title: Stem cells and combination therapy for the treatment of traumatic brain injury.
abstract: TBI is a nondegenerative, noncongenital insult to the brain from an external mechanical force; for instance a violent blow in a car accident. It is a complex injury with a broad spectrum of symptoms and has become a major cause of death and disability in addition to being a burden on public health and societies worldwide. As such, finding a therapy for TBI has become a major health concern for many countries, which has led to the emergence of many monotherapies that have shown promising effects in animal models of TBI, but have not yet proven any significant efficacy in clinical trials. In this paper, we will review existing and novel TBI treatment options. We will first shed light on the complex pathophysiology and molecular mechanisms of this disorder, understanding of which is a necessity for launching any treatment option. We will then review most of the currently available treatments for TBI including the recent approaches in the field of stem cell therapy as an optimal solution to treat TBI. Therapy using endogenous stem cells will be reviewed, followed by therapies utilizing exogenous stem cells from embryonic, induced pluripotent, mesenchymal, and neural origin. Combination therapy is also discussed as an emergent novel approach to treat TBI. Two approaches are highlighted, an approach concerning growth factors and another using ROCK inhibitors. These approaches are highlighted with regard to their benefits in minimizing the outcomes of TBI. Finally, we focus on the consequent improvements in motor and cognitive functions after stem cell therapy. Overall, this review will cover existing treatment options and recent advancements in TBI therapy, with a focus on the potential application of these strategies as a solution to improve the functional outcomes of TBI.
authors.affiliation: ER045, Laboratory of Stem Cells, Faculty of Sciences, DSST, PRASE, Lebanese University, Beirut, Lebanon.
authors.forename: AmiraSan
authors.initials: A
authors.lastname: Dekmak
authors.affiliation: ER045, Laboratory of Stem Cells, Faculty of Sciences, DSST, PRASE, Lebanese University, Beirut, Lebanon; Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon.
authors.forename: Sarah
authors.initials: S
authors.lastname: Mantash
authors.affiliation: Department of Biological and Chemical Sciences, Lebanese International University, Beirut, Lebanon.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Shaito
authors.affiliation: Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon.
authors.forename: Amer
authors.initials: A
authors.lastname: Toutonji
authors.affiliation: ER045, Laboratory of Stem Cells, Faculty of Sciences, DSST, PRASE, Lebanese University, Beirut, Lebanon; Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon.
authors.forename: Naify
authors.initials: N
authors.lastname: Ramadan
authors.affiliation: Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon.
authors.forename: Hussein
authors.initials: H
authors.lastname: Ghazale
authors.affiliation: ER045, Laboratory of Stem Cells, Faculty of Sciences, DSST, PRASE, Lebanese University, Beirut, Lebanon.
authors.forename: Nouhad
authors.initials: N
authors.lastname: Kassem
authors.affiliation: Faculty of Medicine, Hariri School of Nursing, American University of Beirut, Beirut, Lebanon.
authors.forename: Hala
authors.initials: H
authors.lastname: Darwish
authors.affiliation: ER045, Laboratory of Stem Cells, Faculty of Sciences, DSST, PRASE, Lebanese University, Beirut, Lebanon; Laboratory of Cardiovascular Diseases and Stem Cells, Biology Department, Faculty of Sciences-I, Lebanese University, Beirut, Lebanon. Electronic address: kzibara@ul.edu.lb.
authors.forename: Kazem
authors.initials: K
authors.lastname: Zibara
mesh_terms: D000818:Animals; D000070642:Brain Injuries, Traumatic / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods; D006801:Humans; D033581:Stem Cell Transplantation / Q000379:methods
keywords: Combination therapy; Growth factors; Pathophysiology; ROCK inhibitors; Stem cells; Traumatic brain injury; Treatment