Liu Xinfeng, Ye Ruidong, Yan Tao, Yu Shan Ping, Wei Ling, Xu Gelin, Fan Xinying, Jiang Yongjun, Stetler R Anne, Liu George, Chen Jieli
Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
Prog Neurobiol. 2014 Apr;115:92-115. doi: 10.1016/j.pneurobio.2013.11.007. Epub 2013 Dec 12.
Cell therapy is emerging as a viable therapy to restore neurological function after stroke. Many types of stem/progenitor cells from different sources have been explored for their feasibility and efficacy for the treatment of stroke. Transplanted cells not only have the potential to replace the lost circuitry, but also produce growth and trophic factors, or stimulate the release of such factors from host brain cells, thereby enhancing endogenous brain repair processes. Although stem/progenitor cells have shown a promising role in ischemic stroke in experimental studies as well as initial clinical pilot studies, cellular therapy is still at an early stage in humans. Many critical issues need to be addressed including the therapeutic time window, cell type selection, delivery route, and in vivo monitoring of their migration pattern. This review attempts to provide a comprehensive synopsis of preclinical evidence and clinical experience of various donor cell types, their restorative mechanisms, delivery routes, imaging strategies, future prospects and challenges for translating cell therapies as a neurorestorative regimen in clinical applications.
细胞疗法正逐渐成为一种可行的疗法,用于恢复中风后的神经功能。人们已经探索了多种来自不同来源的干细胞/祖细胞用于治疗中风的可行性和疗效。移植的细胞不仅有可能替代受损的神经回路,还能产生生长因子和营养因子,或刺激宿主脑细胞释放此类因子,从而增强内源性脑修复过程。尽管干细胞/祖细胞在缺血性中风的实验研究以及初步临床试点研究中已显示出有前景的作用,但细胞疗法在人体中仍处于早期阶段。许多关键问题需要解决,包括治疗时间窗、细胞类型选择、给药途径以及对其迁移模式的体内监测。本综述试图全面概述各种供体细胞类型的临床前证据和临床经验、它们的修复机制、给药途径、成像策略、未来前景以及将细胞疗法转化为临床应用中的神经修复方案所面临的挑战。