The role of autophagy in spinal cord injury: Mechanisms, crosstalk, and therapeutic strategies

Spinal cord injury is a neurological disorder resulting from trauma, typically affecting sensory and motor function at the injury site, even leading to paralysis and internal dysfunction. The treatment of spinal cord injury mainly relies on pharmacological and surgical interventions; however, significant challenges remain in the protection and repair of neural tissues. Autophagy, an intracellular process responsible for the degradation and recycling of macromolecular components, plays a vital role in spinal cord injury, alleviating the severity of injury by inhibiting cell apoptosis and inflammatory responses. In this review, we provide an overview of the physiological mechanisms underlying autophagy and spinal cord injury and detail the crosstalk between autophagy and other modes of cell death in spinal cord injury. In addition, we discuss the potential of targeting autophagy as a therapeutic strategy for spinal cord injury through approaches that focus on promoting or inhibiting this process, targeting specific autophagic substrates or pathways, and combining autophagy modulation with other neuroprotective or restorative interventions. In summary, this review proposes that strict regulation of autophagy may represent a viable strategy for the treatment of spinal cord injury.