8/2/2023 0 Comments Stem cell treatment for stroke![]() Cell therapies account for a different biopharmaceutical approach than rtPA. ![]() The Stroke Progress review group has now identified neurorestoration as a major priority for stroke research. Following a stroke, patients show some recovery trough plasticity and brain remodeling, and questions are raised if cellular therapy could be used to tap into these recovery processes and promote recovery of function. Observations from animal studies suggest that improved functioning is associated with restorative processes. It becomes clear that other approaches promoting recovery of neurological cells rather than neuroprotection need to be explored and developed. Once stroke-induced cell damage has occurred, little can be done to improve the neurological function, except for rehabilitation therapy and pharmacological management of comorbidities. After three hours neurological cells become irreversibly damaged. Even when patients are fortunate enough to receive rtPA in the time frame, several neurological deficits persist. Only a minority of patients receives thrombolysis, primarily because of delayed admission to a stroke center and the short time window for the use of rtPA. Despite this recommendation, rtPA is widely underused. International guidelines advise rtPA as a first-line treatment for eligible patients when administered within 4.5 hours after the onset of stroke. Currently the only approved medical therapy for patients with an acute ischemic stroke is recombinant tissue plasminogen activator (rtPA). Notwithstanding the advances in acute care and secondary preventive approaches, a stroke continues to be a major burden on the healthcare system worldwide. It is the second leading cause of global death. The ischemic stroke or infarction represents almost 70 percent of all strokes. On yearly basis numbers of stroke patients who live with the consequences or subsequently died from it, are increasing. Stroke remains a major universal health problem. Systematic review, Stroke, Stem cells therapy, Translation, Human, Rodents, Neurorestoration Good preclinical research is necessary to determine the optimal route of administration, the optimal cell dose and type and the most accurate administration time of the stem cells. Large, well-designed preclinical trials are urgently needed. Study quality is pointed out as one of the major reasons for failed translation of preclinical evidence to clinic. Pooled study data of the randomized controlled clinical trials did show a significant improvement in neurologic outcome, but not in functional recovery. This improvement in rodents is not translated into clinical trials in humans. These results are in line with previously conducted meta-analyses. Stem cell therapy has a positive effect on behavior and histological outcome in rodent stroke models. After data extraction and assessment of study quality, the pooled effects were calculated using Revman5. ![]() We provide a systemic review of the evidence of efficacy of cell-based therapy in both preclinical and clinical setting.Īfter screening of databases, 76 studies were included in our systematic review of studies in rodent stroke models and 4 randomized clinical trials were used for the systematic review of studies in humans. Our research consists of 2 systematic reviews where preclinical and clinical studies were pooled. Stem cell therapy was first initiated in several preclinical studies with promising results and lately in some clinical trials. Currently the only approved therapy is recombinant tissue plasminogen activator, which should be administered within a narrow time window of 4.5 hours.
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