New opportunities for bioscaffold-enabled spinal cord injury repair

Abstract

Spinal cord injury (SCI) leads to high rates of central nervous system impairment and imposes a significant treatment burden, highlighting the need for effective repair strategies. Bioscaffolds are considered to be multifunctional materials composed of bioactive polymers and signaling molecules, showing potential comparable to tissue engineering approaches utilizing exogenous stem cells. These bioscaffolds, which act as biological frameworks, can modulate intrinsic neuronal regeneration and the external microenvironment to facilitate SCI repair. This review explores the current status and future prospects of three-dimensional bioscaffolds for SCI repair, covering the pathophysiology of spinal cord injury, associated repair mechanisms, and key bioscaffold properties influencing repair efficiency. Notably, the review highlights new insights into the use of therapeutic bioscaffolds to promote endogenous stem cell differentiation, enhance axon growth, regulate the injury microenvironment, and support SCI repair. Finally, expert opinions are discussed, summarizing design principles for effective SCI-repair bioscaffolds and underscoring their significant potential for clinical applications.