Comprehensive Concept of Regenerative Medicine for Ischemic Stroke With Bone Marrow Stromal Cells

Introduction

Few drugs have been developed to effectively rescue the patients with ischemic stroke in spite of the huge efforts to develop them for longer than 50 years . As alternative approach, cell therapy has recently been expected as one of the promising strategies to enhance functional recovery after ischemic stroke. A variety of cells have been studied as the candidate donor cells for this purpose. These include embryonic stem (ES) cells, neural stem cells, inducible pluripotent stem (iPS) cells, and bone marrow stromal cells (BMSCs). Of these, the BMSCs may have the most enormous therapeutic potential among them, because they can be obtained from the patients themselves and easily expanded without posing any ethical and immunological problems. The BMSCs are non-hematopoietic cells in the bone marrow and regulate the proliferation and differentiation of hematopoietic cells. The transplanted BMSCs significantly enhance functional recovery after the insults in animal models of ischemic stroke. On the other hand, studies during 2012 to 2013 showed that the adult stem cells, including BMSCs, are observed in the peripheral blood and play an important role in repairing the injured tissues .

Based on these observations, some of preliminary clinical testing has already been conducted to evaluate the safety and therapeutic effects of BMSC transplantation for the patients with both acute and chronic neurological disorders . However, it should be reminded that a variety of questions or problems still remains to be solved in order to establish BMSC transplantation as scientifically proven entity in clinical situation . This chapter reviews recent knowledge on therapeutic impacts of BMSC transplantation on ischemic stroke.