Preface

Chapter 7 **Cellular Transplantation-Based Therapeutic Strategies for**

Karim and Habiba Aurangzeb

**VI** Contents

**Spinal Cord Injuries: Preclinical and Clinical Updates 123** Ishaq N. Khan, Wafaa S. Ramadan, Ghada A. Abdel-Hamid, Saleh Al

> It is my privilege to be the editor of the book *Essentials of Spinal Cord Injury Medicine.* This book is a sequel to our previous IntechOpen publication *Topics in Paraplegia* and includes seven new chapters about spinal cord injury starting from basic knowledge, functional anat‐ omy to medical complications, which limit rehabilitation potential and new research in spi‐ nal cord injury.

> Spinal cord injury is a severe, often life-threatening traumatic condition leading to serious neurological dysfunctions. The first chapter presents the pathological hallmarks of spinal cord injury, which includes inflammation, reactive gliosis, axonal demyelination, neuronal death, and cyst formation. Understanding the pathophysiology of injury will improve our knowledge in neuroprotection and neuroregeneration leading to better rehabilitation prog‐ nosis. Important data on therapeutic strategies in preclinical and clinical phases, targeting mechanisms in acute and chronic stages of SCI, as well as their limitations and advances are presented in the second chapter. The third chapter describes the medical etiologies and treatments for spastic paraplegias due to nontraumatic spinal cord disorders. Because of ag‐ ing, epidemiological studies have found, mainly in developed countries, a shift in the causes of spinal cord injury from traumatic to nontraumatic, which may overtake traumatic in the next decade. The next chapter discusses penetrating spinal cord injury, which is a relatively rare entity affecting mainly young males, and in the fifth chapter, infectious complications after spinal cord injury and the preventive role of rehabilitation are analyzed.

> Finally, the last two chapters include new data about powered exoskeletons, which provide patients with SCI the ability to walk with lowest energy consumption, and last but not least, a chapter with preclinical and clinical updates of cellular transplantation that majorly in‐ volves cells' population derived from human embryonic stem cells, mesenchymal stem cells, and human-induced pluripotent stem cells, the extent of success from cellular transplanta‐ tion, associated controversies, and other emerging technologies concludes the project. As clinicians, we are often facing the problem subjected to spinal cord injury to rely on us to provide information about new therapies or novel possibilities. I would like to thank all the authors who participated and IntechOpen, especially Ms. Kristina Kardum, for the kind co‐ operation in the development of the project.

> > **Yannis Dionyssiotis, MD, PhD, s.FEBPRM** Head of Physical Medicine and Rehabilitation Department European Interbalkan Medical Center

> > > Thessaloniki, Greece

**Chapter 1**

**Provisional chapter**

**Understanding Molecular Pathology along Injured**

**Understanding Molecular Pathology along Injured** 

**Neuroprotection and Regeneration**

**Neuroprotection and Regeneration**

Lenka Kresakova, Katarina Vdoviakova, Milan Cizek, Tomas Smolek, Veronika Cubinkova, Jusal Quanico,

Lenka Kresakova, Katarina Vdoviakova, Milan Cizek, Tomas Smolek, Veronika Cubinkova, Jusal Quanico,

Dasa Cizkova, Adriana-Natalia Murgoci,

Dasa Cizkova, Adriana-Natalia Murgoci,

Additional information is available at the end of the chapter

maximum value of each individual treatment.

Additional information is available at the end of the chapter

Isabelle Fournier and Michel Salzet

Isabelle Fournier and Michel Salzet

http://dx.doi.org/10.5772/intechopen.72118

**Abstract**

**Spinal Cord Axis: Moving Frontiers toward Effective**

Spinal cord injury (SCI) is a severe, often life threatening, traumatic condition leading to serious neurological dysfunctions. The pathological hallmarks of SCI include inflammation, reactive gliosis, axonal demyelination, neuronal death, and cyst formation. Although much has been learned about the progression of SCI pathology affecting a large number of biochemical cascades and reactions, the roles of proteins involved in these processes are not well understood. Advances in proteomic technologies have made it possible to examine the spinal cord proteome from healthy and experimental animals and disclose a detailed overview on the spatial and temporal regionalization of these secondary processes. Data clearly demonstrated that neurotrophic molecules dominated in the segment above the central lesion, while the proteins associated with necrotic/apoptotic pathways abound the segment below the lesion. This knowledge is extremely important in finding optimal targets and pathways on which complementary neuroprotective and neuroregenerative approaches should be focused on. In terms of neuroprotection, several active substances and cell-based therapy together with biomaterials releasing bioactive substances showed partial improvement of spinal cord injury. However, one of the major challenges is to select specific therapies that can be combined safely and in the appropriate order to provide the

**Spinal Cord Axis: Moving Frontiers toward Effective** 

DOI: 10.5772/intechopen.72118

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

**Keywords:** spinal cord injury, secondary processes, proteome, biomaterials

**Provisional chapter**
