Amelioration of Penetrating Ballistic-Like Brain Injury Induced Cognitive Deficits after Neuronal Differentiation of Transplanted Human Neural Stem Cells

Abstract

Penetrating traumatic brain injury (PTBI) is one of the major cause of death and disability worldwide. Previous studies with penetrating ballistic-like brain injury (PBBI), a PTBI rat model revealed widespread perilesional neurodegeneration, similar to that seen in humans following gunshot wound to the head, which is unmitigated by any available therapies to date. Therefore, we evaluated human neural stem cell (hNSC) engraftment to putatively exploit the potential of cell therapy that has been seen in other central nervous system injury models. Toward this objective, green fluorescent protein (GFP) labeled hNSC (400,000 per animal) were transplanted in immunosuppressed Sprague-Dawley (SD), Fisher, and athymic (ATN) PBBI rats 1 week after injury. Tacrolimus (3 mg/kg 2 days prior to transplantation, then 1 mg/kg/day), methylprednisolone (10 mg/kg on the day of transplant, 1 mg/kg/week thereafter), and mycophenolate mofetil (30 mg/kg/day) for 7 days following transplantation were used to confer immunosuppression. Engraftment in SD and ATN was comparable at 8 weeks post-transplantation. Evaluation of hNSC differentiation and distribution revealed increased neuronal differentiation of transplanted cells with time. At 16 weeks post-transplantation, neither cell proliferation nor glial lineage markers were detected. Transplanted cell morphology was similar to that of neighboring host neurons, and there was relatively little migration of cells from the peritransplant site. By 16 weeks, GFP-positive processes extended both rostrocaudally and bilaterally into parenchyma, spreading along host white matter tracts, traversing the internal capsule, and extending ∼13 mm caudally from transplantation site reaching into the brainstem. In a Morris water maze test at 8 weeks post-transplantation, animals with transplants had shorter latency to platform than vehicle-treated animals. However, weak injury-induced cognitive deficits in the control group at the delayed time point confounded benefits of durable engraftment and neuronal differentiation. Therefore, these results justify further studies to progress towards clinical translation of hNSC therapy for PTBI.

Stable Intracerebral Transplantation of Neural Stem Cells for the Treatment of Paralysis Due to Ischemic Stroke

“…In animal studies of SCI, traumatic brain injury, and ischemic stroke, implantation of NSI‐566 during acute or subacute period has consistently produced cavity‐filling tissue by the cells . Still, it is surprising that such cavity‐filling effect is observed in a human brain tissue lesioned 2 years prior to the cell implantation.…”

The Potential of Stem Cells in Treatment of Traumatic Brain Injury

“…We have found that after transplantation into the injured brain following TBI, these cells can survive for a long period and become region-specific functional cells [92]. Transplantation of the adult-generated NSCs in mouse TBI models has shown improvements of learning deficits [93, 94]. …”

Cognition and Intervention in Traumatic Brain Injury

“…The destructive ravages of externally-or internally-induced damage to the brain and CNS trauma, whether this be of mild, moderate or severe extent, will invariably be the consequence of proximal-distal causation, proliferation and severity [1][2][3], such as cerebral ischemia which afflicts millions of individuals worldwide with eventual survivors suffering from long-term functional and cognitive deficits. Cerebral damage in traumatic brain injury (TBI) may be accompanied by headache, of varying intensities and localizations, dizziness and illfeeling, loss of consciousness, blurring of vision, hearing impediments, confusion states, loss of memory and cognitive capacity, seizure activity, paralysis and coma as the primary-registered symptoms and expressions, with the expectation of accompanying damage to bloodbrain-barrier integrity, accelerated apoptosis and excitotoxicity [4][5][6].…”