Cell Therapy in Stroke—Cautious Steps Towards a Clinical Treatment

Abstract

In the future, stroke patients may receive stem cell therapy as this has the potential to restore lost functions. However, the development of clinically deliverable therapy has been slower and more challenging than expected. Despite recommendations by STAIR and STEPS consortiums, there remain flaws in experimental studies such as lack of animals with comorbidities, inconsistent approaches to experimental design, and concurrent rehabilitation that might lead to a bias towards positive results. Clinical studies have typically been small, lacking control groups as well as often without clear biological hypotheses to guide patient selection. Furthermore, they have used a wide range of cell types, doses, and delivery methods, and outcome measures. Although some ongoing and recent trial programs offer hints that these obstacles are now being tackled, the Horizon2020 funded RESSTORE trial will be given as an example of inconsistent regulatory requirements and challenges in harmonized cell production, logistic, and clinical criteria in an international multicenter study. The PISCES trials highlight the complex issues around intracerebral cell transplantation. Therefore, a better understanding of translational challenges is expected to pave the way to more successful help for stroke patients.

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Funding

This work was supported by RESSTORE project (www.resstore.eu) funded by the European Commission under the H2020 program (grant number 681044).

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Correspondence to Jukka Jolkkonen.

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Dr. Keith Muir is chief Investigator for PISCES 1 and PISCES 2 trials, funded by ReNeuron Ltd. He participated in advisory boards for ReNeuron. No other authors have a conflict of interest.

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Detante, O., Muir, K. & Jolkkonen, J. Cell Therapy in Stroke—Cautious Steps Towards a Clinical Treatment. Transl. Stroke Res. 9, 321–332 (2018). https://doi.org/10.1007/s12975-017-0587-6

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Keywords

  • Cell therapy
  • Cerebrovascular diseases
  • Experimental studies
  • Clinical trials
  • Translation