Bone Marrow‑Derived Mononuclear Cells in the Treatment of Neurological Diseases: Knowns and Unknowns

Cellular and Molecular Neurobiology, 2023 · DOI: https://doi.org/10.1007/s10571-023-01377-x · Published: June 25, 2023

Simple Explanation

Bone marrow-derived mononuclear cells (BMMNCs) have been explored for treating various neurological diseases. They are easy to obtain and prepare for treatment. However, the exact ways they work and the best methods for using them (like dosage and delivery) are not fully understood. BMMNCs might help by encouraging the growth of new blood vessels, protecting nerve cells, and reducing inflammation. The goal of current research is to refine how BMMNCs are used, figure out the best ways to administer them, and identify which patients are most likely to benefit. This review looks at what we know and don't know about using BMMNCs to treat conditions like stroke, cerebral palsy, spinal cord injury, and autism. It also discusses the advantages and limitations of this approach.

Study Duration

Not specified

Participants

Various clinical trials with different neurological diseases

Evidence Level

Review Paper

Key Findings

1
BMMNCs have been applied in clinical trials for stroke, cerebral palsy, spinal cord injury, traumatic brain injury, amyotrophic lateral sclerosis, autism spectrum disorder and epilepsy.
2
Proposed mechanisms for the action of BMMNCs include homing, differentiation and paracrine effects (angiogenesis, neuroprotection, and anti-inflammation).
3
Indications for BMMNC administration in treating neurological diseases should be based on the etiology, and BMMNC administration should be indicated only for patients without genetic abnormalities.

Research Summary

This review discusses known and unknown aspects of BMMNCs, including the cell harvesting, administration route and dose; mechanisms of action; and their applications in neurological diseases, including stroke, cerebral palsy, spinal cord injury, traumatic brain injury, amyotrophic lateral sclerosis, autism spectrum disorder, and epilepsy. Recommendations on indications for BMMNC administration and the advantages and limitations of BMMNC applications for neurological diseases are discussed. The intrathecal route is ideal because it is minimally invasive while maximizing the number of infused cells reaching the target areas.

Practical Implications

Optimizing Administration Route

Favoring intrathecal administration for neurological diseases to maximize cell delivery and minimize invasiveness.

Personalized Treatment Strategy

Tailoring BMMNC therapy based on disease etiology, genetics, and stage for better outcomes.

Focusing Future Research

Enhancing BMMNC therapy by further exploring mechanisms of action, roles of subtypes, and optimal administration strategies.

Study Limitations

1
Optimal dose, number of injections, and delivery route for each neurological disease have not yet been established.
2
BMMNCs include different subtypes, whose individual roles have not yet been fully studied.
3
The lack of control groups has it difficult to draw an accurate conclusion about the effects of a single BMMNC administration.

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