Probiotics as Emerging Neurotherapeutics in Spinal Cord Injury: Modulating Inflammation, Infection, and Regeneration

Spinal cord injury (SCI) is a life-altering condition that often leads to severe motor, sensory, and autonomic dysfunction. The pathophysiology of SCI involves primary mechanical damage followed by secondary injury, characterized by inflammation, oxidative stress, and neurodegeneration. Traditional treatment options focus primarily on symptomatic relief and rehabilitation, with limited success in neural regeneration. In recent years, probiotics have emerged as potential therapeutic agents due to their antibacterial, anti-inflammatory, and neurodegenerative properties. Probiotics influence the gut microbiota, which plays a crucial role in modulating systemic inflammation, immune responses, and neuroprotection. Research suggests that probiotics can enhance neurogenesis, modulate cytokine production, and reduce secondary injury cascades in SCI models. Furthermore, probiotic-derived metabolites, such as short-chain fatty acids and neurotransmitters, contribute to neuroprotection and functional recovery. This review explores the potential of probiotics in SCI management by examining their mechanisms of action, including antibacterial defense, inflammation reduction, and neuronal repair. It also highlights clinical and preclinical studies supporting probiotic interventions for SCI. Given the growing interest in gut-brain interactions, understanding the therapeutic role of probiotics in SCI could lead to novel adjunct treatments, improving the quality of life for affected individuals. However, further research is required to establish standardized probiotic strains, dosages, and treatment regimens.