Locoregional delivery of stem cell-based therapies

Abstract

Interventional regenerative medicine (IRM) uses image-guided, minimally invasive procedures for the targeted delivery of stem cell-based therapies to regenerate, replace, or repair damaged organs. Although many cellular therapies have shown promise in the preclinical setting, clinical results have been suboptimal. Most intravenously delivered cells become trapped in the lungs and reticuloendothelial system, resulting in little therapy reaching target tissues. IRM aims to increase the efficacy of cell-based therapies by locoregional stem cell delivery via endovascular, endoluminal, or direct injection into tissues. This review highlights routes of delivery, disease states, and mechanisms of action involved in the targeted delivery of stem cells.

Fig. 1.. The locoregional delivery of stem cell–based therapies in interventional regenerative medicine.

Locoregional routes of administration of stem cells to treat liver disease have commonly involved portal vein (intraportal) or intra-arterial injections into the hepatic artery. For stroke and Alzheimer’s disease, stem cells have been delivered through intra-arterial (carotid artery), intracerebral, intranasal, and intrathecal routes of administration. In kidney injury, stem cells have been delivered intra-arterially into the suprarenal aorta or renal artery. In peripheral arterial disease, stem cells have been administered intramuscularly, into the gastrocnemius, and intra-arterially, into the femoral artery. In cardiac disease, stem cells have been delivered using intra-arterial (coronary artery) and intramyocardial injections. In type 2 diabetes mellitus, stem cells have been administered via intra-arterial injections into the gastroduodenal, superior pancreaticoduodenal, splenic, celiac, superior mesenteric, or dorsal pancreatic arteries.