UPMC Video Rounds - Stem Cell Therapy for Stroke

November 20, 2019

 

Lawrence Wechsler, MD, chair, Department of Neurology: 

There are a number of different cell types that have been tried for enhancing stroke recovery. But the one that is most commonly used now is a cell type called mesenchymal stem cells.

They can come from a number of different sources. But again, the most common one that is being used is bone marrow–derived cells.

Several early-phase studies that have been done testing these cells in stroke patients to see if they can, number one, if they are safe; and number two, whether there's any indication of enhanced recovery.

Really, you can divide these into early phase or early subacute onset studies, in which patients are treated typically 24 to 48 hours after the onset of stroke. In some cases, up to maybe seven days. And generally, the cells in those cases are delivered intravenously in that very early phase. 

In the chronic phase, the cells are given by direct intracerebral injection through a small burr hole and and then delivered by stereotactic techniques to the site of the stroke directly.

These cells can enhance neurogenesis and angiogenesis and stimulate the brain's endogenous recovery processes to work better.

The other potential mechanism is by immune modulation. And we think that the intravenous infusion of these cells particularly in the subacute phase after stroke, may primarily work by an immune mechanism.

By suppressing that response, the brain may be allowed to recover more completely, and/or there may be less damage in the first place, because of the lack of an inflammatory response.

As we learn more things and try more things, we are moving more and more towards this concept of replacing brain as opposed to enhancing the recovery process that's already there.

 

Learn more about the Department of Neurology at UPMC.