Interdisciplinary advances towards understanding and enhancing the therapeutic potential of stem cell-based therapies for ischaemic stroke

Abstract

Worldwide, stroke is the second single most common cause of death and is a major cause of permanent disability. Moreover, the highest incidence of these pathologies is observed in the elderly, increasing the socioeconomic burden in an aging population. Current available therapies lead to insufficient functional improvement or are not applicable to all patients. This stresses the urgent need for alternative strategies in treating stroke patients, for example cell-based therapies. These cells showed great preclinical potential although the underlying therapeutic mechanisms, preferential route of administration and most suitable stem cell-subtype are unknown. Mechanisms of action include neuroprotection, cell replacement, neurogenesis, immunomodulation and the promotion of both neuroplasticity and angiogenesis in damaged central nervous system regions. Moreover, stem cells have been genetically engineered to enhance their beneficial effects after transplantation. Additionally, noninvasive imaging can be used to provide detailed spatial and functional information on the donor cell fate and the response of the host microenvironment. This chapter provides an overview of recent advances in (bio-)medical research using or manipulating stem cell-based therapies for ischaemic stroke with a focus on their neuroprotective, neuroregenerative and immunomodulatory properties. Additionally, the use of noninvasive imaging to allow temporospatial evaluation of stem cell fate following transplantation in animal stroke models will be discussed.