Clinical outcome and safety of stem cell therapy for ischemic stroke: A systematic review and meta-analysis

Abstract

Background: Several reports on stem cell administration have emerged proving it to be an ideal therapeutic approach for improving neurological functions in ischemic stroke patients. However, some studies also show disappointing results, with some reporting no statistically significant improvements among several different parameters. Several challenges also arise relating to safety and nonscientific aspects, such as ethics. Methods: We performed a systematic review and meta-analysis to evaluate the effect of stem cell therapy on the clinical outcomes of ischemic stroke patients. A systematic review and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A thorough literature search was conducted on PubMed, Scopus, and Cochrane databases. Articles were selected systematically based on the PRISMA protocol and reviewed completely. A total of 19 publications pertaining to stem cell therapy on the ischemic route were included and reviewed. Efficacy outcomes were measured with the National Institutes of Health Stroke Scale, modified Rankin Scale, or Barthel Index. Results: The results of the meta-analysis indicate that the efficacy outcomes suggest favorable results after stem cell therapy, although not all study results are statistically significant. Stem cell therapy in stroke cases showed a better outcome than standard conservative therapy alone, although our analysis shows that many factors can influence this outcome, and significant effects can only be seen after several months. Conclusion: The results of this study show promising and satisfying efficacy and a relatively low rate of serious adverse events.

Mesenchymal stem cell‐derived exosomes: Shaping the next era of stroke treatment

“…These regenerative and anti‐inflammatory characteristics aid in stroke patients’ neurological function and recovery. Clinical trials evaluating the safety and efficacy of MSC therapy in stroke have yielded promising results, paving the path for novel cell‐based therapeutics for this debilitating condition 32 …”

“…Clinical trials evaluating the safety and efficacy of MSC therapy in stroke have yielded promising results, paving the path for novel cell-based therapeutics for this debilitating condition. 32 Given the above qualities, MSCs are naturally the ideal choice for cellular therapy in treating ischemic stroke. MSCs execute an essential role in the production of exosomes.…”

“…Clinical trials evaluating the safety and efficacy of MSC therapy in stroke have yielded promising results, paving the path for novel cell‐based therapeutics for this debilitating condition. 32 …”

Mesenchymal Stem Cell Therapy for Ischemic Stroke in Animal Model: A Systematic Review

“…Because of stem cells ability to self-replication and self-differentiation (23)(24)(25)(26)(27), stem cell therapy is recognized by its potential neurodegenerative capabilities in stroke patients such as mechanisms involving angiogenesis, neurogenesis, immune modulation, and even synaptic plasticity, which can result in both structural and functional improvement and regeneration of brain tissues. (6,8,(28)(29)(30) Currently, in clinical trials of patients with ischemic stroke, many types of stem cells are used and among them; bone marrow-derived mesenchymal stromal cells (BM-MSCs) is the most extensively researched due to its effects by immunomodulation and release of trophic factors that can promote angiogenesis, synaptogenesis, and neural precursors recruitment. (31)(32)(33)(34) Other types of MSCs also include umbilical cord derived mesenchymal stem cell (UC-MSC) and adipose derived mesenchymal stem cell (AD-MSC), which shares their specific usefulness in ischemic stroke treatment; both in pre-clinical and clinical setting.…”