Metal-based materials as promising therapeutic agents for spinal cord injury: current status and future directions

Spinal cord injury (SCI) is a devastating neurological disorder that significantly impacts motor, sensory, and autonomic functions. Current treatments are limited to surgical interventions, pharmacological management, rehabilitation, and supportive care, as there are no effective therapies that fully address complex pathophysiology of SCI. Metal-based materials have gained attention as potential therapeutic agents for SCI due to their unique redox activity, anti-inflammatory properties, and ability to modulate multiple biological targets. Certain metal-based materials have demonstrated antioxidant activity through ROS scavenging or modulation of redox-related pathways, potentially alleviating oxidative stress during the secondary injury phase of SCI. Depending on their composition and physicochemical properties, some metal-based materials may also modulate neuroinflammatory responses by regulating pro-inflammatory cytokine expression and immune cell polarization, thereby potentially limiting secondary tissue damage. Furthermore, specific metal-based nanomaterials have shown neuroprotective effects and the potential to support neurogenesis and axonal regeneration in preclinical SCI models. Despite their potential, the clinical translation of the materials faces challenges such as biocompatibility, tissue-specific targeting, and controlled release. This review provides an in-depth analysis of the therapeutic potential of these materials in SCI treatment, discusses their mechanisms of action, and outlines future directions for their development as effective therapies for SCI.