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Cell-based and pharmacological neurorestorative therapies for ischemic stroke
Poornima Venkat1, Yi Shen2, Michael Chopp3
1Department of Neurology, Henry Ford Hospital, Detroit, MI, 48202, USA.
Abstract:
Ischemic stroke remains one of most common causes of death and disability worldwide. Stroke triggers a cascade of events leading to rapid neuronal damage and death. Neuroprotective agents that showed promise in preclinical experiments have failed to translate to the clinic. Even after decades of research, tPA remains the only FDA approved drug for stroke treatment. However, tPA is effective when administered 3-4.5 h after stroke onset and the vast majority of stroke patients do not receive tPA therapy. Therefore, there is a pressing need for novel therapies for ischemic stroke. Since stroke induces rapid cell damage and death, neuroprotective strategies that aim to salvage or replace injured brain tissue are challenged by treatment time frames. To overcome the barriers of neuroprotective therapies, there is an increasing focus on neurorestorative therapies for stroke. In this review article, we provide an update on neurorestorative treatments for stroke using cell therapy such as bone marrow derived mesenchymal stromal cells (BMSCs), human umbilical cord blood cells (HUCBCs) and select pharmacological approaches including Minocycline and Candesartan that have been employed in clinical trials. This review article discusses the present understanding of mechanisms of neurorestorative therapies and summarizes ongoing clinical trials. This article is part of the Special Issue entitled 'Cerebral Ischemia'.
Insights
Novel neurorestorative therapies, including cell treatments and specific drugs, offer new hope for ischemic stroke patients. These approaches aim to repair brain tissue, overcoming limitations of current treatments and time constraints.
Area of Science:
- Neuroscience
- Regenerative Medicine
- Pharmacology
Background:
- Ischemic stroke is a leading cause of death and disability globally.
- Current treatments like tPA have narrow therapeutic windows and limited efficacy.
- Existing neuroprotective strategies often fail in clinical translation due to rapid neuronal damage.
Purpose of the Study:
- To review advancements in neurorestorative therapies for ischemic stroke.
- To update on cell-based therapies and pharmacological agents used in clinical trials.
- To discuss the mechanisms and ongoing clinical progress of neurorestorative treatments.
Main Methods:
- Review of current literature on neurorestorative treatments for ischemic stroke.
- Focus on cell therapies: bone marrow-derived mesenchymal stromal cells (BMSCs) and human umbilical cord blood cells (HUCBCs).
- Analysis of pharmacological approaches: Minocycline and Candesartan in clinical trials.
Main Results:
- Neurorestorative therapies show promise in overcoming the time limitations of neuroprotection.
- Cell therapies and specific drugs are being investigated for their potential to repair brain tissue.
- Several neurorestorative agents are currently in clinical trials for stroke treatment.
Conclusions:
- Neurorestorative strategies represent a promising frontier for stroke treatment.
- Cell-based and pharmacological interventions offer potential for repairing stroke-induced brain damage.
- Ongoing clinical trials are crucial for validating the efficacy of these novel therapies.
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