Repair strategy for traumatic spinal cord injury; an advance in bioengineering-based preclinical approaches
Résumé
Recovery from traumatic spinal cord injury (SCI) usually fails due to a cascade of cellular and molecular events that compromise neural tissue reconstitution by giving rise to glial scarring and cavity formation. We designed a scaffold material for SCI treatment containing only chitosan and water as fragmented physical hydrogel suspension (Chitosan-FPHS), with defined degree of acetylation (DA), polymer concentration, and mean fragment size. As a proof of concept, we previously demonstrated (Chedly et al., 2017) that implantation of Chitosan-FPHS alone into rat spinal cord immediately after a bilateral dorsal hemisection promoted reconstitution of spinal tissue and vasculature. Fibrous glial scarring was diminished, allowing the border between lesion site and intact tissue to become permissive for regrowth of numerous axons into, and for some even beyond the lesion site. This structural remodeling was associated with significant, long-lasting gain in locomotor function recovery. We are now investigating our strategy in a rat model of contusion injury, which is even more severe than the bilateral dorsal hemisection used in the initial study, and above all a much more common type of SCI in humans. Our data show that also after a contusion injury Chitosan-FPHS, now implanted 24 hours post-injury, is highly effective in that it improves functional locomotor recovery and tissue restoration. A major contribution of the biomaterial to tissue repair appears to be its modulation of the inflammatory response, favoring inflammation resolution through macrophage polarization towards the anti-inflammatory M2 phenotype. Thus, our tissue engineering approach seems very promising, as it promotes a highly dynamic tissue restorative process by favoring cell survival and axon growth, and by modulating the immune response. Our perspective for a follow-up of the present study is to determine the suitable time window for the biomaterial implantation to test the relevance of the strategy in a chronic lesion model.