Advances in restorative neurosurgery: Endovascular delivery and fate determination of transplanted stem cells

Abstract

o e p t i m he amalgam of molecular biology and neurosurgery (cellular and molecular neurosurgery) ffers immense promise for neurorestoration and he management of neurodegenerative deficiencies, evelopmental disorders, neoplasms, stroke, and rauma. Fundamental concepts pertaining to these rospects were formulated in companion papers ublished in 1997 and refined in 2003, which arked the 50 anniversary of Watson and Crick’s undamental description of the structure of the NA double helix. Over the last several years, efforts to render hese concepts into practical treatments have conisted of transplanting various populations of neuonal progenitors, including clonogenically exanded stem-cell lines, into the central nervous ystem (CNS). These attempts have been thwarted y erratic physical delivery and unpredictable diferentiation (fate) of the transplanted cells. In an effort to circumvent these impediments, e have recently proposed strategies for intrarterial delivery of therapeutic cells into the CNS nd advanced the concept of a potential new aproach, endovascular restorative neurosurgery. e’ve also reported the engineering of artificial xtracellular matrix ligands that can direct the fate f stem cells along desired lineages, either before r after transplantation into the CNS. The adances of endovascular delivery and control of ellular fate represent exciting avenues for restortive neurosurgery, as summarized below.