Mohamed Ghada A, Lench Daniel H, Grewal Parneet, Rosenberg Mark, Voeks Jenifer
Department of Neurology, Medical University of South Carolina, Charleston, SC, United States.
Front Neurol. 2024 Aug 9;15:1419867. doi: 10.3389/fneur.2024.1419867. eCollection 2024.
Stroke and traumatic brain injury (TBI) are a significant cause of death and disability nationwide. Both are considered public health concerns in rural communities in the state of South Carolina (SC), particularly affecting the African American population resulting in considerable morbidity, mortality, and economic burden. Stem cell therapy (SCT) has emerged as a potential intervention for both diseases with increasing research trials showing promising results. In this perspective article, the authors aim to discuss the current research in the field of SCT, the results of early phase trials, and the utilization of outcome measures and biomarkers of recovery. We searched PubMed from inception to December 2023 for articles on stem cell therapy in stroke and traumatic brain injury and its impact on rural communities, particularly in SC. Early phase trials of SCT in Stroke and Traumatic Brain injury yield promising safety profile and efficacy results, but the findings have not yet been consistently replicated. Early trials using mesenchymal stem cells for stroke survivors showed safety, feasibility, and improved functional outcomes using broad and domain-specific outcome measures. Neuroimaging markers of recovery such as Functional Magnetic Resonance Imaging (fMRI) and electroencephalography (EEG) combined with neuromodulation, although not widely used in SCT research, could represent a breakthrough when evaluating brain injury and its functional consequences. This article highlights the role of SCT as a promising intervention while addressing the underlying social determinants of health that affect therapeutic outcomes in relation to rural communities such as SC. It also addresses the challenges ethical concerns of stem cell sourcing, the high cost of autologous cell therapies, and the technical difficulties in ensuring transplanted cell survival and strategies to overcome barriers to clinical trial enrollment such as the ethical concerns of stem cell sourcing, the high cost of autologous cell therapies, and the technical difficulties in ensuring transplanted cell survival and equitable healthcare.
中风和创伤性脑损伤(TBI)是全国范围内导致死亡和残疾的重要原因。在南卡罗来纳州(SC)的农村社区,这两者都被视为公共卫生问题,尤其对非裔美国人造成影响,导致相当高的发病率、死亡率和经济负担。干细胞疗法(SCT)已成为这两种疾病的一种潜在干预手段,越来越多的研究试验显示出有希望的结果。在这篇观点文章中,作者旨在讨论SCT领域的当前研究、早期试验的结果以及恢复的结局指标和生物标志物的应用。我们在PubMed数据库中从建库至2023年12月搜索了关于中风和创伤性脑损伤的干细胞疗法及其对农村社区,特别是对SC农村社区影响的文章。SCT在中风和创伤性脑损伤方面的早期试验产生了有希望的安全性概况和疗效结果,但这些发现尚未得到一致的重复验证。早期使用间充质干细胞治疗中风幸存者的试验显示了安全性、可行性,并使用广泛的和特定领域的结局指标改善了功能结局。恢复的神经影像学标志物,如功能磁共振成像(fMRI)和脑电图(EEG)与神经调节相结合,尽管在SCT研究中未被广泛使用,但在评估脑损伤及其功能后果时可能代表一项突破。本文强调了SCT作为一种有前景的干预手段的作用,同时解决影响农村社区(如SC)治疗结局的潜在健康社会决定因素。它还讨论了干细胞来源的伦理问题、自体细胞疗法的高成本以及确保移植细胞存活的技术困难等挑战,以及克服临床试验入组障碍的策略,如干细胞来源的伦理问题、自体细胞疗法的高成本、确保移植细胞存活的技术困难以及公平医疗保健。