Comment

Surgical decompression in acute spinal cord injury: earlier is better

Promoting the recovery of neurological function in patients with traumatic spinal cord injury (TSCI) remains challenging. The balance between astrocyte-mediated neurotrophic and pro-inflammatory responses is critical for TSCI repair. Recently, the utilization of nanomaterials has been considerably explored in immunological reconstructive techniques that specifically target astrocyte-mediated inflammation, yielding positive outcomes. In this review, we aim to condense the present knowledge regarding the astrocyte-mediated inflammation following TSCI. We then review the various categories of nanomaterials utilized in the management of astrocyte-mediated inflammation in TSCI and conclude by summarizing their functions and advantages to offer novel insights for the advancement of effective clinical strategies targeting TSCI.

Nanoparticle technologies offer a non-invasive means to deliver basic fibroblast growth factor (bFGF) for the treatment of spinal cord injury (SCI). However, the inability of bFGF to accumulate at the injury site and inefficient penetration across the blood-spinal cord barrier (BSCB) remain challenges. The present study describes a dual-targeting liposome (bFGF@Lip-Cp&Rp) with injury lesion targeting and BSCB-penetrating capability to deliver bFGF for SCI treatment. The CAQK peptide (Cp) with injury lesion targeting ability and R₂KC peptide (Rp) with BSCB-penetrating capability were grafted onto the liposomes for a flexible and non-invasive drug delivery systems preparation. Results exhibit that the dual-targeted liposomes could significantly cross the BSCB and accumulate at the injury site. During the early stage of SCI, bFGF@Lip-Cp&Rp promotes repair of BSCB and facilitates M2-polarization of macrophages. Regular delivery of bFGF@Lip-Cp&Rp increase HUVECs tube formation and angiogenesis, ameliorate the microenvironment of lesion site, suppress the neuronal apoptosis and axonal atrophy in SCI rats. Importantly, continuous treatment of bFGF@Lip-Cp&Rp supports the restoration of limb motor function in SCI rats. In summary, this research implies that the injury site-targeting and BSCB-penetrating liposomes could be a promising therapeutic approach for the treatment of SCI.

Pediatric acute hyperextension spinal cord injury (SCI) named as PAHSCI by us, is a special type of thoracolumbar SCI without radiographic abnormality and highly related to back-bend in dance training, which has been increasingly reported. At present, it has become the leading cause of SCI in children, and brings a heavy social and economic burden. Both domestic and foreign academic institutions and dance education organizations lack a correct understanding of PAHSCI and relevant standards, specifications or guidelines. In order to provide standardized guidance, the expert team formulated this guideline based on the principles of science and practicability, starting from the diagnosis, differential diagnosis, etiology, admission evaluation, treatment, complications and prevention. This guideline puts forward 23 recommendations for 14 related issues.

An excellent drug delivery system is particularly important in trauma repair, especially for chronic hard-healing trauma, such as spinal cord injury (SCI). The SCI is difficult to repair as it is heavily influenced by inflammatory cell infiltration, neuronal axon rupture, and signal transmission interruption. Here, we present a stretched inverse opal film (SIOF) as a responsive drug carrier to deliver fibroblast growth factor 10 (FGF10) and chloroquine phosphate (CQ) for SCI repair. The SIOF was prepared by negatively replicating the silica nanospheres crystal array and was stretched to six times its original length. Benefiting from the elaborate interconnected nanopores of the SIOF, the temperature-sensitive hydrogel can host the black phosphorous quantum dots (BPQDs), and the two drugs (CQ and FGF 10) (Drugs-Gel@SIOF) for SCI repair. The excellent photothermal effect of BPQDs under the near-infrared (NIR) irradiation serves to regulate the release of drugs from the Drugs-Gel@SIOF. Furthermore, the SIOF has high biocompatibility and a special surface topology that orientates cell growth and promotes cytoskeleton elongation. The Drugs-Gel@SIOF showed an excellent effect of inhibiting inflammation and promoting axon growth. The practical performance of the Drugs-Gel@SIOF in promoting the recovery of motor function had been demonstrated by treating the spinal cord trauma rat model. These results indicate that this SIOF is an ideal intelligent delivery system with great potentials in nerve repair.