Intra-arterial administration of cell-based biological agents for ischemic stroke therapy

ABSTRACT

Introduction: Ischemic stroke is becoming a primary cause of disability and death worldwide. To date, therapeutic options remain limited focusing on mechanical thrombolysis or administration of thrombolytic agents. However, these therapies do not promote neuroprotection and neuro-restoration of the ischemic area of the brain.

Areas covered: This review highlights the option of minimal invasive, intra-arterial, administration of biological agents for stroke therapy. The authors provide an update of all available studies, discuss issues that influence outcomes and describe future perspectives which aim to improve clinical outcomes. New therapeutic options based on cellular and molecular interactions following an ischemic brain event, will be highlighted.

Expert opinion: Intra-arterial administration of biological agents during trans-catheter thrombolysis or thrombectomy could limit neuronal cell death and facilitate regeneration or neurogenesis following ischemic brain injury. Despite the initial progress, further meticulous studies are needed in order to establish the clinical use of stem cell-induced neuroprotection and neuroregeneration.

KEYWORDS:

• Acute ischemic stroke
• gene therapy
• growth factor
• intra-arterial delivery
• neurogenesis
• neuroprotection
• steam cells
• vectors

Article Highlights

• Ischemic stroke is a complex pathology with limited therapeutic options and multiple pathways instigated differently over time.

• In the era of vascular thrombectomy, intra-arterial delivery of biological agents is tested in many rats, mouse, and dog experimental stroke models as well as in humans with promising results.

• The developments of gene therapy in conjunction with the evolution of viral and non-viral vectors provide significant opportunities for interventions in stroke mechanisms.

• Gene therapy in combination with currently available therapies should be considered as an extra tool for AIS treatment with a view to personalized and tailored therapy approach.

• Further research is needed to elucidate the mechanisms of action which lead to stem cell-induced neuroprotection and neurogeneration.

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This manuscript is not funded.