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2024

NOVAS FRONTEIRAS: TERAPIAS CELULARES NA REABILITAÇÃO APÓS LESÃO DA MEDULA ESPINHAL

NEW FRONTIERS: CELL THERAPIES IN REHABILITATION POST SPINAL CORD INJURY

NOVAS FRONTEIRAS TERAPIAS CELULARES NA.pdf

10.56161/sci.ed.202410288C7

Rhuan da Silva Santos

Afya Faculdade de Ciências Médicas Itabuna

Orcid ID do autor (https://orcid.org/0009-0001-5835-5205)

Alexandre Abreu Carvalho

Afya Faculdade de Ciências Médicas Itabuna

Orcid ID do autor (https://orcid.org/0009-0009-3499-3016)

Geovanna dos Santos Pereira

Afya Faculdade de Ciências Médicas Itabuna

Orcid ID do autor (https://orcid.org/0009-0004-3820-2473)

Isabela de Freitas Maia

Afya Faculdade de Ciências Médicas Itabuna

Orcid ID do autor (https://orcid.org/0009-0006-4653-2725)

Isadora de Araujo Freitas

Afya Faculdade de Ciências Médicas Itabuna

Orcid ID do autor (https://orcid.org/0009-0000-7382-464X)

Matheus Henrique Oliveira Santos

Afya Faculdade de Ciências Médicas Itabuna

Orcid ID do autor (https://orcid.org/0009-0005-3766-3056)

Maylla Karolina Leão Céo Brandão

Afya Faculdade de Ciências Médicas Itabuna

Orcid ID do autor (https://orcid.org/0009-0004-6942-7050)

Mel Rocha de Melo

Afya Faculdade de Ciências Médicas Itabuna

Orcid ID do autor (https://orcid.org/0009-0003-6707-985X)

Murilo Leite Mamedio Bahia

Afya Faculdade de Ciências Médicas Itabuna

Orcid ID do autor (https://orcid.org/0009-0001-5224-6577)

Luciana Thais Rangel Souza

Afya Faculdade de Ciências Médicas Itabuna

Orcid ID do autor (https://orcid.org/0009-0003-9133-5446)

RESUMO

INTRODUÇÃO: A Lesão de Medula Espinhal (LME) se caracteriza por um dano à medula espinhal, acometendo a função nervosa gravemente devido à incapacidade do Sistema Nervoso Central (SNC) de se regenerar. A LME desencadeia degeneração axonal, neuroinflamação e cicatrização glial. OBJETIVO: Discutir as terapias celulares utilizadas no manejo pós-LME. MÉTODOS: Revisão narrativa de literatura com caráter descritivo e qualitativo com levantamento bibliográfico realizado nas bases de dados online da Scientific Eletronic Library Online (SciELO), National Library of Medicine (PubMed) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Para a busca, utilizou-se os descritores "Spinal Cord Injuries", "Cell Proliferation", "Spinal Cord Regeneration" e "Transplantation", acrescidos com operador booleano AND. RESULTADOS: Encontrou-se 157 artigos, dentre os quais 29 corresponderam aos critérios de inclusão deste estudo. As Células Progenitoras de Oligodendrócitos (OPCs) são fundamentais para a mielinização no SNC e proliferam rapidamente após lesões, com o IGF-1 acentuando sua sobrevivência e acelerando a remielinização. As Células de Schwann (SCs) atuam no Sistema Nervoso Periférico (SNP) e liberam fatores neurotróficos que favorecem a regeneração nervosa. Quando combinadas com eletroacupuntura, evidenciou-se mostrou resultados satisfatórios na recuperação funcional. As células ependimárias possuem características de células-tronco e aumentam sua capacidade regenerativa após lesões, embora a modulação de conexinas possa impactar esse processo. As Células-Tronco Neurais (NSCs) são pluripotentes, podendo se diferenciar em células neurais, com hidrogeis melhorando sua eficácia no transplante. As Células-Tronco Mesenquimais (MSCs) também têm potencial no tratamento de lesões medulares, modulando a inflamação e promovendo a regeneração, enquanto exossomos derivados de SCs ajudam na regeneração axonal. CONCLUSÃO: Notou-se a complexidade nos mecanismos de regeneração neural, nas interações entre o microambiente da LME e nas células transplantadas, necessitando de pesquisas adicionais para melhorar intervenções terapêuticas e resultados funcionais para pacientes com LME.

PALAVRAS-CHAVE: Traumas da Medula Espinhal; Regeneração da Medula Espinal; Proliferação Celular; Transplantação.

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