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Advanced Neurology Stem cell therapy in stroke treatment: Advances and prospects

of stem cell administration. The potential for stem cells to and NSCs are two examples of stem cell types whose
become lodged in blood-filtering organs is a significant self-renewal has been demonstrated to be supported by
problem in the systemic infusion of stem cells (first-pass the addition of basic fibroblast growth factor (bFGF).
effect). To prevent this, different delivery methods are In addition, balancing self-renewal and differentiation
used, along with techniques to reduce lung adhesion and through the optimization of oxygen content and cytokine
improve the homing of systemically administered cells. combinations in the culture environment can have a
Venous access is preferable to arterial access for stroke substantial impact on stem cell fate decisions. Along
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recovery as arterial access can cause blockage, leading with these adjustments, continuous perfusion systems
to stroke. Apart from intravenous administration, in bioreactors can improve waste removal and nutrient
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alternative methods like intrathecal injections enable the supply, which will increase cell viability and growth rates
direct delivery of stem cells into the cerebrospinal fluid in comparison to conventional static cultures. A dynamic
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(CSF), avoiding obstacles like the blood-brain barrier culture environment is necessary for rapidly multiplying
(BBB) and guaranteeing that a greater number of cells stem cells to meet their metabolic requirements. In
reach the central nervous system (CNS). For more precise addition, MSC-derived extracellular vesicles (EVs) have
targeting of certain vascular areas, intra-arterial delivery become crucial mediators in tissue regeneration and cell
via catheter can also be used. However, there are risks communication because they contain bioactive chemicals
associated with this technique, including the possibility of that can alter recipient cell activity. Overall, improving
arterial blockage. In addition, more sophisticated methods culture methods and medium composition is essential to
for delivering stem cells specifically to affected regions while unlocking stem cells’ therapeutic potential in regenerative
reducing systemic exposure have been made possible by medicine. Researchers can improve the effectiveness
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advancements in catheter technology. The use of scaffolds of stem cell treatments for a range of tissue repair and
and biomaterials, which offer localized support for stem regeneration applications by addressing the drawbacks of
cell engraftment and retention at the site of damage, is conventional culture techniques and creating ideal settings
another emerging strategy. Growth factor or cytokine for specific stem cell types. 61
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preconditioning methods can also be used before injection
to increase cell survival rates and functional outcomes after 5.4. Extracellular vesicles generated by stem cells
transplantation. Overall, enhancing therapeutic efficacy An innovative and therapeutically viable cell-free therapy
and reducing side effects in stem cell therapy requires strategy, which avoids many of the drawbacks of direct
the optimization of administration techniques. Ongoing cell transplantation, utilizes EVs produced by stem
research aims to investigate novel delivery methods and cells. This approach may represent a paradigm shift in
refine current protocols to improve patient outcomes in regenerative medicine by using secretions such as trophic
regenerative medicine applications. 55 factors, cytokines, and chemokines, which are generated
by paracrine signaling in exosomes and microvesicles.
5.3. Modification of the culture media and stem cells Vascular occlusion, which results in tumor growth
ex-vivo and infarction, is a key factor in human ischemic or
Telomere shortening leads to decreased telomerase hemorrhagic strokes. In addition, soluble substances, such
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activity, impaired cellular secretions, and altered as EVs produced by MSCs are essential for tissue healing.
interactions with the environment, which may contribute EVs produced from stem cells are enriched with bioactive
to the reduced activity of progenitor cells. Many culture substances such as proteins, lipids, and microRNAs
expansion techniques, such as genetic modification of (miRNAs), which play an essential role in promoting
cells, pretreatment with trophic factors, isolation and cellular communication and regeneration. In contrast, EVs
utilization of functional subpopulations of stem cells, derived from stem cells transport more complex cargos
and modulation of intracellular signaling, can reduce compared to those from other cellular sources, which
senescence while increasing MSC proliferation, survival, enhances their therapeutic potential. One of the important
and nutritional support. The medium used in stem cell factors for their effectiveness is their ability to cross the
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cultivation determines the eventual result. Instead of using BBB to deliver therapeutic drugs directly to the CNS.
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human serum, platelets, or xenogeneic fetal bovine serum, Bioactive substances encapsulated within EVs improves
lysates allow MSCs to grow and rejuvenate quickly without their stability and bioavailability, shielding them from
adversely affecting the immunophenotype. Recent studies deterioration while circulating in the body. Furthermore,
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indicate that maintaining stem cell identity and promoting the distinct makeup of EVs produced from stem cells
differentiation requires the use of a specified serum-free enables them to provide regenerative benefits comparable
medium supplemented with certain growth factors. iPSCs to those of their parent cells, while reducing the risks

Volume 4 Issue 3 (2025) 6 doi: 10.36922/an.5582