Alwjwaj Mansour, Kadir Rais Reskiawan A, Bayraktutan Ulvi
Stroke, Division of Clinical Neuroscience, University of Nottingham, Clinical Sciences Building, City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK.
Neural Regen Res. 2021 Aug;16(8):1483-1489. doi: 10.4103/1673-5374.303012.
Ischemic stroke continues to be a leading cause of mortality and morbidity in the world. Despite recent advances in the field of stroke medicine, thrombolysis with recombinant tissue plasminogen activator remains as the only pharmacological therapy for stroke patients. However, due to short therapeutic window (4.5 hours of stroke onset) and increased risk of hemorrhage beyond this point, each year globally less than 1% of stroke patients receive this therapy which necessitate the discovery of safe and efficacious therapeutics that can be used beyond the acute phase of stroke. Accumulating evidence indicates that endothelial progenitor cells (EPCs), equipped with an inherent capacity to migrate, proliferate and differentiate, may be one such therapeutics. However, the limited availability of EPCs in peripheral blood and early senescence of few isolated cells in culture conditions adversely affect their application as effective therapeutics. Given that much of the EPC-mediated reparative effects on neurovasculature is realized by a wide range of biologically active substances released by these cells, it is possible that EPC-secretome may serve as an important therapeutic after an ischemic stroke. In light of this assumption, this review paper firstly discusses the main constituents of EPC-secretome that may exert the beneficial effects of EPCs on neurovasculature, and then reviews the currently scant literature that focuses on its therapeutic capacity.
缺血性中风仍然是全球死亡率和发病率的主要原因。尽管中风医学领域最近取得了进展，但重组组织型纤溶酶原激活剂溶栓仍然是中风患者唯一的药物治疗方法。然而，由于治疗窗口较短（中风发作后4.5小时），且在此之后出血风险增加，全球每年接受这种治疗的中风患者不到1%，这就需要发现可在中风急性期之后使用的安全有效的治疗方法。越来越多的证据表明，具有迁移、增殖和分化固有能力的内皮祖细胞（EPCs）可能就是这样一种治疗方法。然而，外周血中EPCs的可用性有限，以及培养条件下少数分离细胞的早期衰老，对其作为有效治疗方法的应用产生了不利影响。鉴于EPCs对神经血管系统的修复作用很大程度上是由这些细胞释放的多种生物活性物质实现的，EPCs分泌组有可能在缺血性中风后作为一种重要的治疗方法。基于这一假设，本文首先讨论了EPCs分泌组中可能对神经血管系统发挥有益作用的主要成分，然后综述了目前关于其治疗能力的少量文献。
