Abstract
Stroke is the main cause of disability and death in the world within neurological diseases. Despite such a huge impact, enzymatic, and mechanical recanalization are the only treatments available so far for ischemic stroke, but only <20% of patients can benefit from them. The use of stem cells as a possible cell therapy in stroke has been tested for years. The results obtained from these studies, although conflicting or controversial in some aspects, are promising. In the last few years, the recent development of the induced pluripotent stem cells has opened new possibilities to find new cell therapies against stroke. In this review, we will provide an overview of the state of the art of cell therapy in stroke. We will describe the current situation of the most employed stem cells and the use of induced pluripotent stem cells in stroke pathology. We will also present a summary of the different clinical trials that are being carried out or that already have results on the use of stem cells as a potential therapeutic intervention for stroke.
Highlights
From the moment that the capacity of differentiation and self-renewal of stem cells became known, their use as cell therapy for a wide range of diseases has been considered
We offer a general overview of the use of adult stem cells and induced pluripotent stem cells (iPSCs) in stroke, addressing the main problems and the main clinical trials that already present results
Aimed to clarify the discrepancies about the best route for cell administration in stroke, we have recently reported an experimental study to investigate whether mesenchymal stem cells (MSCs) were able to reach the brain following i.a. or i.v. administration after transient cerebral ischemia in rats and to evaluate the therapeutic effects of both routes [22]
Summary
From the moment that the capacity of differentiation and self-renewal of stem cells became known, their use as cell therapy for a wide range of diseases has been considered. Some studies have reported that iPSC-derived NSCs transplanted in the brain of mice subjected to stroke have no tumorigenicity risk [29] or iPSCs in intracerebral hemorrhage stroke [77], one of the main limitations of iPSCs in order to achieve a future translationality to the clinical is the formation of teratomas or tumorigenicity in the following weeks after cell administration [80]. This is due to the environmental effects of the niche where the iPSCs are implanted. It would be possible to generate these cells from reprogrammed iPSCs from adult somatic cells of a CADASIL patient and perform mono and co-cultures that would allow one to study and better understand the molecular mechanisms of this disease and clarify
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