Advances in human stem cell therapies: pre-clinical studies and the outlook for central nervous system regeneration

Neural Regeneration Research, 2021 · DOI: https://doi.org/10.4103/1673-5374.295287 · Published: April 1, 2021

Simple Explanation

Cell transplantation, alongside the discovery of stem cells, has become a key part of regenerative medicine. Embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) can turn into new neurons to replace damaged cells after an injury. Research in rodents has found that ESCs and iPSCs can connect and work within the nervous system. There are ethical concerns about using ESCs, and iPSCs might not be ideal for personalized treatments due to genetic diseases. Stem cell banks, which match donor stem cells to patients, may be a better option. Stem cells can also be genetically modified to help regenerate the nervous system. The review highlights the obstacles in stem cell therapies, while also covering methods to overcome them. Human stem cell grafts hold great promise for CNS treatments with potential for patient-specific therapies in CNS diseases and injuries.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Human ESC-derived cells transplanted into rodent models have shown success, with ESC-derived axons detected along host white matter tracts and grafted neurons displaying action potentials.
2
Human iPSC-derived NPCs transplanted into the rat somatosensory cortex following stroke-induced injury resulted in functional recovery with evidence of integration into the immunocompromised host brain.
3
Delaying transplantation timing after injury in adult mice improves graft survival by avoiding the immediate immune response.

Research Summary

Human stem cell grafts offer promise for treating central nervous system (CNS) conditions, potentially enabling patient-specific therapies for diseases and injuries. Structured, tissue-based transplantation shows improved integration and survival. Careful management of the immune response is essential to create a supportive environment for regeneration, which may involve pre-conditioning cells or using drugs to modify the inhibitory injury environment. Different diseases need different stem cell therapy approaches. Some may require replacing damaged neurons, while others focus on promoting natural repair or using pro-regenerative factors. Spinal cord injuries might need a combination of these strategies.

Practical Implications

Optimized Stem Cell Banks

Shift towards optimized stem cell banks to overcome limitations of personalized iPSC therapies.

Combination Therapies

Combining stem cell transplantation with pre-conditioning or pharmacological interventions to enhance graft survival and integration.

Structured Tissue-Based Transplantation

Focus on tissue-based transplantation approaches like pre-developed axon tracts or organoids for improved outcomes.

Study Limitations

1
Ethical concerns surrounding the use of embryonic stem cells.
2
Challenges in personalized medicine using iPSCs, especially for genetic diseases.
3
Limitations in graft survival and integration into the host environment.

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