Cell replacement therapy for intracerebral hemorrhage

Author:

Andres Robert H.12,Guzman Raphael1,Ducray Angélique D.2,Mordasini Pasquale23,Gera Atul1,Barth Alain4,Widmer Hans R.2,Steinberg Gary K.1

Affiliation:

1. 1Department of Neurosurgery, Stanford University Medical Center, Stanford, California;

2. 2Departments of Neurosurgery and

3. 3Neuroradiology, University of Berne, Inselspital, CH-3010 Berne, Switzerland; and

4. 4Department of Neurosurgery, Medical University of Graz, A-8036 Graz, Austria

Abstract

✓ Intracerebral hemorrhage (ICH), for which no effective treatment strategy is currently available, constitutes one of the most devastating forms of stroke. As a result, developing therapeutic options for ICH is of great interest to the medical community. The 3 potential therapies that have the most promise are cell replacement therapy, enhancing endogenous repair mechanisms, and utilizing various neuroprotective drugs. Replacement of damaged cells and restoration of function can be accomplished by transplantation of cells derived from different sources, such as embryonic or somatic stem cells, umbilical cord blood, and genetically modified cell lines. Early experimental data showing the benefits of cell transplantation on functional recovery after ICH have been promising. Nevertheless, several studies have focused on another therapeutic avenue, investigating novel ways to activate and direct endogenous repair mechanisms in the central nervous system, through exposure to specific neuronal growth factors or by inactivating inhibitory molecules. Lastly, neuroprotective drugs may offer an additional tool for improving neuronal survival in the perihematomal area. However, a number of scientific issues must be addressed before these experimental techniques can be translated into clinical therapy. In this review, the authors outline the recent advances in the basic science of treatment strategies for ICH.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Subject

Neurology (clinical),General Medicine,Surgery

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