Targeting glial scar formation for spinal cord injury: mechanisms, strategies, and research progress review

Spinal cord injury is often followed by the formation of a glial scar which acts as a major barrier for axonal regrowth and recovery after spinal injuries. The glial scar consists of a complex mixture of cells and extracellular molecules that have different effects; they protect injured areas from further damage but at the same time inhibit axonal sprouting. We have performed a thorough and detailed study of the underlying biological mechanisms in scarring by focusing on the interactions among the astrocytes, microglial, fibroblastic, or immune-related components. With recent advances in experimental model systems and translational studies, here we review therapeutic interventions aimed to modulate scarring, including gene transfer, cell delivery, immunomodulation, and biomaterial scaffolds. Integrating recent advances, the present review aims at providing an effective theoretical basis as well as new treatment approaches for the treatment of SCI patients.