Pharmacological approaches to induce neuroregeneration in spinal cord injury: An overview

Spinal cord (SC) injury causes serious neurological alterations that importantly disturb the physical, emotional and economical stability of affected individuals. Damage to the neural tissue is primarily caused by the lesion itself and secondarily by a multitude of destructive mechanisms that develop afterwards. Unfortunately, the restoring capacity of the central nervous system is very limited because of reduced intrinsic growth capacity and non-permissive environment for axonal elongation. The regenerative processes are blocked by diverse factors such as growth inhibitory proteins and the glial scar formed in the site of lesion. In spite of these problems, central neurons regenerate if a permissive environment is provided. In line with this thought, some pharmacological compounds have been tested to achieve neuroregeneration. The main objective of this manuscript is to provide the state-of-art of chemotherapeutic treatments for spinal cord regeneration after injury in the field. The efficacy and usefulness of different therapeutic strategies will be reviewed, including Rho-ROCK inhibitors, cyclic AMPenhancers, glial scar inhibitors and immunophilin ligands. Aside from this, the use of hydrogels alone or in combination with drugs, growth factors or stem cells will also be revised.