neural stem cell therapy for stroke

Some advantages to using iPSCs are that they present fewer ethical concerns and fewer immune issues since they can be extracted and reprogrammed from a patient’s own tissue [47]. However, the exact mechanisms underlying increased BBB permeability in the early ischemia-reperfusion (IR) stages are not well understood. Effect of human neural precursor cell transplantation on endogenous neurogenesis after focal cerebral ischemia in the rat. Neurogenesis in adult subventricular zone. Depletion of lymphocytes in mice suggests that T cells, but not B cells, are responsible for further CNS damage in the acute stroke phase [117, 118]. Delayed transplantation of human ESC-derived neural precursor cells also reduced infarct volume and improved behavioral outcome in rats [233]. Animal studies report that neurogenesis is very low by middle age [29], and human data support that hippocampal neurogenesis diminishes sharply over time [30]. Annu Rev Neurosci. It is well established that NSCs provide therapeutic gene products to modify the extracellular microenvironment and promote neuronal circuit plasticity [69, 177, 178]. Zhang L, Yi H, Xia XP, Zhao Y. Croat Med J. 2012;135:3298–310. For each experiment, all cell injections were performed on the same day. Unfortunately, neurogenesis from endogenous NSCs does not supply enough cells to repair neurological damage and newly formed cells may not fully integrate into the neuronal network in ischemic stroke brains [33, 165, 166]. Oki K, Tatarishvili J, Wood J, Koch P, Wattananit S, Mine Y, Monni E, Tornero D, Ahlenius H, Ladewig J, et al. Circulation. Nat Med. Multiple sclerosis in 54 twinships: concordance rate is independent of zygosity. Garrido-Mesa N, Camuesco D, Arribas B, Comalada M, Bailon E, Cueto-Sola M, Utrilla P, Nieto A, Zarzuelo A, Rodriguez-Cabezas ME, et al. Heart disease and stroke Statistics-2017 update: a report from the American Heart Association. One such injury is stroke, a worldwide leading cause of death and disability. 2003;343(2):129–33. In addition, a compromised integrity of the BBB allows entry of foreign proteins, fluid, and immune cells into the extracellular space within the CNS, which contributes to vasoactive edema and amplifies tissue damage [140]. Schematic diagram of NSC transplantation illustrating multiple therapeutic benefits in ischemic stroke. Nat Med. Moriyama Y, Takagi N, Hashimura K, Itokawa C, Tanonaka K. Intravenous injection of neural progenitor cells facilitates angiogenesis after cerebral ischemia. However, previous studies have shown that fetal‐NSCs undergo senescence earlier than other NSC lines, which would make large‐scale manufacturing more difficult (Wright, Prowse, Wallace, Linskens, & Svendsen, 2006). Neurotrophins: roles in neuronal development and function. NSCs from both humans and animals contain various chemokine receptors that facilitate their migration to areas of upregulated pro-inflammatory chemokine expression in the CNS [57,58,59]. Another study showed that conditionally immortalized NSCs, murine NSC line clone 36 (MHP36), promoted functional recovery following intracranial transplantation 2 d after MCAO in mice [210]. 2016;7:10523. Stroke. Nat Biotechnol. 2017;4:29. NSCs are multipotent and specifically differentiate into neural cell types (e.g., neurons, astrocytes and oligodendrocytes) and thus likely hold the greatest potential for cell replacement therapy after stroke. Isolation and propagation of NSCs can also be accomplished through other in vitro methods. Ernst A, Alkass K, Bernard S, Salehpour M, Perl S, Tisdale J, Possnert G, Druid H, Frisen J. Neurogenesis in the striatum of the adult human brain. Below are multiple actions of NSCs transplanted in the subacute phase of stroke. Induced pluripotent stem cells and embryonic stem cells are distinguished by gene expression signatures. Transplanted stem cell-secreted vascular endothelial growth factor effects poststroke recovery, inflammation, and vascular repair. Recent studies have demonstrated that NSC culture‐conditioned media and purified media products inhibit apoptosis, reduce lesion size, and promote functional recovery in stroked preclinical models (Akerblom, Sachdeva, & Jakobsson, 2012; Delaloy et al., 2010; Madelaine et al., 2017; Stappert, Roese‐Koerner, & Brustle, 2015; Sutaria, Badawi, Phelps, & Schmittgen, 2017; Webb, Kaiser, Jurgielewicz et al., 2018; Webb, Kaiser, Scoville et al., 2018; Yang et al., 2018; Zhang et al., 2015). Huang EJ, Reichardt LF. 2017;14:112. 2006;17(1–2):121–8. In preclinical stroke models, NSCs have been shown to modulate inflammation, foster neuroplasticity and neural reorganization, promote angiogenesis, and act as a cellular replacement by differentiating into mature neural cell types. FEBS Lett. Redmond DE Jr, Bjugstad KB, Teng YD, Ourednik V, Ourednik J, Wakeman DR, Parsons XH, Gonzalez R, Blanchard BC, Kim SU, et al. 2011;116(4):499–507. Hicks C, Stevanato L, Stroemer RP, Tang E, Richardson S, Sinden JD. 1998;18(8):887–95. Vasoactive edema is eventually resolved from post-stroke angiogenesis, but the generation of new blood vessels is too slow to prevent acute edema-associated CNS damage following stroke. Transplantation of NSCs after 7 d showed that grafted NSCs made synaptic connections with host neurons and displayed electrophysiological properties of mature neurons [176]. Stem cells act through multiple mechanisms to benefit mice with neurodegenerative metabolic disease. Stroemer P, Patel S, Hope A, Oliveira C, Pollock K, Sinden J. By 2060, these numbers will likely have doubled. Harris AK, Ergul A, Kozak A, Machado LS, Johnson MH, Fagan SC.

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