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Regenerative Medicine - from Protocol to Patient pp 115–145Cite as

Regenerative Therapy for Central Nervous System Trauma

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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 reviews the mechanism of this inhibition on which some of the strategies to promote regeneration in the CNS are based. These strategies are considered for application in traumatic brain injury (TBI) and spinal cord injury (SCI) separately. Degradation of inhibitors such as chondroitin sulfate proteoglycans in the glial scar at the site of SCI 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 after SCI. Apart from acute TBI, chronic traumatic encephalopathy is being increasingly recognized as a cause of cognitive impairment and strategies for regeneration are similar to those for neurodegenerative disorders. Cell and gene therapies are under investigation for CNS regeneration. Developments in nanobiotechnology also show potential for CNS repair. However, 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, hyperbaric oxygen, electrical fields, and physical therapies are promising for functional regeneration of the CNS following trauma.

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  1. Jain PharmaBiotech, Blaesiring 7, CH-4057, Basel, Switzerland

    Kewal K. Jain M.D., FRACS, FFPM

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Correspondence to Kewal K. Jain M.D., FRACS, FFPM .

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  1. KIlinik und Poliklinik für Herzchirurgie, Universitätsmedizin Rostock, Rostock, Mecklenburg-Vorpomm., Germany

    Gustav Steinhoff

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Jain, K.K. (2016). Regenerative Therapy for Central Nervous System Trauma. In: Steinhoff, G. (eds) Regenerative Medicine - from Protocol to Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-28293-0_6

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