Acidic Fibroblast Growth Factor in Spinal Cord Injury.

Spinal cord injury (SCI), with an incidence rate at 246 per million-person-years for adults in Taiwan, remains a devastating disease in the current era. Elderly men with lower socioeconomic status have an even higher risk for SCI. Despite advances made in medicine and technology to date, there are few effective treatments for SCI due to the limitations in regenerative capacity in the adult central nervous system. There have been experiments and clinical trials aimed at neuro-regeneration in human SCI, which have encompassed cell- and molecule-based therapies. Furthermore, there have been strategies aimed at restoring connection, including autologous peripheral nerve grafts and biomaterial scaffolds which theoretically promote axonal growth. Most of the molecule-based therapies target the modulation of the inhibitory molecules for axonal growth, degradation of glial scarring obstacles, and stimulation of intrinsic regenerative capacity. Among them, acidic fibroblast growth factor (aFGF) has been investigated for nerve repair; it is mitogenic and pluripotent in nature and could enhance axonal growth and mitigate glial scaring. For more than two decades the authors have conducted multiple trials, including human and animal experiments, using aFGF to repair nerve injuries, including central and peripheral nerves. Promising results in using aFGF for neural regeneration have been demonstrated, and future emphasis on aFGF as a neurotrophic factor should warrant more trials and applications. Focusing on aFGF, the current review aimed to summarize the historical evolution of the utilization of aFGF in SCI and nerve injuries, present applications and trials, brief its possible mechanisms, and to provide future perspectives.