aLaboratory of Neurobiology, Vesalius Research Center, VIB bExperimental Neurology and Leuven Research Institute for Neurodegenerative Diseases (LIND), University of Leuven cDepartment of Neurology, University Hospitals Leuven, Leuven, Belgium dDepartment of Neurosurgery, Stanford Stroke Center, and Stanford Institute for Neuro-Innovation & Translational Neurosciences, Stanford University School of Medicine, Stanford, California, USA.
Curr Opin Neurol. 2013 Dec;26(6):617-25. doi: 10.1097/WCO.0000000000000023.
The central nervous system has limited capacity for regeneration after acute and chronic injury. An attractive approach to stimulate neural plasticity in the brain is to transplant stem cells in order to restore function. Here, we discuss potential mechanisms of action, current knowledge and future perspectives of clinical stem cell research for stroke and traumatic brain injury.
Preclinical data using various models suggest stem cell therapy to be a promising therapeutic avenue. Progress has been made in elucidating the mechanism of action of various cell types used, shifting the hypothesis from neural replacement to enhancing endogenous repair processes. Translation of these findings in clinical trials is currently being pursued with emphasis on both safety as well as efficacy.
Clinical trials are currently recruiting patients in phase I and II trials to gain more insight in the therapeutic potential of stem cells in acute cerebral injury. A close interplay between results of these clinical trials and more extensive basic research is essential for future trial design, choosing the optimal transplantation strategy and selecting the right patients.
中枢神经系统在急性和慢性损伤后再生能力有限。一种有吸引力的刺激大脑神经可塑性的方法是移植干细胞以恢复功能。在这里,我们讨论了用于中风和创伤性脑损伤的临床干细胞研究的潜在作用机制、现有知识和未来展望。
使用各种模型的临床前数据表明干细胞疗法是一种很有前途的治疗途径。已经在阐明所使用的各种细胞类型的作用机制方面取得了进展,从神经替代转向增强内源性修复过程的假说。目前正在进行临床试验的翻译,重点是安全性和有效性。
目前正在招募 I 期和 II 期临床试验的患者,以更深入地了解急性脑损伤中干细胞的治疗潜力。这些临床试验的结果与更广泛的基础研究之间的密切相互作用对于未来的试验设计、选择最佳的移植策略和选择合适的患者至关重要。