Nearly six million people die from strokes each year, accounting for at least 10% of all fatalities, and two thirds of stroke survivors experience ongoing disability. More than 80 million people have recovered from strokes globally; ischaemic strokesaccount for 70% of cases. Although advancements in imaging technology and thrombectomy technology have led to revolutionary breakthroughs in the treatment of ischaemic stroke, thrombolysis is still not a common procedure due to its short therapeutic window and risk of hemorrhagic consequences. A potentially useful new treatment option for promoting neurologic recovery following a stroke is stem cell therapy. Using the immune system to function and improve neurologic recovery after an ischaemic stroke has moved from a theoretical to a practical treatment option. Because mesenchymal stem cells (MSCs) have the capacity to proliferate, differentiate, and exhibit immunomodulatory qualities, their transplantation is an appealing therapeutic approach. Although MSCs are not limited to bone marrow, adipose, or placenta tissue, they all possess the fundamental capacity to exhibit cell migratory patterns and exhibit immunomodulatory properties.
Method of Action
• Anti-inflammatory Effects: By secreting anti-inflammatory cytokines and modifying immune cell responses, MSCs can lessen inflammation in the brain.
• Neuroprotection: MSCs secrete growth factors that support tissue healing and shield neurones from harm, such as vascular endothelial growth factor (VEGF) and brain-derived neurotrophic factor (BDNF).
• Angiogenesis: MSCs encourage the development of new blood vessels in the injured area, which enhances the ischaemic region’s oxygen and blood supply.
• Neurogenesis: MSCs have the ability to promote the growth of new neurones and maintain the viability of existing ones, aiding in the restoration of brain function.
Potential benefits
• Reduction of Brain Damage: MSC therapy has the potential to lessen the degree of brain damage brought on by an ischaemic stroke‘s oxygen shortage.
• Functional Recovery: According to preliminary research, MSCs may help stroke patients’ motor function, cognitive function, and overall neurological recovery.
• Minimally Invasive: Multiple modalities of administration, including intravenous injection and direct delivery to the brain, allow for flexible treatment strategies using MSCs.
Challenges and Recommendations
1. Delivery Technique: One of the main areas of ongoing research is how to transport MSCs to the brain—by intravenous, intra-arterial, or direct brain injection.
2. Timing: Research is currently ongoing to determine the best time to start MSC therapy following a stroke. Although treatment may still be effective throughout the chronic period, early intervention may be more advantageous.
3. Cell Source: Different tissues (bone marrow, umbilical cord, adipose tissue) can produce MSCs, however it’s not apparent which source works best for stroke treatment.
4. MSC-based treatments for ischaemic stroke have a lot of promise, but further research is required to completely comprehend the long-term advantages, standardise methods, and optimise dosage.
Assessment of the Patient and Eligibility
• Identifying a stroke: Imaging methods like MRIs and CT scans are required to confirm the kind of stroke—ischemic or hemorrhagic.
• Evaluation of Eligibility: Stem cell therapy is not appropriate for every stroke patient. The degree of brain damage, the amount of time since the stroke, general health, and other medical issues are frequently factors that determine eligibility. Candidates are usually assessed during both the acute and chronic stages of a stroke.
Selecting a Stem Cell Source
• The most popular kind of stem cells for treating stroke patients are called mesenchymal stem cells, or MSCs. They may originate from various sources:
• MSCs Derived from Bone Marrow (BM-MSCs): Taken from the bone marrow of the recipient or the patient.
• Derived from donated umbilical cords, umbilical cord-derived MSCs (UC-MSCs) circumvent the invasive process of bone marrow aspiration.
• Derived from fat tissue, adipose-derived MSCs(AD-MSCs) are frequently obtained by liposuction.
• Induced Pluripotent Stem Cells (iPSCs): Because iPSCs can differentiate into multiple cell types, including neurones, they are used in some experimental research.
Stem Cell Setup
• Cell Isolation: The stem cells are isolated in a lab following the procurement of the tissue (fat, bone marrow, or umbilical cord). After that, these cells are cultivated to proliferate.
• Quality Control: To make sure the cells fulfil the requirements for therapeutic usage, they are examined for viability, sterility, and functionality.
In summary, stem cell therapy has a bright future for stroke rehabilitation, but research in this field is still ongoing. It is crucial that patients thinking about this therapy speak with experts and think about taking part in controlled clinical trials.
