The Potential of Biomaterial-Based Approaches as Therapies for Ischemic Stroke: A Systematic Review and Meta-Analysis of Pre-clinical Studies

Bolan, Faye; Louca, Irene; Heal, Calvin; Cunningham, Catriona

doi:10.3389/fneur.2019.00924

Cited by 14 publications

(14 citation statements)

References 110 publications

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“…Direct support of recovery processes can be achieved by inserting biomaterials such as hydrogels or living scaffolds which promote a permissive environment and/or may be used to deliver cells or bioactive molecules. 30 …”

Section: Principle Possibilities To Foster Post-stroke Recoverymentioning

confidence: 99%

Principles and requirements for stroke recovery science

Sommer

Schäbitz

2020

J Cereb Blood Flow Metab

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The disappointing results in bench-to-bedside translation of neuroprotective strategies caused a certain shift in stroke research towards enhancing the endogenous recovery potential of the brain. One reason for this focus on recovery is the much wider time window for therapeutic interventions which is open for at least several months. Since recently two large clinical studies using d-amphetamine or fluoxetine, respectively, to enhance post-stroke neurological outcome failed again it is a good time for a critical reflection on principles and requirements for stroke recovery science. In principal, stroke recovery science deals with all events from the molecular up to the functional and behavioral level occurring after brain ischemia eventually ending up with any measurable improvement of various clinical parameters. A detailed knowledge of the spontaneously occurring post-ischemic regeneration processes is the indispensable prerequisite for any therapeutic approaches aiming to modify these responses to enhance post-stroke recovery. This review will briefly illuminate the molecular mechanisms of post-ischemic regeneration and the principle possibilities to foster post-stroke recovery. In this context, recent translational approaches are analyzed. Finally, the principal and specific requirements and pitfalls in stroke recovery research as well as potential explanations for translational failures will be discussed.

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Section: Principle Possibilities To Foster Post-stroke Recoverymentioning

confidence: 99%

Principles and requirements for stroke recovery science

Sommer

Schäbitz

2020

J Cereb Blood Flow Metab

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“…A recent meta-analysis found that biomaterialbased interventions have led to lesion volume reduction and improved neurological outcomes in stroke rodent models. 162 Hydrogels act as 3D scaffolds that improve stem cell survival and differentiation, both in vivo and in vitro. 163 However, they must be finely engineered for optimal cell delivery.…”

Section: Biomaterialsmentioning

confidence: 99%

“…This highlights the need to optimize these biomaterials for stem cell viability, differentiation, and proliferation. A recent meta-analysis found that biomaterialbased interventions have led to lesion volume reduction and improved neurological outcomes in stroke rodent models [ 162 ].…”

Section: Improvement Of Stem Cell Application In Ischemic Brain Injurmentioning

confidence: 99%

Optimizing Stem Cell Therapy after Ischemic Brain Injury

et al. 2020

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Stem cells have been used for regenerative and therapeutic purposes in a variety of diseases. In ischemic brain injury, preclinical studies have been promising, but have failed to translate results to clinical trials. We aimed to explore the application of stem cells after ischemic brain injury by focusing on topics such as delivery routes, regeneration efficacy, adverse effects, and <i>in vivo</i> potential optimization. PUBMED and Web of Science were searched for the latest studies examining stem cell therapy applications in ischemic brain injury, particularly after stroke or cardiac arrest, with a focus on studies addressing delivery optimization, stem cell type comparison, or translational aspects. Other studies providing further understanding or potential contributions to ischemic brain injury treatment were also included. Multiple stem cell types have been investigated in ischemic brain injury treatment, with a strong literature base in the treatment of stroke. Studies have suggested that stem cell administration after ischemic brain injury exerts paracrine effects via growth factor release, blood-brain barrier integrity protection, and allows for exosome release for ischemic injury mitigation. To date, limited studies have investigated these therapeutic mechanisms in the setting of cardiac arrest or therapeutic hypothermia. Several delivery modalities are available, each with limitations regarding invasiveness and safety outcomes. Intranasal delivery presents a potentially improved mechanism, and hypoxic conditioning offers a potential stem cell therapy optimization strategy for ischemic brain injury. The use of stem cells to treat ischemic brain injury in clinical trials is in its early phase; however, increasing preclinical evidence suggests that stem cells can contribute to the down-regulation of inflammatory phenotypes and regeneration following injury. The safety and the tolerability profile of stem cells have been confirmed, and their potent therapeutic effects make them powerful therapeutic agents for ischemic brain injury patients.

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“…Most studies administered hydrogels days or weeks after stroke, while few studies investigated hydrogel administration earlier than 24 h post‐IS. [ 66 ] The difference in approaches for hydrogel treatment in IS versus ICH and TBI is noteworthy and future studies in ICH should consider delayed treatment paradigms.…”

Section: Study Design: Time Of Administrationmentioning

confidence: 99%

Regenerative Potential of Hydrogels for Intracerebral Hemorrhage: Lessons from Ischemic Stroke and Traumatic Brain Injury Research

Thomas

Louca

Bolan

et al. 2021

Adv Healthcare Materials

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Intracerebral hemorrhage (ICH) is a deadly and debilitating type of stroke, caused by the rupture of cerebral blood vessels. To date, there are no restorative interventions approved for use in ICH patients, highlighting a critical unmet need. ICH shares some pathological features with other acute brain injuries such as ischemic stroke (IS) and traumatic brain injury (TBI), including the loss of brain tissue, disruption of the blood–brain barrier, and activation of a potent inflammatory response. New biomaterials such as hydrogels have been recently investigated for their therapeutic benefit in both experimental IS and TBI, owing to their provision of architectural support for damaged brain tissue and ability to deliver cellular and molecular therapies. Conversely, research on the use of hydrogels for ICH therapy is still in its infancy, with very few published reports investigating their therapeutic potential. Here, the published use of hydrogels in experimental ICH is commented upon and how approaches reported in the IS and TBI fields may be applied to ICH research to inform the design of future therapies is described. Unique aspects of ICH that are distinct from IS and TBI that should be considered when translating biomaterial‐based therapies between disease models are also highlighted.

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The Potential of Biomaterial-Based Approaches as Therapies for Ischemic Stroke: A Systematic Review and Meta-Analysis of Pre-clinical Studies

Cited by 14 publications

References 110 publications

Principles and requirements for stroke recovery science

Principles and requirements for stroke recovery science

Optimizing Stem Cell Therapy after Ischemic Brain Injury

Regenerative Potential of Hydrogels for Intracerebral Hemorrhage: Lessons from Ischemic Stroke and Traumatic Brain Injury Research

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