Epidural Stimulation Combined with Triple Gene Therapy for Spinal Cord Injury Treatment

Int J Mol Sci. 2020 Nov 24;21(23):8896. doi: 10.3390/ijms21238896.

Abstract

The translation of new therapies for spinal cord injury to clinical trials can be facilitated with large animal models close in morpho-physiological scale to humans. Here, we report functional restoration and morphological reorganization after spinal contusion in pigs, following a combined treatment of locomotor training facilitated with epidural electrical stimulation (EES) and cell-mediated triple gene therapy with umbilical cord blood mononuclear cells overexpressing recombinant vascular endothelial growth factor, glial-derived neurotrophic factor, and neural cell adhesion molecule. Preliminary results obtained on a small sample of pigs 2 months after spinal contusion revealed the difference in post-traumatic spinal cord outcomes in control and treated animals. In treated pigs, motor performance was enabled by EES and the corresponding morpho-functional changes in hind limb skeletal muscles were accompanied by the reorganization of the glial cell, the reaction of stress cell, and synaptic proteins. Our data demonstrate effects of combined EES-facilitated motor training and cell-mediated triple gene therapy after spinal contusion in large animals, informing a background for further animal studies and clinical translation.

Keywords: adenoviral vector; cell-mediated gene therapy; epidural electrical stimulation; glial cell-derived neurotrophic factor; human umbilical cord blood mononuclear cell; neural cell adhesion molecule; pigs; spinal cord injury; vascular endothelial growth factor.

MeSH terms

  • Adenoviridae / genetics
  • Animals
  • Cell- and Tissue-Based Therapy / methods
  • Disease Models, Animal
  • Electric Stimulation Therapy*
  • Epidural Space
  • Genetic Therapy / methods
  • Genetic Vectors / therapeutic use
  • Glial Cell Line-Derived Neurotrophic Factor / genetics*
  • Glial Cell Line-Derived Neurotrophic Factor / therapeutic use
  • Humans
  • Motor Activity / genetics
  • Motor Activity / physiology
  • Neural Cell Adhesion Molecules / genetics*
  • Neural Cell Adhesion Molecules / therapeutic use
  • Neuroglia / transplantation
  • Recovery of Function / genetics
  • Recovery of Function / radiation effects
  • Spinal Cord / physiopathology
  • Spinal Cord / radiation effects
  • Spinal Cord Injuries / genetics
  • Spinal Cord Injuries / physiopathology
  • Spinal Cord Injuries / therapy*
  • Swine / genetics
  • Vascular Endothelial Growth Factor A / genetics*
  • Vascular Endothelial Growth Factor A / therapeutic use

Substances

  • Glial Cell Line-Derived Neurotrophic Factor
  • Neural Cell Adhesion Molecules
  • Vascular Endothelial Growth Factor A