Neural stem cell therapy for subacute and chronic ischemic stroke

• Published in: Stem cell research & therapy Vol. 9; no. 1; p. 154
• Main Authors: Boese, Austin C, Le, Quan-Son Eric, Pham, Dylan, Hamblin, Milton H, Lee, Jean-Pyo
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 13.06.2018; BioMed Central; BMC
• Subjects: Aging; Analysis; Angiogenesis; Blood-brain barrier; Blood-brain barrier, Neural stem cells, Stroke, Tissue plasminogen activator, Transplantation; Brain injury; Brain Ischemia - pathology; Brain Ischemia - therapy; Care and treatment; Cell death; Chronic Disease; Diabetes; Growth factors; Homeostasis; Humans; Immunosuppressive agents; Ischemia; Nervous system; Neural stem cells; Neurogenesis; Parenchyma; Parenchyma (Botany); Patients; Reperfusion; Review; Rodents; Stem cell transplantation; Stem Cell Transplantation - methods; Stem cells; Stroke; Stroke - pathology; Stroke - therapy; t-Plasminogen activator; Thrombolysis; Tissue Plasminogen Activator - pharmacology; Tissue Plasminogen Activator - therapeutic use; Transplantation; Transplants & implants; Blood-brain barrier, Neural stem cells, Stroke, Tissue plasminogen activator, Transplantation
• ISSN: 1757-6512; 1757-6512
• DOI: 10.1186/s13287-018-0913-2

Neural stem cells (NSCs) play vital roles in brain homeostasis and exhibit a broad repertoire of potentially therapeutic actions following neurovascular injury. One such injury is stroke, a worldwide leading cause of death and disability. Clinically, extensive injury from ischemic stroke results from ischemia-reperfusion (IR), which is accompanied by inflammation, blood-brain barrier (BBB) damage, neural cell death, and extensive tissue loss. Tissue plasminogen activator (tPA) is still the only US Food and Drug Administration-approved clot-lysing agent. Whereas the thrombolytic role of tPA within the vasculature is beneficial, the effects of tPA (in a non-thrombolytic role) within the brain parenchyma have been reported as harmful. Thus, new therapies are needed to reduce the deleterious side effects of tPA and quickly facilitate vascular repair following stroke. The Stroke Treatment Academic Industry Roundtable (STAIR) recommends that stroke therapies "focus on drugs/devices/treatments with multiple mechanisms of action and that target multiple pathways". Thus, based on multifactorial ischemic cascades in various stroke stages, effective stroke therapies need to focus on targeting and ameliorating early IR injury as well as facilitating angiogenesis, neurogenesis, and neurorestorative mechanisms following stroke. This review will discuss the preclinical perspectives of NSC transplantation as a promising treatment for neurovascular injury and will emphasize both the subacute and chronic phase of ischemic stroke.