Spinal cord injury (SCI) repair lacks clinically validated restorative therapies. Transplantation of exogenous neural stem cells (NSCs) offers significant potential for therapeutic applications; however, challenges remain, including substantial cell loss, uncontrolled differentiation, and limited tissue integration within inflammatory microenvironments. Furthermore, the workflow associated with traditional NSC transplantation-including cryopreservation, thawing, transportation, and injection-remains fragmented, resulting in systemic limitations. These issues manifest as reduced cell viability and stemness, an elevated risk of contamination, and dosing inaccuracies. All these significantly impede clinical translation. An integrated system for NSC preservation, transport, and transplantation is required to meet the following criteria: (i) maintenance of high cell viability and stemness post-cryopreservation and thawing; (ii) modulation of the acute-phase immune microenvironment; (iii) regulation of the differentiation fate of transplanted NSCs; (iv) injectable, standardized, and closed-system operation. To meet these requirements, we established a comprehensive cryopreservation, thawing, and transplant (CTT) integrated platform. Utilizing the bioactive material PM-BMH@Exo, this platform enables seamless end-to-end workflow integration through a mechanism that preserves bioactivity. It not only ensures high viability retention and directed differentiation of NSCs but also effectively mitigates the rapid viability decline of cells observed after traditional cryopreservation. Furthermore, the system enables closed-loop operations spanning cryopreservation, thawing, and minimally invasive injection. It breaks through systemic bottlenecks from multi-step procedures, comprehensively enhancing the timeliness and standardization of therapeutic interventions. We systematically evaluated the system's feasibility and efficacy via in vitro and in vivo experiments. This study presents a technologically viable and clinically compatible pathway with potential applications for SCI repair.
Ren et al. (2026) studied this question.