Mesenchymal stem cells therapy for Ischaemic stroke: Mechanism and progress

Area of Science:

• Neuroscience
• Regenerative Medicine
• Immunology

Background:

• Ischemic stroke is a major cause of death and disability globally.
• Current acute treatments like thrombolysis and thrombectomy have limitations, including narrow therapeutic windows and incomplete addressing of sustained neurovascular injury and inflammation.
• These limitations highlight the need for novel strategies that promote endogenous repair and functional recovery.

Purpose of the Study:

• To provide a comprehensive analysis of mesenchymal stem cells (MSCs) as a regenerative strategy for ischemic stroke.
• To explore the multimodal mechanisms of action of MSCs, including their paracrine effects on inflammation and neurovascular plasticity.
• To synthesize preclinical and clinical evidence, discuss translational challenges, and outline future directions for MSC-based stroke therapies.

Main Methods:

• Review of preclinical studies and clinical trials investigating MSCs for ischemic stroke.
• Analysis of MSCs sources (bone marrow, umbilical cord, adipose tissue) and their mechanisms of action.
• Examination of MSCs' role in modulating the immune microenvironment and promoting tissue regeneration.

Main Results:

• MSCs exert therapeutic effects primarily through multimodal paracrine actions, including immune modulation and promotion of pro-repair macrophage phenotypes.
• MSCs enhance neurovascular plasticity and tissue regeneration via bioactive factors and extracellular vesicles.
• Preclinical and clinical data suggest MSCs hold significant potential for improving long-term functional recovery in stroke patients.

Conclusions:

• MSCs represent a promising regenerative approach for ischemic stroke, targeting key aspects of pathophysiology beyond acute revascularization.
• MSC-based therapies have the potential to address sustained neurovascular injury, inflammation, and insufficient repair, leading to improved functional outcomes.
• Further research and clinical trials are needed to overcome translational challenges and fully realize the potential of MSCs in stroke care.