Stem cell therapy for acute cerebral injury

Abstract

Purpose of review The central nervous system has limited capacity for regeneration after acute and chronic injury. An attractive approach to stimulate neural plasticity in the brain is to transplant stem cells in order to restore function. Here we discuss potential mechanisms of action, current knowledge and future perspectives of clinical stem cell research for stroke and traumatic brain injury. Recent findings Preclinical data using various models suggest stem cell therapy to be a promising therapeutic avenue. Progress has been made in elucidating the mechanism of action of various cell types used, shifting the hypothesis from neural replacement to enhancing endogenous repair processes. Translation of these findings in clinical trials is currently being pursued with emphasis on both safety as well as efficacy. Summary Clinical trials are currently recruiting patients in phase I and II trials to gain more insight in the therapeutic potential of stem cells in acute cerebral injury. A close interplay between results of these clinical trials and more extensive basic research is essential for future trial design: Choosing the optimal transplantation strategy and selecting the right patients.

Neurorestoration after stroke

“…105 Multiple trials have been performed or are ongoing that use these exogenous stem cells (Table 1). 98 …”

Hydrogels for brain repair after stroke: an emerging treatment option

“…Stem or progenitor cell transplantation after stroke was shown to promote recovery in pre-clinical models. However, these studies are limited by poor survival of the transplant when administered as a suspended form into the damaged brain due to the immunological attack and the abrupt withdrawal of growth factor and adhesive support [15]. Transplanted NPCs that do survive often remain in an undifferentiated state [15].…”

“…However, these studies are limited by poor survival of the transplant when administered as a suspended form into the damaged brain due to the immunological attack and the abrupt withdrawal of growth factor and adhesive support [15]. Transplanted NPCs that do survive often remain in an undifferentiated state [15]. Pro-angiogenic approaches were also tested with the systemic or intracerebral delivery of soluble VEGF and were shown to be unsuccessful.…”

“…Injectable hydrogels can also serve as a cell transplantation vehicle to deliver NPCs. However, because access to the brain and the skull requires invasive delivery, the direct delivery of cells into the brain after stroke in conjunction with a pro-repair biomaterial must be controlled so that tissue adjacent to the infarct is not damaged [15]. Although in pre-clinical models the location of the stroke and the injection volume can be controlled such that hydrogel injections are possible without harmful effects, this will not be the case when translating to a clinical study.…”

Targeting Neurogenesis: A Promising Therapeutic Strategy for Post-Stroke Treatment with Chinese Herbal Medicine

“…Enhanced neurogenesis either by stem cell transplantation or stimulation of endogenous neurogenesis could partly amend the damaged brain functions, raising hopes for brain repair treatment. Recent progress in stem cell therapy proposes the approach of transplantation of NSCs targeting brain repair [17,18]. Experimentally, the transplantation of NSCs is a promising strategy for the replacement of dead or injured neurons.…”