Brain repair: cell therapy in stroke

Dheeraj Kalladka, Keith W Muir Institute of Neuroscience and Psychology, University of Glasgow, Southern General Hospital, Glasgow, United Kingdom Abstract: Stroke affects one in every six people worldwide, and is the leading cause of adult disability. Some spontaneous recovery is usual but of lim...

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Autores principales:	Kalladka D, Muir KW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Cytology QH573-671
Acceso en línea:	https://doaj.org/article/ce3c4bcca1874dd2b13cbd9be7729e39
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spelling	oai:doaj.org-article:ce3c4bcca1874dd2b13cbd9be7729e392021-12-02T06:08:56ZBrain repair: cell therapy in stroke1178-6957https://doaj.org/article/ce3c4bcca1874dd2b13cbd9be7729e392014-02-01T00:00:00Zhttp://www.dovepress.com/brain-repair-cell-therapy-in-stroke-a15928https://doaj.org/toc/1178-6957 Dheeraj Kalladka, Keith W Muir Institute of Neuroscience and Psychology, University of Glasgow, Southern General Hospital, Glasgow, United Kingdom Abstract: Stroke affects one in every six people worldwide, and is the leading cause of adult disability. Some spontaneous recovery is usual but of limited extent, and the mechanisms of late recovery are not completely understood. Endogenous neurogenesis in humans is thought to contribute to repair, but its extent is unknown. Exogenous cell therapy is promising as a means of augmenting brain repair, with evidence in animal stroke models of cell migration, survival, and differentiation, enhanced endogenous angiogenesis and neurogenesis, immunomodulation, and the secretion of trophic factors by stem cells from a variety of sources, but the potential mechanisms of action are incompletely understood. In the animal models of stroke, both mesenchymal stem cells (MSCs) and neural stem cells (NSCs) improve functional recovery, and MSCs reduce the infarct volume when administered acutely, but the heterogeneity in the choice of assessment scales, publication bias, and the possible confounding effects of immunosuppressants make the comparison of effects across cell types difficult. The use of adult-derived cells avoids the ethical issues around embryonic cells but may have more restricted differentiation potential. The use of autologous cells avoids rejection risk, but the sources are restricted, and culture expansion may be necessary, delaying treatment. Allogeneic cells offer controlled cell numbers and immediate availability, which may have advantages for acute treatment. Early clinical trials of both NSCs and MSCs are ongoing, and clinical safety data are emerging from limited numbers of selected patients. Ongoing research to identify prognostic imaging markers may help to improve patient selection, and the novel imaging techniques may identify biomarkers of recovery and the mechanism of action for cell therapies. Keywords: stroke, cerebrovascular disease, cell therapy, neurological diseaseKalladka DMuir KWDove Medical PressarticleCytologyQH573-671ENStem Cells and Cloning: Advances and Applications, Vol 2014, Iss default, Pp 31-44 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cytology QH573-671
spellingShingle	Cytology QH573-671 Kalladka D Muir KW Brain repair: cell therapy in stroke
description	Dheeraj Kalladka, Keith W Muir Institute of Neuroscience and Psychology, University of Glasgow, Southern General Hospital, Glasgow, United Kingdom Abstract: Stroke affects one in every six people worldwide, and is the leading cause of adult disability. Some spontaneous recovery is usual but of limited extent, and the mechanisms of late recovery are not completely understood. Endogenous neurogenesis in humans is thought to contribute to repair, but its extent is unknown. Exogenous cell therapy is promising as a means of augmenting brain repair, with evidence in animal stroke models of cell migration, survival, and differentiation, enhanced endogenous angiogenesis and neurogenesis, immunomodulation, and the secretion of trophic factors by stem cells from a variety of sources, but the potential mechanisms of action are incompletely understood. In the animal models of stroke, both mesenchymal stem cells (MSCs) and neural stem cells (NSCs) improve functional recovery, and MSCs reduce the infarct volume when administered acutely, but the heterogeneity in the choice of assessment scales, publication bias, and the possible confounding effects of immunosuppressants make the comparison of effects across cell types difficult. The use of adult-derived cells avoids the ethical issues around embryonic cells but may have more restricted differentiation potential. The use of autologous cells avoids rejection risk, but the sources are restricted, and culture expansion may be necessary, delaying treatment. Allogeneic cells offer controlled cell numbers and immediate availability, which may have advantages for acute treatment. Early clinical trials of both NSCs and MSCs are ongoing, and clinical safety data are emerging from limited numbers of selected patients. Ongoing research to identify prognostic imaging markers may help to improve patient selection, and the novel imaging techniques may identify biomarkers of recovery and the mechanism of action for cell therapies. Keywords: stroke, cerebrovascular disease, cell therapy, neurological disease
format	article
author	Kalladka D Muir KW
author_facet	Kalladka D Muir KW
author_sort	Kalladka D
title	Brain repair: cell therapy in stroke
title_short	Brain repair: cell therapy in stroke
title_full	Brain repair: cell therapy in stroke
title_fullStr	Brain repair: cell therapy in stroke
title_full_unstemmed	Brain repair: cell therapy in stroke
title_sort	brain repair: cell therapy in stroke
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/ce3c4bcca1874dd2b13cbd9be7729e39
work_keys_str_mv	AT kalladkad brainrepaircelltherapyinstroke AT muirkw brainrepaircelltherapyinstroke
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Brain repair: cell therapy in stroke

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