Department of Neurology, Henry Ford Health System, Education & Research Building, #3056, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
Expert Opin Biol Ther. 2013 Sep;13(9):1229-40. doi: 10.1517/14712598.2013.804507. Epub 2013 Jun 6.
Stroke is a major cause of mortality and disability in adults worldwide. Unfortunately, current therapy which targets vessel recanalization has a narrow treatment window, and at this time neuroprotective approaches are not effective for stroke treatment. However, after stroke the parenchymal and endothelial cells in the central nervous system (CNS) respond in concert to ischemic stressors and create a microenvironment in which successful recovery may ensue. Neurogenesis, synaptogenesis, axonal sprouting, glial cell activation, angiogenesis and vascular remodeling within the brain and the spinal cord are stimulated post stroke. Cell based-therapy amplifies these endogenous restorative effects within the CNS to promote functional outcome.
This article reviews current knowledge of cell-based therapy in the adult brain after stroke, including transplanted cell type, benefits and risks, with an emphasis on mechanisms of action.
Experimental studies and clinical trials with cell-based therapy in stroke appear promising. Cell-based therapy is not intended for the replacement of damaged cells, but for the remodeling of the CNS by promoting neuroplasticity, angiogenesis and immunomodulation. However, there are risks associated with the use of cell-based therapy, and adequate evaluation of these potential risks is a prerequisite before clinical application for stroke patients.
中风是全世界成年人死亡和残疾的主要原因。不幸的是，目前针对血管再通的治疗方法有一个狭窄的治疗窗口，而此时神经保护方法对中风治疗无效。然而，中风后中枢神经系统（CNS）的实质细胞和内皮细胞会协同对缺血应激作出反应，并产生一个有利于成功恢复的微环境。中风后大脑和脊髓内的神经发生、突触形成、轴突发芽、神经胶质细胞激活、血管生成和血管重塑都会受到刺激。细胞疗法会放大中枢神经系统内的这些内源性修复作用，从而促进功能恢复。
本文综述了中风后成人脑内的细胞疗法的现有知识，包括移植细胞类型、益处和风险，并重点介绍了作用机制。
细胞疗法在中风方面的实验研究和临床试验似乎很有前景。细胞疗法的目的不是替代受损细胞，而是通过促进神经可塑性、血管生成和免疫调节来重塑中枢神经系统。然而，细胞疗法的使用存在风险，在将其应用于中风患者之前，对这些潜在风险进行充分评估是必要的前提。
