One potentially promising area for stem cell treatment is treating patients after a stroke. According to the Centers for Disease Control and Prevention, approximately 800,000 Americans each year have a stroke. These strokes vary dramatically in terms of severity, with some causing death and others resulting in significant damage to a person’s motor and cognitive functions. Although stem cell therapy has been used to treat a variety of conditions, minimizing both patient risks and treatment costs, it has not yet been widely used in stroke prevention and post-stroke treatment. However, new research indicates that it may fundamentally change the outlook for millions of stroke sufferers around the world.
Traditionally, interventional therapy has used either embryonic stem cells or adult stem cells. For a variety of reasons, stroke patients are treated with adult stem cells. It is important to remember that stem cells are undifferentiated cells. This means that they can develop into the cells of various organs and body parts, depending on which genes are turned on or off. Does this mean that if stem cells are injected into a stroke victim that they become brain or central nervous system cells? The answer to this question is no.
What Does Stem Cell Implantation Look Like?
First of all, it is important to highlight the process of how these stem cells are inserted into the patient who has had a stroke. The stem cells are inserted directly into the patient’s brain via a surgical procedure. The injection happens in the area that surrounds the part of the brain that was damaged by the stroke (this requires extensive diagnostic testing so that the correct areas of the brain are identified). As with any surgery, there are risks involved with the implantation process. However, most preliminary studies have shown outstanding results. But, these results still need to be successfully replicated over a wider patient base.
What Do Implanted Stem Cells Do?
Many people think that when these stem cells are implanted into the brain that they will differentiate and develop into new brain cells. But, this, as noted above, is simply not the case.
Instead, when these stem cells are implanted into the brain, the stem cells release growth factors and a wide range of proteins. These growth factors and proteins, as well as other substances, give the body’s own healing process a natural nudge. This nudge may accomplish numerous things. For example, it can encourage damaged neurons to form new synapses. These new synapses can encourage improved communication between the brain and the body, for example, it may help address motor or speech limitations. And, this is not the only thing that the growth factors can help with. The growth factors can also help the brain build new blood vessels near the injury site. Increased blood flow can lead to improved brain functioning.
Traditionally, treatment for strokes have been limited in their efficacy. Some options do exist. For example, medications can be used to treat and dissolve clots that may cause strokes in some patients; and, doctors can also use surgical intervention to decrease pressure and intracranial swelling after a stroke. Also, frequently, following a stroke, a patient will receive intensive physical and occupational therapy, as well as speech and language sessions. These interventions can lead to certain improvements. However, these improvements are often relatively minor; they do not address all of the challenges that patients may be facing. And, the improvements usually only happen during the first six months after a stroke. After the first six months, the patient’s condition often remains static. And, often, patients struggle with a whole range of physical and other challenges that can be frustrating for both them and their loved ones.
Ideally, stem cell therapy will address this frustration, dramatically extending the window in which a person can see life-changing improvements.
The Future of Stem Cell Treatment
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It is important to remember that many of the impressive research results highlighted above are preliminary. This research needs to be replicated in wider patient samples. This replication needs to check a variety of factors. First, it needs to ensure that there are no adverse health and safety issues associated with the stem cell implants. To date, no problems like this have cropped up. And, second, the ongoing tests need to explore and verify to what degree patients experience an improvement in their symptoms.
A recent clinical study in the United Kingdom showed that there was improvement over a far greater time period than one would traditionally see with stroke patients. This definitely offers hope to patients; and, hope is a very important thing. However, on the downside, the improvements in tasks, such as grasping and lifting, were not as significant as one would have hoped for. Yet, this was countered by the fact that patients also saw improvements in the Modified Rankin Scale and the Barthel Index. Both of these measures were defined to improve the ability to accurately assess how well a patient post-stroke functions on a daily basis.
In addition to expanding the study out to a broader group of patients, researchers note that it is also important to ensure that the studies meet best practice standards. Best practice standards mean that the studies need to be randomized and placebo-controlled. This will allow researchers to confidently conclude that the improvements are due to the stem cell implantation and are not simply due to some of the natural improvement that tends to be seen in the first six months after a stroke.
Hundreds of thousands of patients in the United States have strokes each year; and, the numbers rise into the millions if one looks at patients worldwide. Strokes can be fatal; and, even if a patient survives, the post-stroke impact can be debilitating, dramatically changing the patient’s quality of life. Traditionally, there have been limited treatment options available to patients who have strokes. Most treatment has focused on interventions, such as physical and occupational therapy and speech and language to attempt to return functioning to the same level that it was at prior to the stroke. But, often these rehabilitation efforts are only somewhat effective and improvements often only occur immediately after the stroke.
Because of this, doctors and researchers have begun to look at other options to treat strokes. One potentially promising approach is stem cell implantation. In this process, stem cells are directly implanted into the area of the brain that was damaged by the stroke. These stem cells release growth factors and proteins and stimulate the brain to begin the healing process on its own. Ideally, the brain will re-grow neuron synapses and stimulate new blood vessels to develop. Initial research shows promising results. Patients who have received these implants seem to have improved functioning on a variety of counts and measures. But, as with many areas of stem cell research, more research and studies need to be conducted to get definitive results on how effective stem cells can be in treating strokes and stroke-related symptoms. And, this can definitely take time.
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