. 2022 Apr 8;10:35. doi: 10.1038/s41413-022-00199-9

Table 1.

Pharmacologic repair strategy of spinal cord injury

Medicine	Mechanism	Representative findings
Microenvironmental regulator
Corticosteroids	• Upregulate the release of anti-inflammatory cytokines • Reduce the extravasation of inflammatory cells • Promote the survival of neurons	• NASCIS-1, NASCIS-2 and NASCIS-3 has been completed. • The controversial research is still being further clarified.
Minocycline	• Excellent lipid solubility²⁰⁶ • Reduce inflammatory response and prevent neuronal apoptosis²⁰⁷	• Phase II study proved that minocycline can significantly improve the ASIA motor score for patients with SCI.²⁰⁸ • Phase III is underway
Riluzole	• Sodium channel blocker • Inhibiting excitotoxicity by reducing the release of presynaptic glutamate to inhibit excitotoxicity²⁰⁹	• Phase I trial showed that Riluzole is effective in improving the ASIA score without serious adverse events • Phase II/III multicenter, randomized trial is in progress^210,211
Granulocyte-colony- stimulating factor (G-CSF)	• Promote differentiation and proliferation of granulocytes • Induce migration of bone marrow mesenchymal cells to SCI sites and inhibit apoptosis²¹²	• Phase I/II trial have shown that CSF can significantly improve motor function in patients with cervical and thoracic spinal cord injuries for 5 days.²¹³
Chondroitinase ABC (ChABC)	• Eliminate CSPG glycosaminoglycan (GAG) chains to achieve the inactivation of CSPGs⁹⁴ • Promoting axonal regeneration	• Preclinical researches have shown that the superiority of ChABC in regulating the inhibitory environment^214–216
Ganglioside (GM-1)	• Downregulate caspase-3 and upregulate the expression of NGF • Maintain neuronal cell survival	• Phase I clinical trial conducted a preliminary assessment of the safety and effectiveness of GM-1 • Phase III trial shown that GM-1 did not show a significant difference in the improvement of the primary outcome measures. • More experiments are demonstrating the role of GM-1 in spinal cord injury.
Magnesium	• Block NMDA receptors to prevent glutamatergic excitotoxicity	• Preclinical studies have demonstrated that Magnesium has a neuroprotective effect on the rat model of SCI and optimizes motor functional outcome²¹⁷
Neuroregenertive activator
Cethrin	• A recombinant of VX-210 • Involve the down-regulation of the RHOA pathway to promote axonal regeneration²¹⁸	• The phase I/IIa study has demonstrated the effectiveness of this medicine in improving motor function²¹⁹ • Phase IIb/III trial is being carried out²²⁰
Nogo-A antibodies	• The antibody of a myelin-derived axon growth inhibitor • Inhibit Nogo-A to facilitate nerve repair and reconstruction after SCI	• Nogo-A antibodies have proved an attraction in facilitating nerve regeneration in preclinical SCI trials, and a phase I research has been completed^221,222 • Phase II placebo-controlled trial is underway
Basic fibroblast growth factor (bFGF)	• A ligand of tyrosine kinase receptor • Inhibit inflammatory response, glial scar and astrogliosis and stimulate axon regeneration • Neuroprotective function	• A preliminary Phase I clinical study has shown that FGF may have a positive effect in improving ASIA motor score • Phase I/II trial has evaluated with the unpublished conclusion^223,224