Mulia Gabriella Jeanne, Anna Novelia, Wu John Chung-Che, Ma Hon-Ping, Chiang Yung-Hsiao, Ou Ju-Chi, Chen Kai-Yun
International Master Program in Medical Neuroscience, College of Medical Science and Technology, Taipei Medical University, Taipei.
Department of Biotechnology, Indonesia International Institute for Life Sciences, East Jakarta, Indonesia.
Cell Transplant. 2025 Jan-Dec;34:9636897251315121. doi: 10.1177/09636897251315121.
Stroke, a neurological condition from compromised cerebral blood perfusion, remains a major global cause of mortality and disability. Conventional therapies like tissue plasminogen activator are limited by narrow therapeutic windows and potential adverse effects, highlighting the urgency for novel treatments. Stem cell-based therapies, with their neuroprotective and regenerative properties, present a promising yet highly diverse alternative. By conducting literature search and data extraction from the PubMed, Embase, and Cochrane databases, this meta-analysis assessed the clinical efficacy and safety of stem cell-based therapies administered via intravenous (IV) and non-IV routes in 17 studies with stroke patients. Primary outcomes included the National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), and modified Rankin Scale (mRS), while secondary outcomes included mortality and adverse events. Results demonstrated significant improvements in NIHSS, BI, and mRS scores, particularly in non-IV groups within 6- and 12-month follow-ups, suggesting delayed but enhanced therapeutic efficacy. Mortality was reduced in both IV and non-IV groups, indicating treatment safety. Adverse events, categorized into neurological and systemic complications, showed no significant differences between intervention and control groups, further emphasizing the safety of stem cell therapies. Non-IV routes showed more long-term benefits, potentially due to enhanced cell delivery and integration. These findings demonstrate the potential of stem cell therapies to improve functional recovery and survival in stroke patients, regardless of administration route. However, the delayed response underscores the need for extended follow-up in clinical applications. Further research is required to standardize treatment protocols, optimize cell types and doses, and address patient-specific factors to integrate stem cell therapies into routine clinical practice.
中风是一种因脑血流灌注受损引起的神经疾病，仍然是全球死亡和残疾的主要原因。像组织纤溶酶原激活剂这样的传统疗法受到狭窄治疗窗和潜在副作用的限制，凸显了新型治疗方法的紧迫性。基于干细胞的疗法具有神经保护和再生特性，是一种有前景但高度多样化的替代方案。通过对PubMed、Embase和Cochrane数据库进行文献检索和数据提取，这项荟萃分析评估了17项针对中风患者的研究中，通过静脉内（IV）和非静脉内途径施用的基于干细胞的疗法的临床疗效和安全性。主要结局包括美国国立卫生研究院卒中量表（NIHSS）、巴氏指数（BI）和改良Rankin量表（mRS），而次要结局包括死亡率和不良事件。结果表明，NIHSS、BI和mRS评分有显著改善，特别是在6个月和12个月随访期间的非静脉内组，表明治疗效果延迟但增强。静脉内和非静脉内组的死亡率均降低，表明治疗安全。不良事件分为神经和全身并发症，干预组和对照组之间无显著差异，进一步强调了干细胞疗法的安全性。非静脉内途径显示出更多的长期益处，可能是由于细胞递送和整合增强。这些发现表明，无论给药途径如何，干细胞疗法都有改善中风患者功能恢复和生存的潜力。然而，延迟反应强调了在临床应用中需要延长随访时间。需要进一步研究以规范治疗方案、优化细胞类型和剂量，并解决患者特异性因素，以便将干细胞疗法纳入常规临床实践。
