Spinal cord injury: plasticity, regeneration and the challenge of translational drug development

A Blesch, MH Tuszynski - Trends in neurosciences, 2009 - cell.com
Trends in neurosciences, 2009cell.com
Over the past three decades, multiple mechanisms limiting central nervous system
regeneration have been identified. Here, we address plasticity arising from spared systems
as a particularly important and often unrecognized mechanism that potentially contributes to
functional recovery in studies of 'regeneration'after spinal cord injury. We then discuss
complexities involved in translating findings from animal models to human clinical trials in
spinal cord injury; current strategies might be too limited in scope to yield detectable benefits …
Over the past three decades, multiple mechanisms limiting central nervous system regeneration have been identified. Here, we address plasticity arising from spared systems as a particularly important and often unrecognized mechanism that potentially contributes to functional recovery in studies of ‘regeneration' after spinal cord injury. We then discuss complexities involved in translating findings from animal models to human clinical trials in spinal cord injury; current strategies might be too limited in scope to yield detectable benefits in the complex and variable arena of human injury. Our animal models are imperfect, and the very variability that we attempt to control in the course of conducting rigorous research might, ironically, limit our ability to identify the most promising therapies in the human arena. Therapeutic candidates are most likely to have a detectable effect in human trials if they elicit benefits in severe contusion and larger animal models and pass the test of independent replication.
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