Stem Cell Use In Strokes: The Need for a Global Database of All Stem Cell Injection

Your own stem cells have the ability to repair tissue internally (endogenously). They help with the secretion of cytokines, growth factors, and other key molecules that reorganize damaged, scarred, inflamed, and maybe even dead tissue. Stem cell injections have been used multiple times in stroke victims with good results (Reference 1-10)


Stroke is a key global cause of death and permanent disability in adulthood. The only currently available treatment is thrombectomy (which is preferable to thrombolysis: nice article summarized on WSJ: https://www.wsj.com/articles/a-treatment-is-revolutionizing-stroke-carebut-not-everyone-receives-it-1517933226) and thrombolysis.

However because the race against time is key when someone is having a stroke, the above treatments often can not be administered fast enough and the patient ends up having permanent scarred brain tissue leading to a lifetime of neurological deficits. 


Here is a list of papers that have shown the benefit of stem cell uses in strokes. 
1. improvement of neurofunctional deficits (1), 
2. reduction of infarct volume (2,3)
3. an extension of the time windows for intervention (2,3)
4. pro-regenerative cerebral reorganization (4)
5. potentially even limited tissue restoration (5)
6. decreasing of post-stroke neuroinflammation (6)
7. clinical study to confirm safety and to collect evidence for the therapeutic benefit of stem cell-based treatments in human stroke patients (7)


However, there are potential risks with stem cell uses and injections. No procedure is 100% guaranteed safe similar to the fact that it is not a 100% guarantee someone will return home safely when they step out the door in the morning. 


The article below from Europe does a great job of noting the benefits and uses of stem cell therapies for stroke but also studying all the complications to better understand why they are happening. This is key in helping researchers and surgeons can change protocols and follow ups to better decrease risks and complications of stem cell therapy.


It is clear that most researchers and surgeons do not think stem cell therapies are going to “go away.” Instead most believe, stem cell uses are going to continue and likely be expanded for use in many other disease treatments. The  researchers below make it clear: since stem cell injections are not going to stop globally, we all better do a better job of reporting every complication and studying to see why it happened. This is my belief as well. 


For instance, a representative from the Cell Surgical Network says it has done 7300 cases which have been documented and followed in their database using Stromal Vascular Fraction (SVF) and have never had a report of pulmonary emboli or stroke. Were all these patients non-smokers?  Why did they do well and others have issues?


What were the risk factors of patients who had pulmonary emboli after stem cell injections? I know one case was of a 30yo male who was the son of a smoker: is that enough of a risk factor to avoid intravenous stem cell injections? Was he an office worker who never left his desk or overweight? 


We do not know, but we need to study this to find out.


A global database of all stem cell injection/deployment/transplantations is majorly needed. 
Who could lead this? Who would fund this?

Could the US lead the way? 
If Space X and Elon Musk can do an incredible job of launching a Tesla to Mars!!!!—-then we can all get together to do proper outcomes research globally to see what works and what does not. The sooner we do this, the more lives will be saved!


I do not think the reason this is NOT happening is because pharmaceutical companies are scared as some colleagues have suggested. I think it is because no one has taken the lead. 


I believe we need a global moral leader–like a group of moral scientists and surgeons in each field– should lead the way to be able to study the effects and the complications of stem cell injections more objectively. 


We need defined protocols of what data points are needed for pre-procedure and post-procedure assessments per treatment option. Not obtaining a datapoint before and after stem cell use should be an exception, not a rule. 


We need validated questionnaires per disease process to see if patients are truly getting better, not just, “feeling better.”


These are generally available in many fields of medicine and surgery. But we need someone to put it together and lead the way globally!







. 2015; 6: 155.
Published online 2015 Jul 20. doi:  10.3389/fneur.2015.00155
PMCID: PMC4507146

The Dark Side of the Force – Constraints and Complications of Cell Therapies for Stroke

Johannes Boltze,1,2,* Antje Arnold,3,4 Piotr Walczak,3,4 Jukka Jolkkonen,5 Lili Cui,5,† and Daniel-Christoph Wagner1,†
Edited by: Petra Henrich-Noack, Otto-von-Guericke University, Germany
Reviewed by: Aurel Popa-Wagner, University of Medicine Rostock, Germany; Dirk M. Hermann, University Hospital Essen, Germany
*Correspondence: Johannes Boltze, Fraunhofer-Institute for Cell Therapy and Immunology, Perlickstr. 1, Leipzig 04103, Germany, ed.refohnuarf.izi@eztlob.sennahoj
†Lili Cui and Daniel-Christoph Wagner have contributed equally to this work.
Specialty section: This article was submitted to Neurodegeneration, a section of the journal Frontiers in Neurology
Author information ▼ Article notes ► Copyright and License information ▼
Copyright © 2015 Boltze, Arnold, Walczak, Jolkkonen, Cui and Wagner.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

References: 
1. Loubinoux I, Demain B, Davoust C, Plas B, Vaysse L. Stem cells and motor recovery after stroke. Ann Phys Rehabil Med (2014) 57:499–508.10.1016/j.rehab.2014.08.008 [PubMed] 
2. Boltze J, Reich DM, Hau S, Reymann KG, Strassburger M, Lobsien D, et al. Assessment of neuroprotective effects of human umbilical cord blood mononuclear cell subpopulations in vitro and in vivo. Cell Transplant (2012) 21:723–37.10.3727/096368911X586783 [PubMed] [Cross Ref]
3. Boltze J, Schmidt UR, Reich DM, Kranz A, Reymann KG, Strassburger M, et al. Determination of the therapeutic time window for human umbilical cord blood mononuclear cell transplantation following experimental stroke in rats. Cell Transplant (2012) 21:1199–211.10.3727/096368911X589609 [PubMed][Cross Ref]
4. Andres RH, Horie N, Slikker W, Keren-Gill H, Zhan K, Sun G, et al. Human neural stem cells enhance structural plasticity and axonal transport in the ischaemic brain. Brain (2011) 134:1777–89.10.1093/brain/awr094 [PMC free article] [PubMed] [Cross Ref]
5. Taguchi A, Soma T, Tanaka H, Kanda T, Nishimura H, Yoshikawa H, et al. Administration of CD34+ cells after stroke enhances neurogenesis via angiogenesis in a mouse model. J Clin Invest (2004) 114:330–8.10.1172/JCI20622 [PMC free article] [PubMed] [Cross Ref]
6. Yoo SW, Chang DY, Lee HS, Kim GH, Park JS, Ryu BY, et al. Immune suppression following mesenchymal stem cell transplantation in the ischemic brain is mediated by TGF-β. Neurobiol Dis (2013) 58:249–57.10.1016/j.nbd.2013.06.001 [PubMed] [Cross Ref]
7. Savitz SI, Cramer SC, Wechsler L, STEPS 3 Consortium Stem cells as an emerging paradigm in stroke 3: enhancing the development of clinical trials. Stroke (2014) 45:634–9.10.1161/STROKEAHA.113.003379 [PubMed] [Cross Ref]
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