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  4. Stem Cell Therapies for Restorative Treatments of Central Nervous System Ischemia–Reperfusion Injury

Stem Cell Therapies for Restorative Treatments of Central Nervous System Ischemia–Reperfusion Injury

Cellular and Molecular Neurobiology, 2023 · DOI: https://doi.org/10.1007/s10571-022-01204-9 · Published: February 7, 2022

Cardiovascular ScienceRegenerative MedicineNeurology

Simple Explanation

Ischemic damage to the central nervous system (CNS) is a catastrophic postoperative complication of aortic occlusion subsequent to cardiovascular surgery that can cause brain impairment and sometimes even paraplegia. Given the limited ability of the CNS to repair itself, it is of great clinical value to make full use of the proliferative and differentiation potential of stem cells to repair nerves in degenerated and necrotic regions by stem cell transplantation or mobilization This review summarizes the most recent advances in stem cell therapy for ischemia–reperfusion injury in the brain and spinal cord, aiming to advance basic research and the clinical use of stem cell therapy as a promising treatment for this condition.

Study Duration
Not specified
Participants
Not specified
Evidence Level
Level 5, Review Paper

Key Findings

  • 1
    Mesenchymal stem cells (MSCs) have the capacity for self-renewal and can differentiate into any type of cell and exhibit immunomodulatory, anti-inflammatory, and tissue repair properties.
  • 2
    Neural Stem Cells (NSCs) are self-renewing, pluripotent stem cells that can differentiate into neurons, astrocytes, and oligodendrocytes and can effectively replace damaged nerve tissue and form synaptic associations with host neurons.
  • 3
    Induced pluripotent stem cells (iPSCs) have reproductive potential and can differentiate directly into glutamate neurons, motor neurons, and GABAergic neurons, making them a viable therapeutic option for treating cerebral ischemia injury

Research Summary

Ischemic damage to the central nervous system (CNS) is a catastrophic postoperative complication of aortic occlusion subsequent to cardiovascular surgery that can cause brain impairment and sometimes even paraplegia. Given the limited ability of the CNS to repair itself, it is of great clinical value to make full use of the proliferative and differentiation potential of stem cells to repair nerves in degenerated and necrotic regions by stem cell transplantation or mobilization The host immune system rejects and destroys allogeneic stem cells, primarily via T cells, by recognizing the mismatched human leukocyte antigen (HLA).

Practical Implications

Clinical Translation

More clinical trials are needed to establish the safety, durability, and feasibility of stem cell therapies for nerve ischemia and ischemia-reperfusion injury.

Therapeutic Optimization

Optimize the replacement and neuroprotective effects of transplanted cells by developing stem cells with improved functional abilities, such as hypoxia, drug pretreatment, or combination with biomaterials.

Understanding Mechanisms

A better understanding of the mechanisms underlying ischemia-reperfusion injury in the CNS is needed to optimize stem cell transplantation efficiency.

Study Limitations

  • 1
    The host immune system rejects and destroys allogeneic stem cells.
  • 2
    Tumorigenesis risk associated with iPSCs.
  • 3
    Internal environment of the CNS is very complex, and the cell survival rate is poor.

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