Zhou Guoyang, Wang Yongjie, Gao Shiqi, Fu Xiongjie, Cao Yang, Peng Yucong, Zhuang Jianfeng, Hu Junwen, Shao Anwen, Wang Lin
Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Front Cell Dev Biol. 2021 Apr 1;9:646927. doi: 10.3389/fcell.2021.646927. eCollection 2021.
Ischemic stroke (IS) remains one of the major causes of death and disability due to the limited ability of central nervous system cells to regenerate and differentiate. Although several advances have been made in stroke therapies in the last decades, there are only a few approaches available to improve IS outcome. In the acute phase of IS, mechanical thrombectomy and the administration of tissue plasminogen activator have been widely used, while aspirin or clopidogrel represents the main therapy used in the subacute or chronic phase. However, in most cases, stroke patients fail to achieve satisfactory functional recovery under the treatments mentioned above. Recently, cell therapy, especially stem cell therapy, has been considered as a novel and potential therapeutic strategy to improve stroke outcome through mechanisms, including cell differentiation, cell replacement, immunomodulation, neural circuit reconstruction, and protective factor release. Different stem cell types, such as mesenchymal stem cells, marrow mononuclear cells, and neural stem cells, have also been considered for stroke therapy. In recent years, many clinical and preclinical studies on cell therapy have been carried out, and numerous results have shown that cell therapy has bright prospects in the treatment of stroke. However, some cell therapy issues are not yet fully understood, such as its optimal parameters including cell type choice, cell doses, and injection routes; therefore, a closer relationship between basic and clinical research is needed. In this review, the role of cell therapy in stroke treatment and its mechanisms was summarized, as well as the function of different stem cell types in stroke treatment and the clinical trials using stem cell therapy to cure stroke, to reveal future insights on stroke-related cell therapy, and to guide further studies.
由于中枢神经系统细胞再生和分化能力有限，缺血性中风（IS）仍然是死亡和残疾的主要原因之一。尽管在过去几十年中风治疗方面取得了一些进展，但改善缺血性中风预后的方法仍然有限。在缺血性中风的急性期，机械取栓和组织纤溶酶原激活剂的应用已被广泛使用，而阿司匹林或氯吡格雷是亚急性或慢性期的主要治疗药物。然而，在大多数情况下，中风患者在上述治疗下未能实现令人满意的功能恢复。近年来，细胞治疗，尤其是干细胞治疗，被认为是一种通过细胞分化、细胞替代、免疫调节、神经回路重建和保护因子释放等机制改善中风预后的新型潜在治疗策略。不同类型的干细胞，如间充质干细胞、骨髓单个核细胞和神经干细胞，也被考虑用于中风治疗。近年来，已经开展了许多关于细胞治疗的临床和临床前研究，大量结果表明细胞治疗在中风治疗中具有广阔前景。然而，一些细胞治疗问题尚未完全明确，如最佳参数，包括细胞类型选择、细胞剂量和注射途径等；因此，基础研究和临床研究之间需要更紧密的联系。在本综述中，总结了细胞治疗在中风治疗中的作用及其机制，以及不同类型干细胞在中风治疗中的作用和使用干细胞治疗中风的临床试验，以揭示中风相关细胞治疗的未来见解，并指导进一步研究。
