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

associated with live cell treatments, such as cancer and MSCs for transplantation, including the presence of
immune rejections. Recent research indicates that these markers such as CD29, CD44, CD73, CD90, and CD105,
EVs can trigger endogenous repair processes in various and the absence of markers such as CD34, CD45, CD14, and
tissues, promote angiogenesis, and modulate inflammatory human leukocyte antigen (HLA) class II. The cell number,
responses. The targeting capabilities of modified EVs can dosage, and route of administration are other important
also be improved by customizing them to carry specific factors to be considered in pre-clinical investigations.
medicinal compounds. This adaptability makes stem MSCs are transplanted using various methods, including
cell-derived EVs attractive options for therapeutic use in intravenous, intranasal, and intra-arterial delivery of 1 ×
the treatment of various diseases, such as tissue damage, 10 – 8 × 10 cells. Although transplanted MSCs have been
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neurodegenerative disorders, and stroke. 64 shown to adapt to their new surroundings and differentiate
into neurons, astrocytes, and oligodendrocytes following
5.5. The use of 3D bioprocessing methods intravenous and intranasal administration, concerns
Many attempts have been made to develop new 3D remain regarding the impact on MSC migration in the
bioprocesses that can accelerate the clinical application brain. The ability of stem cell transplantation to achieve key
of stem cell research. Apart from the numerous therapeutic outcomes such as tissue regeneration, enhanced
pharmacological and genetic preconditioning methods angiogenesis, neovascularization, improved blood-brain
already discussed, the biological characteristics of stem barrier (BBB) function, and functional restoration remains
cells can be improved by using 3D bioprocessing methods controversial. More studies are needed to develop definitive
that physically mimic the natural in vivo environment. cell therapies for stroke. The outcomes of stem cell therapy
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Gradually, it is becoming evident that multiple passages in stroke are discussed in Figure 3.
during culture expansion utilizing traditional tissue
culture flasks change the natural phenotype of MSCs. As 7. Clinical trial of stem cell therapy in stroke
a result, MSC phenotypes and unique properties can be patients
effectively preserved by forming an MSC collection that Stroke has become the leading cause of long-term
mimics true 3D interactions between adjacent cells or the disability, morbidity, and mortality, significantly reducing
extracellular matrix. However, techniques for growing the quality of life. Neuroinflammation, a key component
stem cells in 3D bioprocesses require further investigation. of the pathophysiology of various forms of cerebrovascular
While cells close to the outer layer remain viable, necrosis diseases, is also associated with stroke. A thorough
occurs in the center of the cell mass due to the restricted search of clinical trials on stroke uncovered 56 studies
transport of nutrients, oxygen, and metabolic waste caused investigating cerebrovascular stroke using regenerative
by conventional static culture conditions. 66 medicine, including both autologous and allogeneic cell
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6. Preclinical studies with stem cells in therapies. Most of these cells were obtained from bone
stroke marrow, adipose tissue, spinal cord, umbilical cord, and
mesenchymal tissue. An observer-blinded, open-label
In recent years, increasing experimental proof has clinical study was carried out to assess the long-term safety
highlighted the potential of stem cells for stroke treatment. and effectiveness of autologous MSCs. Following MSC
Many types of stem cells are effective and safe at both pre- transplantation, patients who received MSC treatment
clinical and clinical levels for treating various neurological showed clinical improvement, which was correlated with
disorders. Preclinical approval of stem cells for stroke both the degree of involvement of the subventricular area in
treatment was significant. Numerous studies have evaluated the lateral ventricle and blood levels of stromal cell-derived
stem cells based on several parameters, including cell type, factor 1 (SDF-1). The frequency of comorbidity was similar
cell number, dosage, route of administration, safety, and to that of control group. A single-blind controlled Phase I/
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efficacy. 67,68 MSCs are the most extensively researched II study that included patients with middle cerebral artery
and utilized stem cells for stroke management. Among (MCA) stroke was conducted. At 5 – 9 days post-stroke,
the tissue sources of MSCs, bone marrow and adipose autologous BM-MNCs were administered as a therapy
tissue are the most prevalent and well-researched, with (Figure 4). An increase in plasma concentration of neural
bone marrow being the earlies identified source. Most growth factor was observed, and no adverse effects were
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preclinical studies have investigated various aspects of stem reported during the 6-month follow-up, except for two
cell transplantation for stroke using autologous BM-MSCs. individuals who experienced partial seizures after 3 months.
Other studies have documented the use of MSCs derived According to the study’s findings, administering BM-MNCs
from adipose tissue, umbilical cord, placenta, and other intravenously is both beneficial and safe. Patients with
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sources. Surface marker profiling is utilized to characterize MCA infarction participated in a randomized, single-

Volume 4 Issue 3 (2025) 7 doi: 10.36922/an.5582