Cell-based and pharmacological neurorestorative therapies for ischemic stroke

NEUROPHARMACOLOGY

卷:134

Review

Venkat, Poornima¹  Shen, Yi^1,2  Chopp, Michael^1,3  Chen, Jieli^1,2 

[1] Henry Ford Hosp, Dept Neurol, Detroit, MI 48202 USA

[2] Tianjin Med Univ, Key Lab Postneurotrauma Neurorepair & Regenerat C, Minist Educ & Tianjin City,Tianjin Neurol Inst, Gerontol Inst,Dept Neurol,Gen Hosp, Tianjin 300052, Peoples R China

[3] Oakland Univ, Dept Phys, Rochester, MI 48309 USA

关键词: Stroke;    Neurorestoration;    Neurovascular remodeling;    White matter remodeling;    Synaptogenesis;    Stem cell therapy;    Mesenchymal stromal cells;    Umbilical cord blood cells;    MicroRNA;    Minocycline;    Candesartan;   

DOI  :  10.1016/j.neuropharm.2017.08.036

来源: Elsevier

【 摘 要 】

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'. (C) 2017 Elsevier Ltd. All rights reserved.

【 授权许可】

Free