Intra-arterial Infusion of Autologous Bone Marrow Mononuclear Stem Cells in Subacute Ischemic Stroke Patients

How would these stem cells travel thru the blood brain barrier and have enough smarts to locate where needed? I see nothing here that proves anything about the efficacy of this. They don't even tell you if the stem cells survived. Placebo effect anyone? Subacute(1 week and up to 3 months) definition means spontaneous recovery still going on. Bogus research, two variables in this.
http://journal.frontiersin.org/article/10.3389/fneur.2016.00228/full?

Azza Abass Ghali¹, Mohamed Khalil Yousef¹, Osama AbdAllah Ragab¹* and Enas Arafa ElZamarany²

• ¹Neuropsychiatry, Tanta University, Tanta, Egypt
• ²Clinical Pathology, Tanta University, Tanta, Egypt

Introduction: Based on many preclinical and small clinical trials, stem cells can help stroke patient with the possibility of replacing the cells and supporting the remaining cells. The aim of this study was to evaluate the safety and feasibility of bone marrow mononuclear (BMMN) stem cell transplantation in subacute ischemic stroke patients.

Materials and methods: Thirty-nine (n = 39) patients with subacute ischemic cerebral infarct due to large artery occlusion in the middle cerebral artery (MCA) territory were recruited. They were distributed into two groups: first group (n = 21) served as an experimental group, which received intra-arterial (IA) mononuclear stem cells (bone marrow-derived mononuclear cell), while the other group (n = 18) served as a control group. All the patients were evaluated clinically by National Institutes of Health Stroke Scale, modified Rankin Scale, Barthel Index, modified and standardized Arabic version of the Comprehensive Aphasia Test, and radiological for 12 months.

Results: The stem cell-treated group showed better improvement, but it was not significant when compared with the non-treated group. The volume of infarction changes at the end of the study was non-significant between both the groups. There was no, or minimal, adverse reactions in stem cell-treated group.

Conclusion: The study results suggest that autologous BMMN stem cell IA transplantation in subacute MCA ischemic stroke patients is safe with very minimal hazards, but no significant improvement of motor, language disturbance, or infarction volume was detected in stem cell-treated group compared with the non-treated group.

Introduction

Stroke represents the third cause of death, followed by cancer and myocardial infarction. Its morbidity and mortality keep increasing during the past few years, especially in developing countries (1).

The prevalence of non-fatal stroke in Egypt is 5.6 per 1,000 populations (2), and the disability-adjusted life years (the sum of life years lost as a result of premature death and years lived with disability adjusted for severity lost per 1,000 population) was 8 in 2003 (3).

Despite the availability of active therapies as thrombolytic therapy and percutaneous intravascular interventions, many patients suffering from stroke often remain disabled (4). These post-stroke disabilities have attracted the attention of researchers to explore more effective and safer treatments. Stem cells offer the promise of a novel neurorestorative strategy for acute brain injury. Recent preclinical studies in rodent stroke model using stem cell therapy have demonstrated significant behavioral recovery and, in some cases, reductions in lesion volume (5).

Although there are many types of stem cells, bone marrow-derived mononuclear cells (BM-MNCs) represent one of the most convenient types for clinical use, as they can be isolated rapidly from autologous bone marrow without culture (6).

There are many potential mechanisms of cellular therapy by which transplanted stem cells are able to locate to the infarcted brain area and differentiate into neuronal and glial phenotypes; there is evidence that cell replacement could contribute to the reestablishment of neuronal circuits by increasing the sprouting of nerve fibers (7).

In the experimental model of stroke, intravenous, intra-striatal, and intra-arterial (IA) infusion of mononuclear stem cells have improved neurological outcome through reduced apoptosis and decreased peri-infarct inflammation and angiogenesis (8).

The aim of this study is to assess the safety and feasibility of autologous bone marrow mononuclear (BMMN) stem cells in managing patients suffering from large artery ischemic stroke in the territories of middle cerebral artery (MCA) in the subacute stage. This study was approved by the ethical committee of Faculty of Medicine, Tanta University, Egypt.

More at link.