Tissue regeneration in stroke: cellular and trophic mechanisms

Abstract

Stroke is a leading cause of morbidity in the developed world and results in chronic disability in many cases. The literature related to the critical factors that regulate tissue self-regeneration in stroke is still limited, which restricts effective therapy. However, optimism in this area has been provided by recent research. The mechanisms involved in tissue regeneration and the mode of the participation of stem/progenitor cells and soluble protein neurotrophic factors in this process may yield a more complete understanding of the nature of stroke. This review summarizes the current understanding of both cellular and humoral issues with a particular emphasis on how these issues contribute to tissue regeneration in stroke.

Keywords::

• angiogenic factor
• cell mobilization
• neurogenesis
• neurotrophin
• regeneration
• stroke

Financial & competing interests disclosure

This work was supported by European Union structural funds – Innovative Economy Operational Program POIG.01.01.02-00-109/09-00. The author has no other 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.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Long-term neurological improvement following stroke depends on the size and location of the cerebral infarct, the accompanying morbidities and the consequent rehabilitation.

• Brain injuries over the course of stroke trigger cellular repair mechanisms that contribute to recovery and might include the activation of neurogenesis in the adult brain.

• The potential to mobilize SPCs with repairing potential is maintained in both ischemic and hemorrhagic stroke, despite the independent origins of these types of stroke.

• Secretory activities that involve neurotrophic factors and the structural integrities of nervous tissue microenvironments are responsible for the efficiency and character of the biochemical processes that occur in these tissues during regeneration following stroke.

• Elucidation of the processes of tissue repair following stroke and the mechanisms of action of all of the essential cellular and humoral players might facilitate the preparation of a background for novel therapeutic strategies that involve combined gene- and cell-based therapies.