Ghonim Hesham T, Shah Sumedh S, Thompson John W, Ambekar Sudheer, Peterson Eric C, Elhammady Mohamed Samy
Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
J Vasc Interv Neurol. 2016 Jan;8(5):30-7.
Despite advances in the management of subarachnoid hemorrhage, a considerable proportion of patients are still left with severe and disabling long-term consequences. Unfortunately, there are limited therapeutic options to counteract the sequelae following the initial insult. The role of stem cells has been studied in the treatment of various diseases. The goal of this study was to provide a literature review regarding the potential advantages of stem-cell therapy to counteract or minimize the sequelae of aneurysmal subarachnoid hemorrhage.
PubMed, Google Scholar, and ClinicalTrials.gov searches were conducted to incorporate pertinent studies that discussed stem cell use in the management of subarachnoid hemorrhage. Included articles were subjected to data extraction for the synthesis of the efficacy of stem-cell therapy.
Four preclinical studies with 181 animal model subjects (44 mice, 137 rats) were incorporated in our review. Endovascular punctures (65%) and blood injections in subarachnoid spaces (17%) were used to induce hemorrhage models. Stem cells were administered intravenously (3.0 × 10(6) cells) or intranasally (1.5 × 10(6) cells). According to literature, mesenchymal cell therapy significantly (p<0.05) induces stem-cell migration to lesion sites, decreases associated neural apoptosis and inflammation, improves ultrastructural integrity of cerebral tissue, and aids in improving sensorimotor function post subarachnoid hemorrhage.
Stem cells, particularly mesenchymal stem cells, have shown promising cellular, morphological, and functional benefits in animal models suffering from induced subarachnoid hemorrhages. However, further studies are warranted to elucidate the full effects of stem-cell therapy for aneurysmal subarachnoid hemorrhage.
尽管蛛网膜下腔出血的治疗取得了进展，但仍有相当一部分患者会留下严重且致残的长期后果。不幸的是，针对初始损伤后的后遗症，可用的治疗选择有限。干细胞在各种疾病治疗中的作用已得到研究。本研究的目的是提供一篇关于干细胞治疗在抵消或最小化动脉瘤性蛛网膜下腔出血后遗症方面潜在优势的文献综述。
在PubMed、谷歌学术和ClinicalTrials.gov上进行检索，纳入讨论干细胞在蛛网膜下腔出血治疗中应用的相关研究。对纳入的文章进行数据提取，以综合分析干细胞治疗的疗效。
我们的综述纳入了4项临床前研究，共181只动物模型受试者（44只小鼠，137只大鼠）。采用血管内穿刺（65%）和蛛网膜下腔注射血液（17%）诱导出血模型。干细胞通过静脉注射（3.0×10⁶个细胞）或鼻内给药（1.5×10⁶个细胞）。根据文献，间充质细胞疗法能显著（p<0.05）诱导干细胞迁移至损伤部位，减少相关的神经细胞凋亡和炎症，改善脑组织的超微结构完整性，并有助于改善蛛网膜下腔出血后的感觉运动功能。
干细胞，尤其是间充质干细胞，在诱导性蛛网膜下腔出血的动物模型中已显示出有前景的细胞层面、形态学和功能方面的益处。然而，有必要进一步研究以阐明干细胞治疗对动脉瘤性蛛网膜下腔出血的全面影响。
