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Traumatic brain injury (TBI)

Brain injury stem cell treatment

Traumatic brain injury (TBI) is mostly caused by an external physical impact producing an altered state of consciousness resulting in impairment of physical functions or cognitive abilities It is one of the leading causes of morbidity and mortality in the world. The damage to the brain could be either focal or diffused depending on the event causing TBI. The outcome consists of two stages (a) primary insult, which occurs at the time of impact (b) Secondary insult, which is a cascade of events after the primary insult with delayed clinical presentation.

Changes in cerebral blood flow and oxygen levels, edema, excitotoxicity, cell death, disruption of the blood-brain barrier, and generalized atrophy are frequently noted in traumatic brain injury (TBI). Such brain damage can manifest as temporary or permanent behavioral and/or emotional disturbances, resulting in functional impairment. Presently, there are limited treatment options for TBI, with management typically involving pharmacological and surgical interventions alongside rehabilitation to address symptoms.

Traumatic brain injury Stem Cell Treatment Unmet medical needs

In chronic TBI, the life expectancy of the affected is normal, but there is high prevalence of the residual disability arising from the injury. These include hemiparesis, spasticity, cognitive, emotional and behavioral issues, etc. The available pharmacological modalities manage these disabilities, but their effect wears off gradually. The rehabilitation resources are inadequate for the increasing number of survivors of TBI. There is diffuse white matter damage which cannot be addressed by current medical treatments. Also, the gliotic areas in the brain cannot be reversed.

Stem cell therapy for traumatic brain injury (TBI) targets the brain’s limited ability to regenerate neurons by focusing on impeding degeneration and replenishing lost or damaged neurons. Over recent years, cell therapy has emerged as a promising treatment avenue for neurological conditions, including traumatic brain injury stem cell treatment. Stem cells possess the ability to migrate toward areas of brain damage and initiate the repair process, facilitating angiogenesis, axonal remodeling, neurogenesis, and synaptogenesis. These mechanisms hold potential for reversing the pathological effects of TBI.

These cells differentiate into various cells including neural cells, oligodendrocytes, etc. In TBI, there is loss of myelin which disrupts the signal transduction and damages the axons. The oligodendrocytes help in remyelination of the damaged axons and repair the disrupted neural connections. Bone marrow cells also produce various growth factors and neurotrophic factors such as brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and hepatocyte growth factor (HGF), which stimulate the endogenous neuroprotection and repair.

Animal studies  

Various experiments on animal models have been carried out to test the safety and feasbility of different types of cells. Reiss et al, transplanted embryonic cells in experimental rats and recorded dramatic improvements. But, over the period of observation they also recorded tumor formation in the rats, raising serious safety concerns about the use of these cells. Series of experiments were conducted to study the neural stem cells in TBI which reported improved neurological functions in the injected rat models via various mechanism. Bone marrow stem cells were also found to be efficacious.

In rat experiments, these cells have been shown to regulate the inflammatory response of immune cells and cytokines associated with traumatic brain injury (TBI)-induced cerebral inflammation. More recently, umbilical cord cells have also been assessed in rat models for traumatic brain injury stem cell treatment. In one experimental study, rats received injections of brain-derived neurotrophic factor (BDNF) gene-modified umbilical cord mesenchymal stem cells (UCMSCs). These cells not only survived but also migrated to cerebral tissues, resulting in significant improvements in behavior and other neurological functions.

Human Studies for Stem Cell for Traumatic brain injury

Traumatic brain injury Stem Cell Treatment(TBI) is still in an experimental stage. Not many clinical trials have been conducted on human subjects. Wang et al published the results of his study conducted on patients with sequelae of TBI. He administered 40 patients with umbilical cord mesenchymal stem cells. They observed improved neurological functions and self care in these patients as compared to the controls. Neurocyte is one of the best

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