Gonzales-Portillo Gabriel S, Sanberg Paul R, Franzblau Max, Gonzales-Portillo Chiara, Diamandis Theo, Staples Meaghan, Sanberg Cyndy D, Borlongan Cesar V
Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Cell Transplant. 2014;23(4-5):531-9. doi: 10.3727/096368914X678337. Epub 2014 Jan 29.
Ischemic brain injury in adults and neonates is a significant clinical problem with limited therapeutic interventions. Currently, clinicians have only tPA available for stroke treatment and hypothermia for cerebral palsy. Owing to the lack of treatment options, there is a need for novel treatments such as stem cell therapy. Various stem cells including cells from embryo, fetus, perinatal, and adult tissues have proved effective in preclinical and small clinical trials. However, a limiting factor in the success of these treatments is the delivery of the cells and their by-products (neurotrophic factors) into the injured brain. We have demonstrated that mannitol, a drug with the potential to transiently open the blood-brain barrier and facilitate the entry of stem cells and trophic factors, as a solution to the delivery problem. The combination of stem cell therapy and mannitol may improve therapeutic outcomes in adult stroke and neonatal cerebral palsy.
成人和新生儿的缺血性脑损伤是一个严重的临床问题,治疗干预手段有限。目前,临床医生治疗中风仅有组织型纤溶酶原激活剂(tPA)可用,治疗脑瘫则只有低温疗法。由于缺乏治疗选择,需要诸如干细胞疗法等新型治疗方法。包括来自胚胎、胎儿、围产期和成人组织的细胞在内的各种干细胞已在临床前和小型临床试验中证明有效。然而,这些治疗成功的一个限制因素是将细胞及其副产物(神经营养因子)输送到受损大脑中。我们已经证明,甘露醇作为一种有可能短暂打开血脑屏障并促进干细胞和营养因子进入的药物,可以解决输送问题。干细胞疗法与甘露醇相结合可能会改善成人中风和新生儿脑瘫的治疗效果。