proyecto Camina A.C. Research Center, Mexico City, CP, 14050, Mexico.
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Bonaventura G, Iemmolo R, La Cognata V, Zimbone M, La Via F, Fragalà ME, Barcellona ML, Pellitteri R, Cavallaro S. Biocompatibility between Silicon or Silicon Carbide surface and Neural Stem Cells. Sci Rep 2019; 9:11540. [PMID: 31395932 PMCID: PMC6687690 DOI: 10.1038/s41598-019-48041-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 07/05/2019] [Indexed: 01/09/2023] Open
Abstract
Silicon has been widely used as a material for microelectronic for more than 60 years, attracting considerable scientific interest as a promising tool for the manufacture of implantable medical devices in the context of neurodegenerative diseases. However, the use of such material involves responsibilities due to its toxicity, and researchers are pushing towards the generation of new classes of composite semiconductors, including the Silicon Carbide (3C-SiC). In the present work, we tested the biocompatibility of Silicon and 3C-SiC using an in vitro model of human neuronal stem cells derived from dental pulp (DP-NSCs) and mouse Olfactory Ensheathing Cells (OECs), a particular glial cell type showing stem cell characteristics. Specifically, we investigated the effects of 3C-SiC on neural cell morphology, viability and mitochondrial membrane potential. Data showed that both DP-NSCs and OECs, cultured on 3C-SiC, did not undergo consistent oxidative stress events and did not exhibit morphological modifications or adverse reactions in mitochondrial membrane potential. Our findings highlight the possibility to use Neural Stem Cells plated on 3C-SiC substrate as clinical tool for lesioned neural areas, paving the way for future perspectives in novel cell therapies for neuro-degenerated patients.
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Affiliation(s)
- Gabriele Bonaventura
- Institute for Biomedical Research and Innovation, Italian National Research Council, Catania, Italy
| | - Rosario Iemmolo
- Institute for Biomedical Research and Innovation, Italian National Research Council, Catania, Italy
| | - Valentina La Cognata
- Institute for Biomedical Research and Innovation, Italian National Research Council, Catania, Italy
| | - Massimo Zimbone
- Institute for Microelectronics and Microsystems, Italian National Research Council, Catania, Italy
| | - Francesco La Via
- Institute for Microelectronics and Microsystems, Italian National Research Council, Catania, Italy
| | | | | | - Rosalia Pellitteri
- Institute for Biomedical Research and Innovation, Italian National Research Council, Catania, Italy
| | - Sebastiano Cavallaro
- Institute for Biomedical Research and Innovation, Italian National Research Council, Catania, Italy.
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9
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Altinova H, Hammes S, Palm M, Gerardo-Nava J, Achenbach P, Deumens R, Hermans E, Führmann T, Boecker A, van Neerven SGA, Bozkurt A, Weis J, Brook GA. Fibroadhesive scarring of grafted collagen scaffolds interferes with implant-host neural tissue integration and bridging in experimental spinal cord injury. Regen Biomater 2019; 6:75-87. [PMID: 30967962 PMCID: PMC6447003 DOI: 10.1093/rb/rbz006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/06/2019] [Indexed: 02/06/2023] Open
Abstract
Severe traumatic spinal cord injury (SCI) results in a devastating and permanent loss of function, and is currently an incurable condition. It is generally accepted that future intervention strategies will require combinational approaches, including bioengineered scaffolds, to support axon growth across tissue scarring and cystic cavitation. Previously, we demonstrated that implantation of a microporous type-I collagen scaffold into an experimental model of SCI was capable of supporting functional recovery in the absence of extensive implant–host neural tissue integration. Here, we demonstrate the reactive host cellular responses that may be detrimental to neural tissue integration after implantation of collagen scaffolds into unilateral resection injuries of the adult rat spinal cord. Immunohistochemistry demonstrated scattered fibroblast-like cell infiltration throughout the scaffolds as well as the presence of variable layers of densely packed cells, the fine processes of which extended along the graft–host interface. Few reactive astroglial or regenerating axonal profiles could be seen traversing this layer. Such encapsulation-type behaviour around bioengineered scaffolds impedes the integration of host neural tissues and reduces the intended bridging role of the implant. Characterization of the cellular and molecular mechanisms underpinning this behaviour will be pivotal in the future design of collagen-based bridging scaffolds intended for regenerative medicine.
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Affiliation(s)
- Haktan Altinova
- Department of Neurosurgery, RWTH Aachen University Hospital, Aachen, Germany.,Institute of Neuropathology, RWTH Aachen University Hospital, Aachen, Germany.,Police Headquarters Berlin, Medical Commission, Berlin, Germany
| | - Sebastian Hammes
- Institute of Neuropathology, RWTH Aachen University Hospital, Aachen, Germany
| | - Moniek Palm
- Institute of Neuropathology, RWTH Aachen University Hospital, Aachen, Germany
| | - Jose Gerardo-Nava
- Institute of Neuropathology, RWTH Aachen University Hospital, Aachen, Germany
| | - Pascal Achenbach
- Institute of Neuropathology, RWTH Aachen University Hospital, Aachen, Germany
| | - Ronald Deumens
- Institute of Neuropathology, RWTH Aachen University Hospital, Aachen, Germany.,Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Emmanuel Hermans
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Tobias Führmann
- Donnelly Centre for Cellular & Biomolecular Research, University of Toronto, Toronto, Canada
| | - Arne Boecker
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Centre Trauma Centre, BG Trauma Centre Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.,Department of Plastic, Reconstructive and Hand Surgery, Burn Centre, RWTH Aachen University Hospital, Aachen, Germany
| | - Sabien Geraldine Antonia van Neerven
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.,Department of Plastic, Reconstructive and Hand Surgery, Burn Centre, RWTH Aachen University Hospital, Aachen, Germany
| | - Ahmet Bozkurt
- Department of Plastic, Reconstructive and Hand Surgery, Burn Centre, RWTH Aachen University Hospital, Aachen, Germany.,Department of Plastic, Aesthetic, Hand and Burn Surgery, Helios University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany
| | - Joachim Weis
- Institute of Neuropathology, RWTH Aachen University Hospital, Aachen, Germany
| | - Gary Anthony Brook
- Institute of Neuropathology, RWTH Aachen University Hospital, Aachen, Germany
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10
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Restoring electrical connection using a conductive biomaterial provides a new therapeutic strategy for rats with spinal cord injury. Neurosci Lett 2019; 692:33-40. [DOI: 10.1016/j.neulet.2018.10.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 09/28/2018] [Accepted: 10/15/2018] [Indexed: 11/22/2022]
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11
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Li M, Wang Y, Zhang J, Cao Z, Wang S, Zheng W, Li Q, Zheng T, Wang X, Xu Q, Chen Z. Culture of pyramidal neural precursors, neural stem cells, and fibroblasts on various biomaterials. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2018; 29:2168-2186. [DOI: 10.1080/09205063.2018.1528520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Mo Li
- Cell Therapy Center, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, and Key Laboratory of Neurodegeneration, Ministry of Education, Beijing, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
- Center of Parkinson's Disease, Beijing Institute for Brain Disorders, Beijing, China
| | - Ying Wang
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
- Department of Neurobiology, Capital Medical University, Beijing, China
| | - Jidi Zhang
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
- Department of Neurobiology, Capital Medical University, Beijing, China
| | - Zheng Cao
- School of Materials Science and Engineering, Tsinghua University, Beijing, China
| | - Shuo Wang
- School of Materials Science and Engineering, Tsinghua University, Beijing, China
| | - Wei Zheng
- Cell Therapy Center, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, and Key Laboratory of Neurodegeneration, Ministry of Education, Beijing, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
- Center of Parkinson's Disease, Beijing Institute for Brain Disorders, Beijing, China
| | - Qian Li
- Cell Therapy Center, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, and Key Laboratory of Neurodegeneration, Ministry of Education, Beijing, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
- Center of Parkinson's Disease, Beijing Institute for Brain Disorders, Beijing, China
| | - Tianqi Zheng
- Cell Therapy Center, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, and Key Laboratory of Neurodegeneration, Ministry of Education, Beijing, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
- Center of Parkinson's Disease, Beijing Institute for Brain Disorders, Beijing, China
| | - Xiumei Wang
- Institute for Regenerative Medicine and Biomimetic Materials, Department of Materials Science and Engineering, Tsinghua University, Beijing, China
| | - Qunyuan Xu
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
- Department of Neurobiology, Capital Medical University, Beijing, China
| | - Zhiguo Chen
- Cell Therapy Center, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, and Key Laboratory of Neurodegeneration, Ministry of Education, Beijing, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
- Center of Parkinson's Disease, Beijing Institute for Brain Disorders, Beijing, China
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12
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Wang L, Shi Q, Dai J, Gu Y, Feng Y, Chen L. Increased vascularization promotes functional recovery in the transected spinal cord rats by implanted vascular endothelial growth factor-targeting collagen scaffold. J Orthop Res 2018; 36:1024-1034. [PMID: 28786500 DOI: 10.1002/jor.23678] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 08/01/2017] [Indexed: 02/04/2023]
Abstract
Spinal cord injury (SCI) is global health concern. The effective strategies for SCI are relevant to the improvement on nerve regeneration microenvironment. Vascular endothelial growth factor (VEGF) is an important cytokine for inducing angiogenesis and accelerating nerve system function recovery from injury. We proposed that VEGF could improve nerve regeneration in SCI. However, an uncontrolled delivery system target to injury site not only decreases the therapeutic efficacy but also increases the risk of tumor information. We implanted collagen scaffold (CS) targeted with a constructed protein, collagen-binding VEGF (CBD-VEGF), to bridge transected spine cord gap in a rat transected SCI model. Functional and histological examinations were conducted to assess the repair capacity of the delivery system CS/CBD-VEGF. The results indicated that the implantation of CS/CBD-VEGF into the model rats improved the survival rate and exerted beneficial effect on functional recovery. The controlled intervention improved the microenvironment, guided axon growth, and promoted neovascularization at the injury site. Therefore, the delivery system with stable binding of VEGF potentially provides a better therapeutic option for SCI. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1024-1034, 2018.
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Affiliation(s)
- Lingjun Wang
- Department of Orthopedic, The First Affiliated Hospital of Soochow University, Suzhou, 215006, P.R. China
| | - Qin Shi
- Department of Orthopedic, The First Affiliated Hospital of Soochow University, Suzhou, 215006, P.R. China
| | - Jianwu Dai
- State Key Laboratory of Molecular Developmental Biology, Chinese Academy of Sciences, Institute of Genetics and Developmental Biology, Beijing, 100000, P.R. China
| | - Yong Gu
- Department of Orthopedic, The First Affiliated Hospital of Soochow University, Suzhou, 215006, P.R. China
| | - Yu Feng
- Department of Orthopedic, The First Affiliated Hospital of Soochow University, Suzhou, 215006, P.R. China
| | - Liang Chen
- Department of Orthopedic, The First Affiliated Hospital of Soochow University, Suzhou, 215006, P.R. China
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13
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Liu S, Schackel T, Weidner N, Puttagunta R. Biomaterial-Supported Cell Transplantation Treatments for Spinal Cord Injury: Challenges and Perspectives. Front Cell Neurosci 2018; 11:430. [PMID: 29375316 PMCID: PMC5768640 DOI: 10.3389/fncel.2017.00430] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 12/20/2017] [Indexed: 12/17/2022] Open
Abstract
Spinal cord injury (SCI), resulting in para- and tetraplegia caused by the partial or complete disruption of descending motor and ascending sensory neurons, represents a complex neurological condition that remains incurable. Following SCI, numerous obstacles comprising of the loss of neural tissue (neurons, astrocytes, and oligodendrocytes), formation of a cavity, inflammation, loss of neuronal circuitry and function must be overcome. Given the multifaceted primary and secondary injury events that occur with SCI treatment options are likely to require combinatorial therapies. While several methods have been explored, only the intersection of two, cell transplantation and biomaterial implantation, will be addressed in detail here. Owing to the constant advance of cell culture technologies, cell-based transplantation has come to the forefront of SCI treatment in order to replace/protect damaged tissue and provide physical as well as trophic support for axonal regrowth. Biomaterial scaffolds provide cells with a protected environment from the surrounding lesion, in addition to bridging extensive damage and providing physical and directional support for axonal regrowth. Moreover, in this combinatorial approach cell transplantation improves scaffold integration and therefore regenerative growth potential. Here, we review the advances in combinatorial therapies of Schwann cells (SCs), astrocytes, olfactory ensheathing cells (OECs), mesenchymal stem cells, as well as neural stem and progenitor cells (NSPCs) with various biomaterial scaffolds.
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Affiliation(s)
- Shengwen Liu
- Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Thomas Schackel
- Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Norbert Weidner
- Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Radhika Puttagunta
- Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
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14
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Struzyna LA, Adewole DO, Gordián-Vélez WJ, Grovola MR, Burrell JC, Katiyar KS, Petrov D, Harris JP, Cullen DK. Anatomically Inspired Three-dimensional Micro-tissue Engineered Neural Networks for Nervous System Reconstruction, Modulation, and Modeling. J Vis Exp 2017. [PMID: 28605376 DOI: 10.3791/55609] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Functional recovery rarely occurs following injury or disease-induced degeneration within the central nervous system (CNS) due to the inhibitory environment and the limited capacity for neurogenesis. We are developing a strategy to simultaneously address neuronal and axonal pathway loss within the damaged CNS. This manuscript presents the fabrication protocol for micro-tissue engineered neural networks (micro-TENNs), implantable constructs consisting of neurons and aligned axonal tracts spanning the extracellular matrix (ECM) lumen of a preformed hydrogel cylinder hundreds of microns in diameter that may extend centimeters in length. Neuronal aggregates are delimited to the extremes of the three-dimensional encasement and are spanned by axonal projections. Micro-TENNs are uniquely poised as a strategy for CNS reconstruction, emulating aspects of brain connectome cytoarchitecture and potentially providing means for network replacement. The neuronal aggregates may synapse with host tissue to form new functional relays to restore and/or modulate missing or damaged circuitry. These constructs may also act as pro-regenerative "living scaffolds" capable of exploiting developmental mechanisms for cell migration and axonal pathfinding, providing synergistic structural and soluble cues based on the state of regeneration. Micro-TENNs are fabricated by pouring liquid hydrogel into a cylindrical mold containing a longitudinally centered needle. Once the hydrogel has gelled, the needle is removed, leaving a hollow micro-column. An ECM solution is added to the lumen to provide an environment suitable for neuronal adhesion and axonal outgrowth. Dissociated neurons are mechanically aggregated for precise seeding within one or both ends of the micro-column. This methodology reliably produces self-contained miniature constructs with long-projecting axonal tracts that may recapitulate features of brain neuroanatomy. Synaptic immunolabeling and genetically encoded calcium indicators suggest that micro-TENNs possess extensive synaptic distribution and intrinsic electrical activity. Consequently, micro-TENNs represent a promising strategy for targeted neurosurgical reconstruction of brain pathways and may also be applied as biofidelic models to study neurobiological phenomena in vitro.
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Affiliation(s)
- Laura A Struzyna
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania; Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania; Center for Neurotrauma, Neurodegeneration & Restoration, Michael J. Crescenz Veterans Affairs Medical Center
| | - Dayo O Adewole
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania; Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania; Center for Neurotrauma, Neurodegeneration & Restoration, Michael J. Crescenz Veterans Affairs Medical Center
| | - Wisberty J Gordián-Vélez
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania; Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania; Center for Neurotrauma, Neurodegeneration & Restoration, Michael J. Crescenz Veterans Affairs Medical Center
| | - Michael R Grovola
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania; Center for Neurotrauma, Neurodegeneration & Restoration, Michael J. Crescenz Veterans Affairs Medical Center
| | - Justin C Burrell
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania; Center for Neurotrauma, Neurodegeneration & Restoration, Michael J. Crescenz Veterans Affairs Medical Center
| | - Kritika S Katiyar
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania; Center for Neurotrauma, Neurodegeneration & Restoration, Michael J. Crescenz Veterans Affairs Medical Center; School of Biomedical Engineering, Drexel University
| | - Dmitriy Petrov
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania; Center for Neurotrauma, Neurodegeneration & Restoration, Michael J. Crescenz Veterans Affairs Medical Center
| | - James P Harris
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania; Center for Neurotrauma, Neurodegeneration & Restoration, Michael J. Crescenz Veterans Affairs Medical Center
| | - D Kacy Cullen
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania; Center for Neurotrauma, Neurodegeneration & Restoration, Michael J. Crescenz Veterans Affairs Medical Center;
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15
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Haggerty AE, Marlow MM, Oudega M. Extracellular matrix components as therapeutics for spinal cord injury. Neurosci Lett 2016; 652:50-55. [PMID: 27702629 DOI: 10.1016/j.neulet.2016.09.053] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 09/22/2016] [Accepted: 09/28/2016] [Indexed: 01/09/2023]
Abstract
There is no treatment for people with spinal cord injury that leads to significant functional improvements. The extracellular matrix is an intricate, 3-dimensional, structural framework that defines the environment for cells in the central nervous system. The components of extracellular matrix have signaling and regulatory roles in the fate and function of neuronal and non-neuronal cells in the central nervous system. This review discusses the therapeutic potential of extracellular matrix components for spinal cord repair.
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Affiliation(s)
- Agnes E Haggerty
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Megan M Marlow
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Martin Oudega
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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16
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López-Dolado E, González-Mayorga A, Gutiérrez MC, Serrano MC. Immunomodulatory and angiogenic responses induced by graphene oxide scaffolds in chronic spinal hemisected rats. Biomaterials 2016; 99:72-81. [PMID: 27214651 DOI: 10.1016/j.biomaterials.2016.05.012] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/02/2016] [Accepted: 05/06/2016] [Indexed: 01/14/2023]
Abstract
Attractive physic-chemical features of graphene oxide (GO) and promising results in vitro with neural cells encourage its exploration for biomedical applications including neural regeneration. Fueled by previous findings at the subacute state, we herein investigate for the first time chronic tissue responses (at 30 days) to 3D scaffolds composed of partially reduced GO (rGO) when implanted in the injured rat spinal cord. These studies aim to define fibrotic, inflammatory and angiogenic changes at the lesion site induced by the chronic implantation of these porous structures. Injured animals receiving no scaffolds show badly structured lesion zones and more cavities than those carrying rGO materials, thus pointing out a significant role of the scaffolds in injury stabilization and sealing. Notably, GFAP(+) cells and pro-regenerative macrophages are evident at their interface. Moreover, rGO scaffolds support angiogenesis around and, more importantly, inside their structure, with abundant and functional new blood vessels in whose proximities inside the scaffolds some regenerated neuronal axons are found. On the contrary, lesion areas without rGO scaffolds show a diminished quantity of blood vessels and no axons at all. These findings provide a foundation for the usefulness of graphene-based materials in the design of novel biomaterials for spinal cord repair and encourage further investigation for the understanding of neural tissue responses to this kind of materials in vivo.
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Affiliation(s)
- Elisa López-Dolado
- Hospital Nacional de Parapléjicos, Servicio de Salud de Castilla-La Mancha (SESCAM), Finca la Peraleda s/n, 45071, Toledo, Spain
| | - Ankor González-Mayorga
- Hospital Nacional de Parapléjicos, Servicio de Salud de Castilla-La Mancha (SESCAM), Finca la Peraleda s/n, 45071, Toledo, Spain
| | - María Concepción Gutiérrez
- Instituto de Ciencia de Materiales de Madrid (ICMM), Consejo Superior de Investigaciones Científicas (CSIC), C/Sor Juana Inés de la Cruz 3, 28049, Madrid, Spain
| | - María Concepción Serrano
- Hospital Nacional de Parapléjicos, Servicio de Salud de Castilla-La Mancha (SESCAM), Finca la Peraleda s/n, 45071, Toledo, Spain.
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