Atormac
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 2889  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 Search
 
  
 Resource Links
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (320 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this Article
   References

 Article Access Statistics
    Viewed1736    
    Printed130    
    Emailed1    
    PDF Downloaded132    
    Comments [Add]    

Recommend this journal

 


 
Table of Contents    
TOPIC OF THE ISSUE: EDITORIAL
Year : 2011  |  Volume : 59  |  Issue : 4  |  Page : 553-554

Stem cell therapy for brain disorders: Why results are discordant?


Department of Neurology, All India Institute of Medical Sciences, New Delhi, India

Date of Submission11-May-2011
Date of Decision15-May-2011
Date of Acceptance16-May-2011
Date of Web Publication30-Aug-2011

Correspondence Address:
Kameshwar Prasad
Prof. Kameshwar Prasad, 704, Department of Neurology, CN Centre, AIIMS, New Delhi
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.84336

Rights and Permissions



How to cite this article:
Prasad K. Stem cell therapy for brain disorders: Why results are discordant?. Neurol India 2011;59:553-4

How to cite this URL:
Prasad K. Stem cell therapy for brain disorders: Why results are discordant?. Neurol India [serial online] 2011 [cited 2019 Sep 15];59:553-4. Available from: http://www.neurologyindia.com/text.asp?2011/59/4/553/84336


Discovery of stem cells has generated unparallel hope and expectation for patients suffering from disabling brain diseases, including trauma, stroke, Alzheimer's disease, multiple sclerosis, Parkinson's disease, and others. Preclinical studies in rodent models of these diseases have shown mixed results-some favorable while some unfavorable. In this month's issue of Neurology India, Moorthy et al. [1] report a study in a cryoinjury rodent model of head trauma and report no statistically significant benefit with the use of mesenchymal stem cells. This is discordant with many other published preclinical studies which show benefit. They discus many reasons for the discordant results, including timing of infusion of stem cells, nature of the model, sample size, and blinding of measurements. An interesting finding is that results from blinded measurements show lower trend of benefit than unblinded measurements of outcome.

As the field of stem cells grows, increase in the number of reported preclinical and clinical studies is certain. There is also bound to be inconsistency among the various reports. The plausible reasons for such inconsistency besides chance, are type of patients or models, timing and nature of stem cell transplantation, dose of stem cells, whether the studies are randomized or nonrandomized, whether measurements are blinded or unblinded, types and timing of outcome measures, and whether the follow-up is complete or incomplete. Most of these issues are still unresolved in the field of brain disorders. Moreover, human studies often turn out to yield different results from preclinical studies. The classical example has been the lessons learnt from neuroprotection trials in stroke. While several animal studies usually showed encouraging results, none passed the test of clinical trials.

The question of timing of stem cell transplantation has been repeatedly debated. In this issue also Moorthy et al. [1] talk of hostile environment in the early stages of trauma that is potentially injurious for stem cells. They argue that infusion at later stages may promote survival of stem cells and hence more benefit. These are theoretical arguments that need to be put to test and resulting data should guide our action, not the theoretical arguments. The stem cells need to be tested in various stages of the disease and the final outcome should guide us regarding the timing for stem cell transplantation. It turns out that most of the studies infusing stem cells in acute stages have yielded positive results suggesting that hostile environment theory is of limited validity. The preclinical data at current stage shows that stem cell transplantation in acute stage of stroke and traumatic brain injury [2] is beneficial. It is quite possible that Moorthy et al. [1] might have missed the benefit because of delay in the timing of stem cell transplantation.

A number of future studies will be required before the various issues mentioned above are sorted out for stem cell therapy for brain disorders. Even though expectations of patients calls for rapid delineation of relevant factors and clear roadmap for harvesting the benefit of stem cell therapy in brain disorders, it seems likely that several years of hard work will be necessary before therapy becomes practical for patients suffering from brain disorders. In this context, we have recently completed a controlled study with 120 patients with stroke funded by Department of Biotechnology, Government of India. Its results are being analyzed. [3]

 
  References Top

1.Moorthy RK, Sam GA, Kumar SV, Chacko G, Mathews V, Chacko AG, et al. Intralesional mesenchymal stromal cell transplant in a rodent model of cortical cryoinjury. Neurol India 2011;59:573-8  Back to cited text no. 1
    
2.Li Y, Chopp M. Marrow stromal cell transplantation in stroke and traumatic brain injury. Neurosci Lett 2009;456:120-3.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.http://www.ctri.in:8080/clinicaltrials_jsp/index.jsp (CTRI - PROVCTRI/2008/091/000046) Accessed 30 May 2008).  Back to cited text no. 3
    




 

Top
Print this article  Email this article
   
Online since 20th March '04
Published by Wolters Kluwer - Medknow