Academic Unit of Mental Health and Clinical Neurosciences, Queens Medical Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK.
Cells. 2024 Jan 6;13(2):112. doi: 10.3390/cells13020112.
Stroke remains one of the leading causes of death and disability worldwide. Current reperfusion treatments for ischaemic stroke are limited due to their narrow therapeutic window in rescuing ischaemic penumbra. Stem cell therapy offers a promising alternative. As a regenerative medicine, stem cells offer a wider range of treatment strategies, including long-term intervention for chronic patients, through the reparation and replacement of injured cells via mechanisms of differentiation and proliferation. The purpose of this review is to evaluate the therapeutic role of stem cells for ischaemic stroke. This paper discusses the pathology during acute, subacute, and chronic phases of cerebral ischaemic injury, highlights the mechanisms involved in mesenchymal, endothelial, haematopoietic, and neural stem cell-mediated cerebrovascular regeneration, and evaluates the pre-clinical and clinical data concerning the safety and efficacy of stem cell-based treatments. The treatment of stroke patients with different types of stem cells appears to be safe and efficacious even at relatively higher concentrations irrespective of the route and timing of administration. The priming or pre-conditioning of cells prior to administration appears to help augment their therapeutic impact. However, larger patient cohorts and later-phase trials are required to consolidate these findings.
中风仍然是全球范围内导致死亡和残疾的主要原因之一。由于缺血半暗带的治疗时间窗狭窄,目前用于缺血性中风的再灌注治疗受到限制。干细胞治疗提供了一种有前途的替代方法。作为一种再生医学,干细胞提供了更广泛的治疗策略,包括通过分化和增殖机制修复和替代受损细胞,对慢性患者进行长期干预。本综述的目的是评估干细胞治疗缺血性中风的治疗作用。本文讨论了脑缺血损伤的急性期、亚急性期和慢性期的病理生理学,强调了间充质、内皮、造血和神经干细胞介导的脑血管再生所涉及的机制,并评估了与基于干细胞的治疗的安全性和疗效相关的临床前和临床数据。用不同类型的干细胞治疗中风患者似乎是安全有效的,即使在相对较高的浓度下,也与给药途径和时间无关。在给药前对细胞进行预处理或预适应似乎有助于增强其治疗效果。然而,需要更大的患者队列和更后期的试验来证实这些发现。