STROKE
Stroke is the most common neurological disorder in adults, and its incidence has increased mainly due to population aging and the increased prevalence of the cardiovascular disease. In addition, current measures to overcome acute attacks have reduced stroke mortality, but many surviving patients are still left with residual cognitive, sensory, and motor disabilities.
Therefore, it is apparent that new therapeutic approaches that can improve functional outcomes after stroke must be further explored.
Regenerative medicine and stem cells offer great promise in this regard, as they have the potential to promote angiogenesis (growth of new blood vessels), neurogenesis (growth of new nerve cells), and control inflammation.
Preclinical studies have shown that these approaches can improve outcomes after stroke. Clinical trials are underway to test their efficacy in humans, providing great hope that regenerative medicine and stem cells will soon offer new and effective treatments for stroke.
For some years, individual studies have documented that stem cell transplantation in acute and chronic ischemic stroke is safe and associated with improved neurological function in follow-ups up to several years (1-9). A recent meta-analysis that included 13 clinical trials with 704 patients found benefits in activities of daily living, neurological damage, and mortality in patients with ischemic stroke treated with stem cells of different types, at different doses, and by various routes of administration (10).
Although the mechanism by which stem cells cross the blood–brain barrier is not well understood, among the different routes of administration used (intralesional, intrathecal, intraarterial, intravenous, intranasal), the last two seem to have advantages because they are less invasive and logistically more straightforward routes (11,12).
REFERENCES
1. Kenmuir CL, Wechsler LR. Update on cell therapy for stroke. Stroke Vasc Neurol. 2017;2(2):59-64. doi: 10.1136/svn-2017-000070.
2. Fang J, Guo Y, Tan S, Li Z, Xie H, Chen P, et al. Autologous Endothelial Progenitor Cells Transplantation for Acute Ischemic Stroke: A 4-Year Follow-Up Study. Stem Cells Transl Med. 2018. doi: 10.1002/sctm.18-0012.
3. Levy ML, Crawford JR, Dib N, Verkh L, Tankovich N, Cramer SC. Phase I/II Study of Safety and Preliminary Efficacy of Intravenous Allogeneic Mesenchymal Stem Cells in Chronic Stroke. Stroke. 2019. doi: 10.1161/STROKEAHA.119.026318.
4. Hammadi AMA, Alhimyari F. Intra-Arterial Injection of Autologous Bone Marrow-Derived Mononuclear Cells in Ischemic Stroke Patients. Exp Clin Transplant. 2019;17(Suppl 1):239-241. doi: 10.6002/etc.MESOT2018.P102.
5. Deng L, Peng Q, Wang H, Pan J, Zhou Y, Pan K, et al. Intrathecal Injection of Allogenic Bone Marrow-Derived Mesenchymal Stromal Cells in Treatment of Patients with Severe Ischemic Stroke: Study Protocol for a Randomized Controlled Observer-Blinded Trial. Transl Stroke Res. 2019;10(2):170-177. doi: 10.1007/s12975-018-0634-y.
6. Chung JW, Chang WH, Bang OY, Moon GJ, Kim SJ, Kim SK, et al. Efficacy and Safety of Intravenous Mesenchymal Stem Cells for Ischemic Stroke. Neurology. 2021:10.1212/WNL.0000000000011440. doi: 10.1212/WNL.0000000000011440.
7. Li J, Zhang Q, Wang W, Lin F, Wang S, Zhao J. Mesenchymal stem cell therapy for ischemic stroke: A look into treatment mechanism and therapeutic potential. J Neurol. 2020. doi: 10.1007/s00415-020-10138-5.
8. Wang K, Rong L, Wei X, Zhang Q, Xiao L. The effectiveness of various cytotherapeutic strategies for the treatment of ischemic stroke: a Bayesian network meta-analysis of randomized controlled trials. Neurol Sci. 2020;41(7):1705-1717. doi: 10.1007/s10072-020-04312-w.
9. Jaillard A, Hommel M, Moisan A, Zeffiro TA, Favre-Wiki IM, Barbieux-Guillot M, Vadot W, et al, Grand S, Detante O; (for the ISIS-HERMES Study Group). Autologous Mesenchymal Stem Cells Improve Motor Recovery in Subacute Ischemic Stroke: a Randomized Clinical Trial. Transl Stroke Res. 2020. doi: 10.1007/s12975-020-00787-z. 10. Wang K, Rong L, Wei X, Zhang Q, Xiao L. The effectiveness of various cytotherapeutic strategies for the treatment of ischemic stroke: a Bayesian network meta-analysis of randomized controlled trials. Neurol Sci. 2020. doi: 10.1007/s10072-020-04312-w.
11. Wilson JJ, Foyle K, Foeng J, Norton T, McKenzie DR, Payne N, et al. Redirecting adult mesenchymal stromal cells to the brain: a new approach for treating CNS autoimmunity and neuroinflammation? Immunol Cell Biol. 2018. doi: 10.1111/imcb.12014.
12. McDonald CA, Djuliannisaa Z, Petraki M, Paton MCB, Penny TR, Sutherland AE, et al. Intranasal Delivery of Mesenchymal Stromal Cells Protects against Neonatal Hypoxic-Ischemic Brain Injury. Int J Mol Sci. 2019;20(10). pii: E2449. doi: 10.3390/ijms20102449.
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Stem cell therapy does not provide a guarantee and is not advertised as a treatment for any cures. This is similar to many other traditional medical treatments. A patient history review is required to determine eligibility and approval for stem cell therapy as an aid to the patient’s body towards supporting the body’s own healing process, if and when possible. All personal information provided is for internal and medical use only by our healthcare providers. Headquartered in Deleware, USA, REJUV, INC. is a resource company and network supplier for REJUVSTEM in Guadalajara and Cancun, Mexico. Rejuv, Inc. is not a stem cell therapy facility or surgical center. These advanced treatments have not yet been approved by the FDA, so they are not available in our office or in the United States. All cell therapies are carried out in Mexico, as regulated by the Ministry of Health, COFERPIS, and other local governments. All treatments are carried out within the legal and regulatory framework of the country in which the particular healthcare provider operates.
