Ischemic stroke and repair: current trends in research and tissue engineering treatments

Abstract

Stroke, the third leading cause of mortality, is usually associated with severe disabilities, high recurrence rate and other poor outcomes. Currently, there are no long-term effective treatments for stroke. Cell and cytokine therapies have been explored previously. However, the therapeutic outcomes are often limited by poor survival of transplanted cells, uncontrolled cell differentiation, ineffective engraftment with host tissues and non-sustained delivery of growth factors. A tissue-engineering approach provides an alternative for treating ischemic stroke. The key design considerations for the tissue engineering approach include: choice of scaffold materials, choice of cells and cytokines and delivery methods. Here, we review current cell and biomaterial based therapies available for ischemic stroke, with a special focus on tissue-engineering strategies for regeneration of stroke-affected neuronal tissue.

Regulation of astrocyte activity via control over stiffness of cellulose acetate electrospun nanofiber

“…Implantable materials for brain disease have purpose to regenerate the damaged tissue by filling the cavity and supporting structure (Wang et al 2014). For example, ischemic stroke obstructs cerebral blood supply, and it causes loss of brain tissue resulting in the formation of infarct cavity.…”

Current developments in cell- and biomaterial-based approaches for stroke repair

“…Several studies have demonstrated that scaffold support enhanced the survival and differentiation of transplanted stem cells and improved neurological functions in experimental stroke [76,[79][80][81]. Zhong et al used NPCs transplanted with hyaluronan/heparin/collagen hydrogel into the infarct cavity 7 days after stroke.…”

“…The less invasive way of delivery is transplantation into the lesion cavity, which, on the other hand, represents a hostile inflammatory environment with no trophic support. For this reason, various biomaterials are being developed in order to provide a stimulatory environment which would support engraftment of transplanted cells and/ or activate endogenous restorative mechanisms in the infarcted brain [76].…”

“…Materials used in stroke treatment are comprised of natural materials, such as collagen, hyaluronic acid (HA), chitosan, fibrin, alginate, or synthetic polymers, such as poly(lactic acid) (PLA), poly(glycolic acid) (PGA), and their copolymer poly(lactic-co-glycolic acid) (PLGA) [76]. Several studies have demonstrated that scaffold support enhanced the survival and differentiation of transplanted stem cells and improved neurological functions in experimental stroke [76,[79][80][81].…”

Comparison among bone marrow mesenchymal stem and mononuclear cells to promote functional recovery after spinal cord injury in rabbits

“…Moreover, it represents a high financial burden for the families and for the health care systems of countries 1,2 . For these reasons, scientific community has made a large effort to discover new and effective approaches to treat these conditions, aiming to promote increased nervous tissue protection, regeneration and neurologic recovery 3,4 . One of the most incident and prevalent forms of CNS lesion is the spinal cord injury (SCI), which causes motor, sensory and autonomic dysfunction 1,5 .…”