Stem cell therapies in stroke rehabilitation: a narrative review of current strategies and future prospects

Nicholas Aderinto, Gbolahan Olatunji, Emmanuel Kokori, Adetola Emmanuel Babalola, Ismaila Ajayi Yusuf, Oluwatobiloba Oluwatomisin Apampa, Bonaventure Michael Ukoaka, John Ehi Aboje, Temiloluwa Adefusi, Abdulrahmon Moradeyo, Opabode Muntaqim Obasanjo, Ikponmwosa Jude Ogieuhi, Oluwatobi Omoworare, Doyin Olatunji
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Abstract

This paper explores the potential of stem cell therapies in revolutionising stroke recovery, addressing the limitations of current treatments and emphasising regenerative medicine as a promising alternative. Stroke, a leading cause of disability and death worldwide, necessitates innovative approaches due to the temporal constraints and regenerative deficiencies in existing therapeutic modalities. The review explores the diverse mechanisms underlying stem cell-mediated recovery, encompassing neuroprotection, neurogenesis, angiogenesis, modulation of inflammatory responses, and induction of host brain plasticity. We searched prominent databases (PubMed, Scopus, Google Scholar, and Web of Science) from inception to January 2024 for studies on “stem cell therapy” or “regenerative medicine” combined with “stroke recovery” or “cerebrovascular accident”. Studies in humans and animals, published in peer-reviewed journals, and investigating the impact of stem cell therapy on stroke recovery were included. We excluded non-English publications and those lacking sufficient outcome data. Evidence from animal studies demonstrates the efficacy of various stem cell types, while human studies, though limited, contribute valuable insights into safety and potential efficacy. Safety considerations, crucial for successful clinical application, emphasise the need for rigorous preclinical and clinical studies, long-term follow-up data, and ethical standards. Challenges in the field, such as study design heterogeneity, optimising stem cell delivery methods, and identifying subpopulations likely to benefit, require concerted efforts to overcome. Standardising methodologies, refining delivery routes, and personalising interventions based on biomarkers are essential. This review positions stem cell therapies as promising for comprehensive neural tissue recovery following stroke.
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中风康复中的干细胞疗法:当前策略与未来前景综述
本文探讨了干细胞疗法在彻底改变中风康复方面的潜力,解决了现有疗法的局限性,并强调再生医学是一种有前途的替代疗法。中风是全球致残和致死的主要原因之一,由于时间限制和现有治疗方法的再生缺陷,有必要采用创新方法。本综述探讨了干细胞介导恢复的各种机制,包括神经保护、神经发生、血管生成、炎症反应调节和诱导宿主大脑可塑性。我们检索了从开始到2024年1月的主要数据库(PubMed、Scopus、Google Scholar和Web of Science)中有关 "干细胞疗法 "或 "再生医学 "以及 "中风恢复 "或 "脑血管意外 "的研究。我们纳入了在同行评审期刊上发表的人类和动物研究,以及调查干细胞疗法对中风康复影响的研究。我们排除了非英文出版物和缺乏足够结果数据的研究。动物研究的证据证明了各种干细胞类型的疗效,而人类研究虽然有限,但对安全性和潜在疗效提供了宝贵的见解。安全性是成功临床应用的关键,强调需要严格的临床前和临床研究、长期随访数据和伦理标准。该领域面临的挑战,如研究设计的异质性、干细胞输送方法的优化以及确定可能受益的亚群,都需要共同努力来克服。标准化方法、改进输送途径以及根据生物标志物进行个性化干预至关重要。本综述认为,干细胞疗法对中风后神经组织的全面恢复大有可为。
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