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Review
. 2008 Aug;8(8):1193-201.
doi: 10.1586/14737175.8.8.1193.

Cell-based therapy in ischemic stroke

David C Hess  1 , Cesar V Borlongan
Affiliations
Review

Cell-based therapy in ischemic stroke

David C Hess et al. Expert Rev Neurother. 2008 Aug.

Abstract

Cell-based therapy for stroke represents a third wave of therapeutics for stroke and one focused on restorative processes with a longer time window of opportunity than neuroprotective therapies. An early time window, within the first week after stroke, is an opportunity for intravenously delivered bone marrow and perinatally derived cells that can home to areas of tissue injury and target brain remodeling. Allogeneic cells will likely be the most scalable and commercially viable product. Later time windows, months after stroke, may be opportunities for intracerebral transplantation of neuronally differentiated cell types. An integrated approach of cell-based therapy with early-phase clinical trials and continued preclinical work with focus on mechanisms of action is needed.

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Figures

Figure 1
Figure 1
The bone marrow is a rich source of stem and progenitor cells. Hematopoietic stem cells (HSC) give rise to CD133+, CD34+, and cells that are both CD34+ and CD133+. Marrow stromal cells (MSC) differentiate into multiple cells types. Rare cell types such as the multipotent adult progenitor cell and MIAMI cells can be expanded in culture and differentiate into cells of all three germ layers. The umbilical cord, the amniotic fluid and the placenta are sources of cell types with regenerative potential.
Figure 2
Figure 2
Depiction of the three “time windows of opportunity” available for stroke. The neuroprotective window is short, lasting hours. The subacute window, is an area of opportunity for intravascularly administered cells by an intra-arterial or intravenous route. Neurotrophic factors will also play an important role in this window. “Chronic stroke” will likely require stereotactic surgical approaches with direct intracerebral delivery of cells differentiated down a neuronal lineage.
See this image and copyright information in PMC

References

    1. Leader B, Baca QJ, Golan DE. Protein therapeutics: a summary and pharmacological classification. Nat Rev Drug Discov. 2008;7(1):21–39. - PubMed
    1. Kordower JH, Chu Y, Hauser RA, Freeman TB, Olanow CW. Lewy body-like pathology in long-term embryonic nigral transplants in Parkinson's disease. Nat Med. 2008 - PubMed
    1. Nadal-Ginard B, Fuster V. Myocardial cell therapy at the crossroads. Nat Clin Pract Cardiovasc Med. 2007;4(1):1. - PubMed

    2. * An editorial calling for a moratorium on cell-based therapy clinical trials.

    1. Cardiac cell therapy: bench or bedside? Nat Clin Pract Cardiovasc Med. 2007;4(8):403. - PubMed

    2. * A counter argument to the editorial calling for a moratorium on cell-based therapy in cardiovascular diseases.

    1. Bath PM, Sprigg N. Colony stimulating factors (including erythropoietin, granulocyte colony stimulating factor and analogues) for stroke. Cochrane Database Syst Rev. 2006;3:CD005207. - PubMed

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