Currently there is no effective therapeutic approach to reverse the brain damage caused by stroke because adult brain cells have limited ability for self-repair and spontaneous axonal regeneration.

At the first glance, the repair of human brain after stroke appears unrealistic as there is a loss of countless number of neurons and glial cells. The functional improvement after stroke requires neuro-restorative process that includes neurogenesis, angiogenesis and synaptic plasticity, or ability of the connection between two neurons to change its strength. Stem cell therapy has the potential to induce all three neuro-restorative processes and to facilitate functional recovery offering a new approach to regenerate damaged brain tissue in stroke patients.

However, in comparison to stem cell-based therapy for other indications, such as cardiac diseases, peripheral arterial disease, diabetes and even spinal cord injury, the number of preclinical research or clinical studies in patients with stroke is very limited. This is the reason that there is still uncertainty in selection of the best type of stem cells for cellular grafts in stroke, or understanding of mechanisms involved in functional recovery and structural reorganization of damaged brain.

When considering stem cell therapy for the treatment of stroke, it is important to remember that brain is a very complex structure containing a maze of various cells, neuronal extensions, electrical signals and chemical transmissions, presenting extremely difficult task for its regeneration and functional recovery.

To be efficient, stem cell-based therapies for stroke are expected to fulfill two goals: they have to provide better circulation in brain through angiogenesis or neoangiogenesis, and to regenerate lost brain tissue.

Stem Cell Therapy for Stroke report shows pipeline that contains only eight R & D products undergoing development by 11 companies. Out of eight products only one product is in Phase III clinical trials and for one product the Investigational New Drug (IND) application is approved. Further analysis reveals that this R & D pipeline is the most conservative when compared to stem cell therapeutic R & D pipelines for the treatment of cardiac diseases, peripheral arterial disease, diabetes and spinal cord injury.

The majority (87%) of stem cells used for the treatment of spinal cord injury are mesenchymal stem cells and mesenchymal-like stem cells, which are undifferentiated in 88% of those products. Autologus stem cells, obtained from patient’s own tissues are used only in 37% of all products and embryonic-derived stem cells were not used in any of products undergoing development for the treatment of stroke

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