امروزه، تحقیق بر روی پیوند NPC در بیماری¬های عصبی در دو راستای مختلف در حال پیشرفت است: از یک طرف، اطلاعات اخیر از مطالعات پیش بالینی در راستای کشف اساس مولکولی انعطاف پذیری درمانی NPC می¬باشند که چارچوب منطقی¬تری را برای طراحی مطالعات بالینی ارائه می¬دهند. از طرف دیگر، آزمایشات پایلوت بر ایمن و امکان پذیر بودن پیوند سلول¬های بنیادی عصبی متمرکز هستند که اینها مسائلی هستند که پیش از ارزیابی کارایی پیوند، بایستی مورد توجه قرار گیرند.

Abstract

PURPOSE OF REVIEW

Transplantation of neural stem/precursor cells (NPCs) has been proposed as a promising therapeutic strategy in almost all neurological disorders characterized by the failure of central nervous system (CNS) endogenous repair mechanisms in restoring the tissue damage and rescuing the lost function. Nevertheless, recent evidence consistently challenges the limited view that transplantation of these cells is solely aimed at protecting the CNS from inflammatory and neurodegenerative damage through cell replacement.

RECENT FINDINGS
Recent preclinical data confirmed that transplanted NPCs may also exert a 'bystander' neuroprotective effect and identified a series of molecules - for example, immunomodulatory substances, neurotrophic growth factors, stem cell regulators as well as guidance molecules - whose in-situ secretion by NPCs is temporally and spatially orchestrated by environmental needs. A better understanding of the molecular and cellular mechanisms sustaining this 'therapeutic plasticity' is of pivotal importance for defining crucial aspects of the bench-to-beside translation of neural stem cell therapy, that is route and timing of administration as well as the best cellular source. Further insight into those latter issues is eagerly expected from the ongoing phase I/II clinical trials, while, on the other hand, new cellular sources are being developed, mainly by exploiting the new possibilities offered by cellular reprogramming.

SUMMARY
Nowadays, the research on NPC transplantation in neurological disorders is advancing on two different fronts: on one hand, recent preclinical data are uncovering the molecular basis of NPC therapeutic plasticity, offering a more solid rational framework for the design of clinical studies. On the other hand, pilot trials are highlighting the safety and feasibility issues of neural stem cell transplantation that need to be addressed before efficacy could be properly evaluated

PMID

22547103

[PubMed - in process]