Abstract
Following the failure of acute neuroprotection therapies, major efforts are currently made worldwide to promote neurological recovery and brain plasticity in the subacute and post-acute phases of stroke. Currently, there is hope that stroke recovery might be promoted by cell-based therapies. The field of stem cell therapy for cerebral ischemia has made significant progress in the last five years. A variety of stem cells have been tested in animal models and humans including adipose stem cells, human umbilical cord blood-derived mesenchymal stem cells, human amnion epithelial cells, human placenta amniotic membrane-derived mesenchymal stem cells, adult human pluripotent-like olfactory stem cells, human bone marrow endothelial progenitor cells, electrically-stimulated human neuronal progenitor cells, or induced pluripotent stem cells (iPSCs) of human origin. Combination therapies in animal models include a mix of two or more therapeutic factors consisting of bone marrow stromal cells, exercise and thyroid hormones, endothelial progenitor cells overexpressing the chemokine CXCL12. Mechanisms underlying the beneficial effects of transplanted cells include the “bystander” effects, paracrine mechanisms, or extracellular vesicles-mediated restorative effects. Mitochondria transfer also appears to be a powerful strategy for regenerative processes. Studies in humans are currently limited to a small number of studies using autologous stem cells mainly aimed to assess tolerability and side-effects of human stem cells in the clinic.
Highlights
Cerebral ischemia is a metabolic disease of the blood vessels affecting mostly the older population for which no rehabilitative therapy exists
Adipose tissue-derived mesenchymal stem cells (ADMSCs) have demonstrated their therapeutic potential in stroke models by improving functional recovery, with an increase in markers related to brain repair in animal models of stroke
Post-stroke rats received normally cultured bone marrow stromal cells (N-Bone marrow stromal cells (BMSC)), BMSCs exposed to hypoxia (H-BMSCs), or DMEM cell culture medium at 24 h after cerebral ischemia
Summary
Cerebral ischemia is a metabolic disease of the blood vessels affecting mostly the older population for which no rehabilitative therapy exists. The older brains are refractory to neuronal regeneration, probably because of the inhibitory environment which does not allow for axonal reconstruction. For this and other reasons, efforts are currently made to promote alternative therapies including physical, pharmacological, or cell-based therapies some of which have been tested in small clinical trials [3]. There is hope that stroke recovery might be promoted by cell-based therapies. Emerging stem cells for stroke therapy include, human amnion epithelial cells, adult human pluripotent-like olfactory stem cells, human bone marrow endothelial progenitor cells, electrically-stimulated human neuronal progenitor cells
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