title: Cell-based therapy for traumatic brain injury.
abstract: Traumatic brain injury is a major economic burden to hospitals in terms of emergency department visits, hospitalizations, and utilization of intensive care units. Current guidelines for the management of severe traumatic brain injuries are primarily supportive, with an emphasis on surveillance (i.e. intracranial pressure) and preventive measures to reduce morbidity and mortality. There are no direct effective therapies available. Over the last fifteen years, pre-clinical studies in regenerative medicine utilizing cell-based therapy have generated enthusiasm as a possible treatment option for traumatic brain injury. In these studies, stem cells and progenitor cells were shown to migrate into the injured brain and proliferate, exerting protective effects through possible cell replacement, gene and protein transfer, and release of anti-inflammatory and growth factors. In this work, we reviewed the pathophysiological mechanisms of traumatic brain injury, the biological rationale for using stem cells and progenitor cells, and the results of clinical trials using cell-based therapy for traumatic brain injury. Although the benefits of cell-based therapy have been clearly demonstrated in pre-clinical studies, some questions remain regarding the biological mechanisms of repair and safety, dose, route and timing of cell delivery, which ultimately will determine its optimal clinical use.
authors.affiliation: Department of Emergency Medicine, Grenoble University Hospital, La Tronche, France.
authors.forename: S
authors.initials: S
authors.lastname: Gennai
authors.affiliation: Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care, La Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Monsel
authors.affiliation: Department of Anesthesiology, University of California San Francisco, 505 Parnassus Ave., Box 0648, San Francisco, CA 94143, USA.
authors.forename: Q
authors.initials: Q
authors.lastname: Hao
authors.affiliation: Department of Anesthesiology, University of California San Francisco, 505 Parnassus Ave., Box 0648, San Francisco, CA 94143, USA.
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Anesthesiology, University of California San Francisco, 505 Parnassus Ave., Box 0648, San Francisco, CA 94143, USA.
authors.forename: V
authors.initials: V
authors.lastname: Gudapati
authors.affiliation: Grenoble Institut des Neurosciences, Unité Inserm U 836, La Tronche, France.
authors.forename: E L
authors.initials: EL
authors.lastname: Barbier
authors.affiliation: Department of Anesthesiology, University of California San Francisco, 505 Parnassus Ave., Box 0648, San Francisco, CA 94143, USA leejw@anesthesia.ucsf.edu.
authors.forename: J W
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000818:Animals; D001930:Brain Injuries / Q000503:physiopathology / Q000628:therapy*; D002986:Clinical Trials as Topic; D053595:Embryonic Stem Cells / Q000637:transplantation; D066026:Endothelial Progenitor Cells / Q000637:transplantation; D006801:Humans; D045164:Mesenchymal Stem Cell Transplantation; D039902:Multipotent Stem Cells / Q000637:transplantation; D018919:Neovascularization, Physiologic; D058953:Neural Stem Cells / Q000637:transplantation; D055495:Neurogenesis; D033581:Stem Cell Transplantation / Q000379:methods*
keywords: cell-based therapy; stem cells; traumatic brain injury