Adult stem cell therapy in stroke
Adult stem cell therapy in stroke
复制标题
DOI：
10.1097/00019052-200502000-00012
复制
发表时间：
2005-02-01
影响因子：
4.8
通讯作者：
Winkler, J
中科院分区：
文献类型：
--
作者：
Haas, S;Weidner, N;Winkler, J
审核目的：急性脑梗死导致神经元回路和支持神经胶质细胞的不可逆的局部限制性损失，并伴有连续的功能缺陷和残疾。目前可用且有效的治疗目标是快速血管再通，同时采取对症措施。干细胞是中风后器官型细胞替代和功能恢复的一个有前途的来源，近年来，以干细胞为重点的研究活动获得了发展势头，使基于再生细胞的治疗成为一种更加可行的现实方法。本文综述了近年来有关脑卒中的临床前和临床细胞基础研究的最新进展，重点介绍了来自成人中枢神经和造血系统的干细胞。最新发现：内源性神经干细胞在中枢神经系统中具有终生存在的能力，在包括脑缺血在内的多种疾病模型中具有替代丢失神经元的能力。考虑到成体神经干细胞移植作为中风后的再生策略，在分离人成体神经干细胞和证明自体神经干细胞移植的可行性方面取得了进展。越来越多的研究提供证据表明，造血干细胞，无论是在刺激内源性干细胞池或外源性造血干细胞应用（移植）后，改善缺血性脑损伤后的功能结果。各种潜在的机制，如转分化成神经谱系，神经保护通过营养支持，和细胞fusions.Summary：许多临床前研究采用成人干细胞为基础的策略，具有很大的希望。对于内源性方法，需要证明细胞替代与功能改善的相关性。在考虑临床应用之前，需要进一步发展实验层面的移植方法。
Purpose of review: Acute cerebral infarction causes irreversible locally restricted loss of the neuronal circuitry and supporting glial cells with consecutive functional deficits and disabilities. The currently available and effective therapy targets fast vessel recanalization accompanied by symptomatic measures. Research activities focusing on stem cells, which represent a promising source for organotypic cell replacement and functional recovery after stroke, have gained momentum in recent years, making regenerative cell-based therapies a much more feasible realistic approach. This review provides an update about preclinical and clinical cell-based studies in stroke focusing on stem cells derived from the adult central nervous and hematopoetic systems.Recent findings: Endogenous neural stem cells, which have been shown to reside throughout life in the central nervous system, have the capacity to replace lost neurons in models for numerous disorders, including cerebral ischemia. Considering adult neural stem cell transplantation as a regenerative strategy after stroke, progress has been made in isolating human adult neural stem cells and demonstrating the feasibility of autologous neural stem cell transplantation. An increasing number of studies provide evidence that hematopoietic stem cells, either after stimulation of endogenous stem cell pools or after exogenous hematopoietic stem cell application (transplantation), improve functional outcome after ischemic brain lesions. Various underlying mechanisms such as transdifferentiation into neural lineages, neuroprotection through trophic support, and cell fusion have been deciphered.Summary: Many preclinical studies employing adult stem cell-based strategies hold great promise. For endogenous approaches the correlate of cell replacement underlying functional improvement needs to be demonstrated. Transplantation approaches on the experimental level need further development before clinical application can be considered.