Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, MN 55455, USA; Stem Cell Institute, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
Brain Res. 2019 Nov 1;1722:146362. doi: 10.1016/j.brainres.2019.146362. Epub 2019 Aug 2.
Stroke remains a prevalent disease with limited treatment options. Available treatments offer little in the way of enhancing neurogenesis and recovery. Because of the limitations of available treatments, new therapies for stroke are needed. Stem cell-based therapies for stroke offer promise because of their potential to provide neurorestorative benefits. Stem cell-based therapies aim to promote neurogenesis and replacement of lost neurons or protect surviving neurons in order to improve neurological recovery. The mechanism through which stem cell treatments mediate their therapeutic effect is largely dependent on the type of stem cell and route of administration. Neural stem cells have been shown in pre-clinical and clinical trials to promote functional recovery when used in intracerebral transplantations. The therapeutic effects of neural stem cells have been attributed to their formation of new neurons and promotion of neuroregeneration. Bone marrow stem cells (BMSC) and mesenchymal stem cells (MSC) have been shown to enhance neurogenesis in pre-clinical models in intracerebral transplantations, but lack clinical evidence to support this therapeutic approach in patients and appear to be less effective than neural stem cells. Intravenous and intra-arterial administration of BMSC and MSC have shown more promise, where their effects are largely mediated through neuroprotective mechanisms. The immune system has been implicated in exacerbating initial damage caused by stroke, and BMSC and MSC have demonstrated immunomodulatory properties capable of dampening post-stroke inflammation and potentially improving recovery. While still in development, stem cell therapies may yield new treatments for stroke which can improve neurological recovery.
中风仍然是一种常见疾病，治疗选择有限。现有的治疗方法在促进神经发生和恢复方面收效甚微。由于现有治疗方法的局限性，需要新的中风治疗方法。基于干细胞的中风治疗方法具有很大的潜力，可以提供神经修复益处，因此具有广阔的应用前景。基于干细胞的治疗方法旨在促进神经发生和替代丢失的神经元或保护存活的神经元，以改善神经恢复。干细胞治疗介导其治疗效果的机制在很大程度上取决于干细胞的类型和给药途径。临床前和临床试验表明，神经干细胞在脑内移植中可促进功能恢复。神经干细胞的治疗效果归因于其形成新神经元和促进神经再生的能力。骨髓间充质干细胞（BMSC）和间充质干细胞（MSC）已被证明可在脑内移植的临床前模型中增强神经发生，但缺乏支持患者这种治疗方法的临床证据，并且似乎不如神经干细胞有效。BMSC 和 MSC 的静脉内和动脉内给药显示出更大的潜力，其作用主要通过神经保护机制介导。免疫系统被认为会加剧中风引起的初始损伤，BMSC 和 MSC 具有免疫调节特性，能够减轻中风后的炎症，并可能改善恢复。虽然仍在开发中，但干细胞疗法可能为中风提供新的治疗方法，从而改善神经恢复。
