Abstract
Stem cell transplantation with rehabilitation therapy presents an effective stroke treatment. Here, we discuss current breakthroughs in stem cell research along with rehabilitation strategies that may have a synergistic outcome when combined together after stroke. Indeed, stem cell transplantation offers a promising new approach and may add to current rehabilitation therapies. By reviewing the pathophysiology of stroke and the mechanisms by which stem cells and rehabilitation attenuate this inflammatory process, we hypothesize that a combined therapy will provide better functional outcomes for patients. Using current preclinical data, we explore the prominent types of stem cells, the existing theories for stem cell repair, rehabilitation treatments inside the brain, rehabilitation modalities outside the brain, and evidence pertaining to the benefits of combined therapy. In this review article, we assess the advantages and disadvantages of using stem cell transplantation with rehabilitation to mitigate the devastating effects of stroke.
Highlights
Licensee MDPI, Basel, Switzerland.Advances in medical accessibility, technology, and treatment over the past century have increased the average human life expectancy, but this comes with higher risks for neurodegenerative diseases and disorders [1,2]
mesenchymal stem cells (MSCs) and neural stem cells (NSCs) produce several growth factors, as well as neurotrophic factors, such as brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) [11,152], which may play a role in enhancing endogenous neurogenesis [11,153]
Combination treatments consisting of stem cell transplantation and an EE or rehabilitation therapy may prove beneficial for stroke patients (Table 1); rehabilitation therapy stands as the default treatment for stroke patients
Summary
The current mainstay of treatment for ischemic stroke is thrombolytic reperfusion through tissue plasminogen activator (tPA) infusion, but the narrow therapeutic window and associated adverse effects have not eliminated stroke as a major cause of mortality and morbidity around the world [4] Other therapies such as endovascular mechanical thrombectomy have a wider therapeutic window, but the window is still hours rather than days, and the damage from prolonged brain ischemia is often irreversible [5,6]. Strategies designed to enhance the regenerative features of the microenvironment may promote improved brain repair Combining these effective therapies thoughtfully for stroke rehabilitation may be the future of stroke treatment and functional recovery. The subsequent sections will focus on the use of stem cells and biomaterials for rehabilitation of the stroke brain
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