中国神经再生研究(英文版) ›› 2024, Vol. 19 ›› Issue (11): 2430-2443.doi: 10.4103/1673-5374.391313

• 综述:脑损伤修复保护与再生 • 上一篇    下一篇

缺血性脑卒中神经修复和再生的新策略:神经干细胞疗法

  

  • 出版日期:2024-11-15 发布日期:2024-03-29

Emerging strategies for nerve repair and regeneration in ischemic stroke: neural stem cell therapy

Siji Wang1, Qianyan He1, Yang Qu1, Wenjing Yin1, Ruoyu Zhao1, Xuyutian Wang3, Yi Yang1, 2, *, Zhen-Ni Guo1, 2, *   

  1. 1Stroke Center, Department of Neurology, the First Hospital of Jilin University, Changchun, Jilin Province, China; 2Neuroscience Research Center, Department of Neurology, the First Hospital of Jilin University, Changchun, Jilin Province, China; 3Department of Breast Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun, Jilin Province, China
  • Online:2024-11-15 Published:2024-03-29
  • Contact: Yi Yang, PhD, yang_yi@jlu.edu.cn; Zhen-Ni Guo, PhD, zhen1ni2@jlu.edu.cn,
  • Supported by:
    This work was supported by the National Natural Science Foundation of China, No. 81971105 (to ZNG); the Science and Technology Department of Jilin Province, No. YDZJ202201ZYTS677 (to ZNG); Talent Reserve Program of the First Hospital of Jilin University, No. JDYYCB-2023002 (to ZNG); the Norman Bethune Health Science Center of Jilin University, No. 2022JBGS03 (to YY); Science and Technology Department of Jilin Province, Nos. YDZJ202302CXJD061, 20220303002SF (to YY); and Jilin Provincial Key Laboratory, No. YDZJ202302CXJD017 (to YY).

摘要:

缺血性脑卒中是导致全球死亡和残疾的主要原因,而临床上可供选择的治疗方法却很有限。干细胞疗法的出现为恢复脑神经元功能的脑卒中治疗领域带来了新希望。外源性神经干细胞(NSCs)被认为不仅有益于细胞替代,还能通过旁观者效应发挥作用。神经干细胞通过分泌生物活性物质,包括细胞外囊泡/外泌体,调节多种生理反应,如神经修复、内源性再生、免疫功能和血脑屏障通透性。然而,由于缺血性脑血管事件的微环境复杂,且移植后的间充质干细胞存活率较低,治疗效果的局限性仍未得到解决。文章详细地阐述了神经干细胞治疗缺血性脑卒中的潜在机制,以及神经干细胞治疗的临床应用策略和临床试验结果,总结了应用神经干细胞工程技术提高神经干细胞存活率及治疗效果的最新研究进展。最终认为,神经干细胞移植在脑缺血模型中显示出了良好的实验结果,未来其在治疗缺血性脑卒中的临床试验中的效果值得期待。

https://orcid.org/0000-0002-9729-8522 (Yi Yang); https://orcid.org/0000-0002-8922-3862 (Zhen-Ni Guo)

Abstract: Ischemic stroke is a major cause of mortality and disability worldwide, with limited treatment options available in clinical practice. The emergence of stem cell therapy has provided new hope to the field of stroke treatment via the restoration of brain neuron function. Exogenous neural stem cells are beneficial not only in cell replacement but also through the bystander effect. Neural stem cells regulate multiple physiological responses, including nerve repair, endogenous regeneration, immune function, and blood-brain barrier permeability, through the secretion of bioactive substances, including extracellular vesicles/exosomes. However, due to the complex microenvironment of ischemic cerebrovascular events and the low survival rate of neural stem cells following transplantation, limitations in the treatment effect remain unresolved. In this paper, we provide a detailed summary of the potential mechanisms of neural stem cell therapy for the treatment of ischemic stroke, review current neural stem cell therapeutic strategies and clinical trial results, and summarize the latest advancements in neural stem cell engineering to improve the survival rate of neural stem cells. We hope that this review could help provide insight into the therapeutic potential of neural stem cells and guide future scientific endeavors on neural stem cells.

Key words: bystander effect, cell replacement, extracellular vesicles, ischemic stroke, neural stem cells, neural stem cell engineering