Revisiting Stem Cell-Based Clinical Trials for Ischemic Stroke.

Joy Q He,Gary K Steinberg,Eric S Sussman

doi:10.3389/fnagi.2020.575990

Joy Q He, Gary K Steinberg + Show 1 more

Open Access

https://doi.org/10.3389/fnagi.2020.575990

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Abstract

Stroke is the leading cause of serious long-term disability, significantly reducing mobility in almost half of the affected patients aged 65 years and older. There are currently no proven neurorestorative treatments for chronic stroke. To address the complex problem of restoring function in ischemic brain tissue, stem cell transplantation-based therapies have emerged as potential restorative therapies. Aligning with the major cell types found within the ischemic brain, stem-cell-based clinical trials for ischemic stroke have fallen under three broad cell lineages: hematopoietic, mesenchymal, and neural. In this review article, we will discuss the scientific rationale for transplanting cells from each of these lineages and provide an overview of published and ongoing trials using this framework.

Highlights

Stroke is the leading cause of serious long-term disability, significantly reducing mobility in almost half of affected patients aged 65 years and older (Benjamin et al, 2017)
The brain responds to ischemia by undergoing liquefactive necrosis, a process in which dead tissue liquefies and is cleared by brain resident phagocytes over months
Aligning with the major cell types found within the ischemic brain, stem-cell-based clinical trials for ischemic stroke have fallen under three broad cell lineages: hematopoietic, mesenchymal, and neural (Table 1)

Summary

Introduction

Stroke is the leading cause of serious long-term disability, significantly reducing mobility in almost half of affected patients aged 65 years and older (Benjamin et al, 2017). Sorted CD34+ From Bone Marrow Hypothesizing that the hematopoietic stem cell-enriched CD34+ fraction of BM-MNCs contained the functional subset of cells responsible for repair during ischemic CNS injury, Moniche et al (2012) conducted a Phase I/II study in which 160 million autologous CD34+ BM-MNCs were infused intra-arterially (MCA) into 10 patients within 5–9 days of stroke onset.

Results

Conclusion