Deans' stroke musings: Clinical state and future directions of stem cell therapy in stroke rehabilitation

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, January 1, 2025

Clinical state and future directions of stem cell therapy in stroke rehabilitation

But why go thru all the trouble of stem cells if exosomes are the reason for the benefits? Which must be why no one seems to be monitoring stem cell survival.

Application of stem cell-derived exosomes in ischemic diseases: opportunity and limitations

Induced Pluripotent Stem Cells for Ischemic Stroke Treatment

The latest here:

Clinical state and future directions of stem cell therapy in stroke rehabilitation

https://doi.org/10.1016/j.expneurol.2024.115132

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Highlights

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Stem cell trials for stroke show good safety, but efficacy remains inconclusive.
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BMMNCs with IV administration are the most utilized in stem cell stroke trials.
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Large controlled trials are ongoing to refine stem cell transplantation protocols.

Abstract

Despite substantial advances in the acute management of stroke, it remains a leading cause of adult disability and mortality worldwide. Currently, the reperfusion modalities thrombolysis and thrombectomy benefit only a fraction of patients in the hyperacute phase of ischemic stroke. Thus, with the exception of vagal nerve stimulation combined with intensive physical therapy, there are no approved neuroprotective/neurorestorative therapies for stroke survivors.

Stem cell therapy is a promising treatment for stroke patients and has been the focus of an increasing number of clinical trials over the past two decades. We provide a comprehensive overview of stem cell therapies available to stroke patients, focusing on the different types and doses of stem cells, timing and route of administration, patient selection, clinical outcomes, translational challenges, and future directions for the field. Information on ongoing and completed studies was retrieved from ClinicalTrials.gov

, PubMed, Google Scholar, ICTRP, and Scopus.

Autologous bone marrow-derived mononuclear cells (BMMNCs) are the most used, followed by autologous bone marrow stromal cells. IV therapy is typically applied in acute to subacute phases, while IT or IC routes are utilized in chronic phases. Although early-phase trials (Phase I/II) indicate strong safety and tolerability, definitive clinical effectiveness has yet to be unequivocally proven. Cochrane meta-analyses show NIH Stroke Scale improvements, though studies often have high bias and small sample sizes.

Larger randomized, double-blind, placebo-controlled trials are ongoing to refine stem cell transplantation protocols, addressing cell type and source, dosage, timing, patient selection, the potential for combination therapies, and clinical efficacy.