Advances in stem cell therapy for stroke: mechanisms, challenges, and future directions

Sheikh, Abdullah Md.1; Hossain, Sayeed2; Tabassum, Shatera1

1Department of Laboratory Medicine, Shimane University Faculty of Medicine, Izumo, Japan

2Pulmonary, Critical Care, and Sleep Medicine, Pulmonary Associates, Wilson Medical Center, Duke LifePoint Hospital, Ste CWilson, NC, USA

*Correspondence to: Abdullah Md. Sheikh, MD. PhD, abdullah@med.shimane-u.ac.jp.

Funding: The study was partially supported by JSPS KAKENHI grant No. 18K07369.

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Regenerative Medicine Reports 1(1):p 76-92, September 2024. | DOI: 10.4103/RMR.REGENMED-D-23-00002

Abstract

Stroke is a leading cause of morbidity and mortality worldwide. However, there is very limited availability of stroke disease-modifying therapies, necessitating innovative therapeutic strategies to address its complex pathophysiology. The objective of this review is to furnish readers with comprehensive knowledge concerning stem cell research in the context of stroke, delving into promises, limitations, and future research directions that can effectively bridge the gap between bench and clinic in stroke research. The discussion encompasses an exploration of the intricate pathophysiology of stroke and comprehensively examines recent advances in stem cell therapy in the context of stroke pathophysiology. Emphasis is given on elucidating underlying mechanisms, persistent challenges, and promising future directions in stem cell therapy for stroke. Mechanistic insights reveal the diverse roles of stem cells in modulating immune responses, providing trophic support, exerting neuroprotective effects, and facilitating neuronal differentiation. However, challenges such as dosing optimization, immunogenicity, precise timing of interventions, and standardizing the therapy necessitate careful consideration. Future directions in stem cell therapy for stroke encompass precision medicine approaches, cell engineering advancements, synergistic combination therapies, and biomaterial-based delivery systems. Standardized protocols, ethical frameworks, and patient engagement initiatives are crucial for steering the field toward transformative and clinically viable outcomes. The convergence of these advancements positions stem cell therapy as a promising avenue for revolutionizing stroke treatment, offering hope for improved outcomes and quality of life for stroke survivors.

脑卒中干细胞治疗的进展：机制、挑战和未来方向

摘要

脑卒中是全球发病率和死亡率的主要原因。然而，脑卒中改良疗法的可用性非常有限，需要新的治疗策略来解决其复杂的病理生理学问题。此次综述提供脑卒中干细胞研究的全面进展，深入探讨可有效弥合脑卒中研究中实验室和临床之间差距的前景、局限性和未来研究方向。文章讨论了脑卒中复杂病理生理学，并在脑卒中病理生理学背景下全面研究干细胞治疗的最新进展。重点阐明脑卒中干细胞治疗的潜在机制、持续的挑战和有希望的未来方向。相关机制包括干细胞在调节免疫反应、提供营养支持、发挥神经保护以及促进神经元分化方面的作用。然而，剂量优化、免疫原性、干预的精确时间和治疗标准化等挑战需要值得探索。脑卒中干细胞治疗的未来方向包括精准医学方法、细胞工程、协同联合疗法和基于生物材料的递送系统。标准化程序、伦理框架和患者参与计划对于指导该领域走向变革性和临床可行结果至关重要。这些进步的融合将干细胞疗法定位为革命性脑卒中治疗的一条有希望的途径，也将为脑卒中幸存者提供改善预后和生活质量的希望。