Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida, USA.
Stem Cells Transl Med. 2019 Sep;8(9):983-988. doi: 10.1002/sctm.19-0076. Epub 2019 May 16.
Four decades of preclinical research demonstrating survival, functional integration, and behavioral effects of transplanted stem cells in experimental stroke models have provided ample scientific basis for initiating limited clinical trials of stem cell therapy in stroke patients. Although safety of the grafted cells has been overwhelmingly documented, efficacy has not been forthcoming. Two recently concluded stroke clinical trials on mesenchymal stem cells (MSCs) highlight the importance of strict adherence to the basic science findings of optimal transplant regimen of cell dose, timing, and route of delivery in enhancing the functional outcomes of cell therapy. Echoing the Stem Cell Therapeutics as an Emerging Paradigm for Stroke and Stroke Treatment Academic Industry Roundtable call for an NIH-guided collaborative consortium of multiple laboratories in testing the safety and efficacy of stem cells and their derivatives, not just as stand-alone but preferably in combination with approved thrombolytic or thrombectomy, may further increase the likelihood of successful fruition of translating stem cell therapy for stroke clinical application. The laboratory and clinical experience with MSC therapy for stroke may guide the future translational research on stem cell-based regenerative medicine in neurological disorders. Stem Cells Translational Medicine 2019;8:983&988.
四十年的临床前研究证明了移植干细胞在实验性中风模型中的生存、功能整合和行为效应,为启动中风患者干细胞治疗的有限临床试验提供了充分的科学依据。尽管移植细胞的安全性已得到充分证明,但疗效尚未显现。最近结束的两项关于间充质干细胞(MSCs)的中风临床试验强调了严格遵循最佳移植方案的细胞剂量、时间和传递途径的基本科学发现的重要性,这可以增强细胞治疗的功能结果。与中风和中风治疗学术产业圆桌会议的干细胞治疗作为新兴范例的呼吁相呼应,呼吁 NIH 指导下的多个实验室合作联盟测试干细胞及其衍生物的安全性和有效性,不仅作为单一治疗方法,最好与已批准的溶栓或血栓切除术联合使用,可能会进一步增加成功将干细胞疗法转化为中风临床应用的可能性。中风 MSC 治疗的实验室和临床经验可能会指导未来基于干细胞的再生医学在神经疾病中的转化研究。《干细胞转化医学》2019;8:983&988。