Stem cell therapy: a new hope for stroke and traumatic brain injury recovery and the challenge for rural minorities in South Carolina

Ghada A. Mohamed, Daniel H. Lench, Parneet Grewal, Mark Rosenberg, Jenifer Voeks
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Abstract

Stroke and traumatic brain injury (TBI) are a significant cause of death and disability nationwide. Both are considered public health concerns in rural communities in the state of South Carolina (SC), particularly affecting the African American population resulting in considerable morbidity, mortality, and economic burden. Stem cell therapy (SCT) has emerged as a potential intervention for both diseases with increasing research trials showing promising results. In this perspective article, the authors aim to discuss the current research in the field of SCT, the results of early phase trials, and the utilization of outcome measures and biomarkers of recovery. We searched PubMed from inception to December 2023 for articles on stem cell therapy in stroke and traumatic brain injury and its impact on rural communities, particularly in SC. Early phase trials of SCT in Stroke and Traumatic Brain injury yield promising safety profile and efficacy results, but the findings have not yet been consistently replicated. Early trials using mesenchymal stem cells for stroke survivors showed safety, feasibility, and improved functional outcomes using broad and domain-specific outcome measures. Neuroimaging markers of recovery such as Functional Magnetic Resonance Imaging (fMRI) and electroencephalography (EEG) combined with neuromodulation, although not widely used in SCT research, could represent a breakthrough when evaluating brain injury and its functional consequences. This article highlights the role of SCT as a promising intervention while addressing the underlying social determinants of health that affect therapeutic outcomes in relation to rural communities such as SC. It also addresses the challenges ethical concerns of stem cell sourcing, the high cost of autologous cell therapies, and the technical difficulties in ensuring transplanted cell survival and strategies to overcome barriers to clinical trial enrollment such as the ethical concerns of stem cell sourcing, the high cost of autologous cell therapies, and the technical difficulties in ensuring transplanted cell survival and equitable healthcare.
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干细胞疗法:中风和脑外伤康复的新希望以及南卡罗来纳州农村少数民族面临的挑战
中风和创伤性脑损伤(TBI)是导致全国范围内死亡和残疾的重要原因。在南卡罗来纳州(SC)的农村社区,这两种疾病都被认为是公共卫生问题,尤其影响到非裔美国人,造成相当大的发病率、死亡率和经济负担。干细胞疗法(SCT)已成为治疗这两种疾病的潜在干预手段,越来越多的研究试验显示其效果良好。在这篇透视文章中,作者旨在讨论当前干细胞移植领域的研究、早期阶段试验的结果以及对康复结果测量和生物标志物的利用。我们在PubMed上搜索了从开始到2023年12月有关中风和脑外伤干细胞疗法及其对农村社区(尤其是南卡罗来纳州)影响的文章。干细胞移植治疗中风和脑外伤的早期阶段试验取得了良好的安全性和疗效,但这些研究结果尚未得到持续复制。使用间充质干细胞治疗中风幸存者的早期试验显示了其安全性、可行性,并通过广泛的和特定领域的结果测量改善了功能结果。功能磁共振成像(fMRI)和脑电图(EEG)等神经影像学恢复标志物与神经调控相结合,虽然在间充质干细胞研究中未得到广泛应用,但在评估脑损伤及其功能后果方面可能是一个突破。本文强调了小儿脑损伤治疗作为一种有前途的干预措施的作用,同时探讨了影响治疗效果的潜在健康社会决定因素,这些因素与南卡罗来纳州等农村社区有关。文章还论述了干细胞来源的伦理问题、自体细胞疗法的高成本、确保移植细胞存活的技术困难等挑战,以及克服临床试验注册障碍的策略,如干细胞来源的伦理问题、自体细胞疗法的高成本、确保移植细胞存活和公平医疗的技术困难等。
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