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Chapter 11 - Perspectives on preclinical evidence for translation in SCI
Book chapter

Chapter 11 - Perspectives on preclinical evidence for translation in SCI

Paul J. Reier, Michael A. Lane and Lyandysha V. Zholudeva
Spinal Cord Injury Pain, pp 227-244
2022
DOI: https://doi.org/10.1016/B978-0-12-818662-6.00001-7

Abstract

Animal models Cell-based approaches Chronic spinal cord injury Clinical translation Intraspinal transplantation Neuropathic pain Posttraumatic syringomyelia Robust therapeutic outcomes
Preclinical research has unveiled therapeutic options for promoting functional outcomes after spinal cord injury (SCI) via neuroprotection, rehabilitation/neuroplasticity, and repair. Such advances have drawn attention to facilitating more timely clinical studies of promising treatments for SCI. However, judicious translation entails a host of scientific and logistical considerations in addition to a sense of urgency shared throughout the SCI community at large. Neuropathic pain is among secondary consequences of spinal trauma for which therapeutic discovery and subsequent clinical translation are crucially needed. Here, we provide a perspective on challenges in bridging the preclinical-to-clinical gap with selective emphasis on cell-based repair of the injured spinal cord and reference to chronic neuropathic pain post-SCI. Focus is initially on preclinical issues that were the foundation for early trials using embryonic neural tissue. Discussion then centers on how those considerations may still apply to future translational approaches. Realizing that rationales for initiating human trials can differ widely, the goal is not to prescribe a specific translational protocol. Instead, the objective is to present views related to systematic, scientific pursuit while not losing sight of the crucial need for more rapid translational progress.

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