Transplantation of olfactory ensheathing cells after spinal injury. II--Experimental variability and clinical perspectives

Over recent years, a certain number of experimental investigations have studied the effect of the transplantation of olfactory ensheathing glial cells (OEC) after spinal traumatism in animal, the rat in particular. Some of these studies have reported improvements in motor (mainly locomotor, postural and respiratory) and sensory function. While these new data provide additional support for the interest of the strategy of EOC transplantation to minimise the incapacitating effects of spinal pathologies in clinical therapy, it nonetheless remains necessary to continue experiments on animal models in order to better understand and master certain important points: beneficial effects according to the nature and composition of the transplants; therapeutic impact according to the type of pathology and the nature of the traumatism; influence of the dose effect; migration of the transplanted OECs (distance, pathways); active principles of the transplants; beneficial effect on various functions, in particular at the level of the vesico-sphincteric area; long-term innocuousness; long-term posttraumatic efficacy. Although therapeutic trials are in progress in certain countries (Australia, China, Portugal), it would nonetheless appear essential that these somewhat obscure points should be better understood before any clinical application might be seriously envisaged, in order to respect the principles of precaution, maximum efficacy and observance of the prevailing ethical rules.