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Published on: January 4, 2015
Translational Potential of Stem Cell-based Therapies in the Treatment of Neonatal Hypoxic-ischemic Brain Injury
Paulina Gebala1,2, Justyna Janowska1, Joanna Sypecka3
1Mossakowski Medical Research Institute, NeuroRepair Department, Polish Academy of Sciences, Pawinskiego 5, Warsaw, 02-106, Poland.
Insights
Neonatal hypoxia-ischemia causes lifelong disability. While therapeutic hypothermia (TH) is standard care, umbilical cord-derived therapies like stem cell transplantation show promise for enhanced neuroprotection and regeneration in newborns.
Area of Science:
- Neonatal Medicine
- Neuroscience
- Regenerative Medicine
Background:
- Neonatal hypoxia-ischemia (HI) is a major cause of neonatal mortality and lifelong neurological deficits.
- Therapeutic hypothermia (TH) is the current gold standard for limiting brain injury but has limitations.
- Enhanced neuroprotection and neuroregeneration are needed for improved outcomes.
Purpose of the Study:
- To review clinical trials on umbilical cord-derived therapies for neonatal HI.
- To evaluate the efficacy of stem cell transplantation and umbilical cord milking.
- To discuss the potential of these therapies in conjunction with TH.
Main Methods:
- Systematic review of clinical trials involving stem cell transplantation and umbilical cord milking in neonates with perinatal asphyxia.
- Analysis of official data from clinical studies.
- Synthesis of evidence on neuroprotective and neuroregenerative effects.
Main Results:
- Therapeutic hypothermia mechanisms include reduced free radical activity and inflammation.
- Umbilical cord components are investigated for enhanced neuroprotection.
- Clinical trial data on stem cell transplantation and umbilical cord milking are presented and discussed.
Conclusions:
- Existing therapies like TH can be enhanced by novel approaches.
- Stem cell transplantation and umbilical cord milking show promise for neonatal HI.
- Further research and clinical application of these therapies are warranted for improved neonatal neuroprotection.
Abstract:
Neonatal hypoxia-ischemia is a leading cause of neonatal death in both developed and developing countries. The consequences of hypoxic-ischemic injury affect the rest of the child's life, often resulting in intellectual or motor disability that persists into adulthood. To date, therapeutic hypothermia (TH) appears to be the only available intervention aimed at limiting brain injury and is recognized as the "gold standard" in neonatal intensive care. The basic mechanisms of neuroprotection achieved by temporal cooling involve the reduction of free radical activity, suppression of the inflammatory response after reperfusion and increased neuronal cell survival. However, the protective effects of hypothermia need to be enhanced by additional therapies that can enhance neuroprotection and support neuroregenerative processes. The components derived from the umbilical cord are thought to confer the above-mentioned beneficial effects. This review summarizes the clinical trials based on stem cell transplantation or umbilical cord milking and presents their effects when supported by official data. The great promise associated with the application of stem cells to neonates suffering from perinatal asphyxia is discussed in the context of the results of their clinical use.
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