Acute central nervous system(CNS)injuries such as spinal cord injury,traumatic brain injury,autoimmune encephalomyelitis,and ischemic stroke are associ- ated with significant morbidity,mortality,and health care costs ...Acute central nervous system(CNS)injuries such as spinal cord injury,traumatic brain injury,autoimmune encephalomyelitis,and ischemic stroke are associ- ated with significant morbidity,mortality,and health care costs worldwide.Preliminary research has shown potential neuroprotection associated with adult tissue derived stem/progenitor cell based therapies.While initial research indicated that engraftment and transdif- ferentiation into neural cells could explain the observed benefit,the exact mechanism remains controversial.A second hypothesis details localized stem/progenitor cell engraftment with alteration of the loco-regional milieu;however,the limited rate of cell engraftment makes this theory less likely.There is a growing amount of pre-clinical data supporting the idea that,after intravenous injection,stem/progenitor cells interact with immuno- logic cells located in organ systems distant to the CNS,thereby altering the systemic immunologic/inflammatory response.Such distant cell"bioreactors"could modulate the observed post-injury pro-inflammatory environment and lead to neuroprotection.In this review,we discuss the current literature detailing the above mechanisms of action for adult stem/progenitor cell based therapies in the CNS.展开更多
基金Supported by Grants NIH T32 GM 08 79201M01 RR 02558+1 种基金Texas Higher Education Coordinating BoardChildren's Memorial Hermann Hospital Foundation
文摘Acute central nervous system(CNS)injuries such as spinal cord injury,traumatic brain injury,autoimmune encephalomyelitis,and ischemic stroke are associ- ated with significant morbidity,mortality,and health care costs worldwide.Preliminary research has shown potential neuroprotection associated with adult tissue derived stem/progenitor cell based therapies.While initial research indicated that engraftment and transdif- ferentiation into neural cells could explain the observed benefit,the exact mechanism remains controversial.A second hypothesis details localized stem/progenitor cell engraftment with alteration of the loco-regional milieu;however,the limited rate of cell engraftment makes this theory less likely.There is a growing amount of pre-clinical data supporting the idea that,after intravenous injection,stem/progenitor cells interact with immuno- logic cells located in organ systems distant to the CNS,thereby altering the systemic immunologic/inflammatory response.Such distant cell"bioreactors"could modulate the observed post-injury pro-inflammatory environment and lead to neuroprotection.In this review,we discuss the current literature detailing the above mechanisms of action for adult stem/progenitor cell based therapies in the CNS.