Intracarotid transplantation has shown potential for efficient stem cell delivery to the brain. However, reported complications, such as compromised cerebral blood flow (CBF), prompted us to perform further safety studies. Glial-restricted precursors (GRPs) and mesenchymal stem cells (MSCs) were transplanted into the internal carotid artery of rats (n ¼ 99), using a microcatheter. Magnetic resonance imaging was used to detect post-transplantation complications, including the development of stroke, for the following experimental variables: cell size, cell dose, cell infusion velocity, delay between artery occlusion and cell infusion, discordant versus concordant xenografting, and intracarotid transplantation with preserved versus compromised blood flow. Immunocompatibility and delayed infusion did not affect the number of complications. An infusion velocity over X1 mL/minute often resulted in stroke (27 out of 44 animals), even with an infusion of vehicle, whereas a lower velocity (0.2 mL/minute) was safe for the infusion of both vehicle and smaller cells (GRPs, diameter ¼ 15 mm). Infusion of larger cells (MSCs, diameter ¼ 25 mm) resulted in a profound decrease (75±17%) in CBF. Stroke lesions occurred frequently (12 out of 15 animals) when injecting 2 Â 10 6 MSCs, but not after lowering the dose to 1 Â 10 6 cells. The present results show that cell size and infusion velocity are critical factors in developing safe protocols for intracarotid stem cell transplantation.
Journal of Cerebral Blood
INTRODUCTIONThe intravascular route of stem cell delivery has met with increasing interest because of the minimally invasive nature of the procedure and the potential for broad cell distribution. Recent reports 1,2 have revealed positive effects of intravascular cell transplantation in animal models of neurologic disorders. The evaluation of neural cell distribution after intravenous cell transplantation has shown that most of the cells are initially entrapped within the lungs and do not travel to the brain.3 It has been hypothesized that an intraarterial approach would be a more efficient route of cell delivery to the brain, as this approach avoids the pulmonary circulation. This approach is particularly attractive when selecting and sorting cells for adhesion molecules, which can enhance cell homing and therapeutic outcome. 4 Moreover, it has been recently shown that transfection of adhesion molecules in progenitor cells results in a dramatic increase of their homing to inflamed brain endothelium.