Singh Manisha, Pandey Pranav K, Bhasin Ashu, Padma M V, Mohanty Sujata
Stem Cell Facility (DBT-Centre of Excellence for Stem Cell Research), All India Institute of Medical Sciences, New Delhi, India.
Dr. Solomon H. Snyder Department of Neurosciences, Johns Hopkins University, Baltimore, MD, United States.
Front Neurosci. 2020 Jun 9;14:473. doi: 10.3389/fnins.2020.00473. eCollection 2020.
Stroke has a debilitating effect on the human body and a serious negative effect on society, with a global incidence of one in every six people. According to the World Health Organization, 15 million people suffer stroke worldwide each year. Of these, 5 million die and another 5 million are permanently disabled. Motor and cognitive deficits like hemiparesis, paralysis, chronic pain, and psychomotor and behavioral symptoms can persist long term and prevent the patient from fully reintegrating into society, therefore continuing to add to the costly healthcare burden of stroke. Regenerative medicine using stem cells seems to be a panacea for sequelae after stroke. Stem cell-based therapy aids neuro-regeneration and neuroprotection for neurological recovery in patients. However, the use of stem cells as a therapy in stroke patients still needs a lot of research at both basic and translational levels. As well as the mode of action of stem cells in reversing the symptoms not being clear, there are several clinical parameters that need to be addressed before establishing stem cell therapy in stroke, such as the type of stem cells to be administered, the number of stem cells, the timing of dosage, whether dose-boosters are required, the route of administration, etc. There are upcoming prospects of cell-free therapy also by using exosomes derived from stem cells. There are several ongoing pre-clinical studies aiming to answer these questions. Despite still being in the development stage, stem cell therapy holds great potential for neurological rehabilitation in patients suffering from stroke.
中风对人体具有致残性影响，对社会产生严重负面影响，全球每六人中就有一人发病。据世界卫生组织统计，全球每年有1500万人中风。其中，500万人死亡，另有500万人永久致残。诸如偏瘫、瘫痪、慢性疼痛以及精神运动和行为症状等运动和认知缺陷可能长期存在，使患者无法完全重新融入社会，从而继续加重中风高昂的医疗负担。利用干细胞的再生医学似乎是中风后遗症的万灵药。基于干细胞的疗法有助于神经再生和神经保护，促进患者神经功能恢复。然而，将干细胞用作中风患者的治疗方法在基础和转化层面仍需大量研究。除了干细胞逆转症状的作用机制尚不清楚外，在确立中风的干细胞治疗之前，还有几个临床参数需要解决，比如要施用的干细胞类型、干细胞数量、给药时间、是否需要剂量增强剂、给药途径等。利用源自干细胞的外泌体进行无细胞治疗也有光明前景。目前有几项临床前研究旨在回答这些问题。尽管仍处于研发阶段，但干细胞疗法对中风患者的神经康复具有巨大潜力。
