Stem Cell Treatments in Preclinical Relevant Stroke Models.

Current health sciences journal Pub Date : 2023-10-01 Epub Date: 2023-12-29 DOI:10.12865/CHSJ.49.04.02
Leonard Radu Pinosanu, Nora Wolff, Denissa Greta Olaru, Aurel Popa-Wagner
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Abstract

Since stroke has limited treatment options, an active search for new therapeutic approaches is required. Initial excitement of using cell-based therapies to stimulate recovery processes in the ischemic brain turned into a more measured perspective, acknowledging obstacles related to the unfavorable environments associated in part with aging. Given the predominance of stroke in older populations, evaluating the effectiveness of cell therapies in aged brain environments is essential and clinically relevant. Despite a common perception of the aged brain being resistant to regeneration, recent research with neural precursor cells and bone marrow-derived mesenchymal stem cells indicates that cell-based therapy can promote plasticity and remodeling in the aged rat brain. However, significant differences in the aged brain compared to the young brain, such as expedited progression of ischemic injury to brain infarction, decreased rate of endogenous neurogenesis, and delayed onset of neurological recovery, must be noted. The effectiveness of cell-based therapies may further be connected to age-related comorbidities such as diabetes or hyperlipidemia, potentially leading to maladaptive or impaired brain remodeling. These age-related factors need careful consideration in the clinical application of restorative therapies for stroke.

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临床前相关中风模型中的干细胞疗法。
由于中风的治疗方案有限,因此需要积极寻找新的治疗方法。最初,人们对使用细胞疗法刺激缺血性脑部恢复过程感到兴奋,但后来,人们认识到与部分老龄化相关的不利环境所造成的障碍,转而采取了更加审慎的态度。鉴于中风主要发生在老年人群中,评估细胞疗法在老年脑环境中的有效性至关重要,而且与临床息息相关。尽管人们普遍认为老年大脑对再生有抵抗力,但最近对神经前体细胞和骨髓间充质干细胞的研究表明,基于细胞的疗法可以促进老年大鼠大脑的可塑性和重塑。然而,必须注意的是,与年轻大脑相比,老年大脑存在明显差异,例如缺血性损伤加速发展为脑梗塞、内源性神经发生率降低以及神经功能恢复开始时间推迟。细胞疗法的有效性还可能与糖尿病或高脂血症等与年龄相关的并发症有关,这些并发症可能导致适应不良或受损的大脑重塑。在临床应用中风恢复疗法时,需要仔细考虑这些与年龄有关的因素。
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