Safety and effectiveness of stem cell therapies in early-phase clinical trials in stroke: a systematic review and meta-analysis

Abstract

Stem cells have demonstrated encouraging potential as reparative therapy for patients suffering from post-stroke disability. Reperfusion interventions in the acute phase of stroke have shown significant benefit but are limited by a narrow window of opportunity in which they are beneficial. Thereafter, rehabilitation is the only intervention available. The current review summarises the current evidence for use of stem cell therapies in stroke from early-phase clinical trials. The safety and feasibility of administering different types of stem cell therapies in stroke seem to be reasonably proven. However, the effectiveness needs still to be established through bigger clinical trials with more pragmatic clinical trial designs that address the challenges raised by the heterogeneous nature of stroke per se, as well those due to unique characteristics of stem cells as therapeutic agents.Electronic supplementary materialThe online version of this article (doi:10.1186/s13287-017-0643-x) contains supplementary material, which is available to authorized users.

PERSPECTIVES: Stroke survivors' views on the design of an early‐phase cell therapy trial for patients with chronic ischaemic stroke

“…The unique challenges posed by personalized application of stem cell therapies pose a question of whether the research designs can be optimized to facilitate meaningful progress in this field …”

“…Regenerative medicine represents a paradigm shift in approach to disease management with the possibility of potential cure or long‐lasting remission for many disease conditions with high‐unmet need. Early clinical studies with stem cell therapies support a novel approach for neuroregeneration and repair following stroke with a potentially longer window of opportunity . Cell therapy comprises a composite of different cell types being investigated in different phases of stroke, with use of different dose and delivery regimens.…”

“…Early clinical studies with stem cell therapies support a novel approach for neuroregeneration and repair following stroke with a potentially longer window of opportunity. 2 Cell therapy comprises a composite of different cell types being investigated in different phases of stroke, with use of different dose and delivery regimens.…”

Long-term results of limbal conjunctival autograft transplantation associated with an amniotic membrane in patients with total limbal stem cells deficiency

“…Regenerative treatment with stem cells has had a breakthrough in medicine in recent years [5] and the specialty of ophthalmology has not been left behind; the international literature has demonstrated the effectiveness of limbal stem cell transplantation in the treatment of corneal neovascularization [9][10][11][12][13][14][15]; however, there are few studies reporting long term results of this procedure in combination with amniotic membrane use. Corneal neovascularization is characterized by a vascularization of the corneal epithelium, chronic inflammation, epithelial defects, photophobia and loss of vision, leading to blindness where corneal transplants are ineffective because the limbal niche induces corneal rejection.…”

“…Great progress has been made in the transplantation of stem cells in various tissues of the human body [5]. At the ocular level since the discovery of stem cells in the corneal limbus by Schermer and coauthors in 1986 [6], many advances have also been made.…”