Evaluation of the Safety and Efficacy of the Therapeutic Potential of Adipose-Derived Stem Cells Injected in the Cerebral Ischemic Penumbra

J Stroke Cerebrovasc Dis. 2018 Sep;27(9):2453-2465. doi: 10.1016/j.jstrokecerebrovasdis.2018.05.001. Epub 2018 Jul 18.

Abstract

Introduction: Stroke represents an attractive target for cell therapy. Although different types of cells have been employed in animal models with variable results, the human adipose-derived stem cells (hASCs) have demonstrated favorable characteristics in the treatment of diseases with inflammatory substrate, but experience in their intracerebral administration is lacking. The purpose of this study is to evaluate the effect and safety of the intracerebral application of hASCs in a stroke model.

Methods: A first group of Athymic Nude mice after stroke received a stereotactic injection of hASCs at a concentration of 4 × 104/µL at the penumbra area, a second group without stroke received the same cell concentration, and a third group had only stroke and no cells. After 7, 15, and 30 days, the animals underwent fluorodeoxyglucose-positron emission tomography and magnetic resonance imaging; subsequently, they were sacrificed for histological evaluation (HuNu, GFAP, IBA-1, Ki67, DCX) of the penumbra area and ipsilateral subventricular zone (iSVZ).

Results: The in vitro studies found no alterations in the molecular karyotype, clonogenic capacity, and expression of 62 kDa transcription factor and telomerase. Animals implanted with cells showed no adverse events. The implanted cells showed no evidence of proliferation or differentiation. However, there was an increase of capillaries, less astrocytes and microglia, and increased bromodeoxyuridine and doublecortin-positive cells in the iSVZ and in the vicinity of ischemic injury.

Conclusions: These results suggest that hASCs in the implanted dose modulate inflammation, promote endogenous neurogenesis, and do not proliferate or migrate in the brain. These data confirm the safety of cell therapy with hASCs.

Keywords: ASC therapy; Stroke; animal model; brain surgery; intracerebral transplantation; stem cells.

MeSH terms

  • Adipose Tissue / cytology
  • Animals
  • Brain / blood supply
  • Brain / diagnostic imaging
  • Brain / metabolism
  • Brain / pathology
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / metabolism
  • Brain Ischemia / pathology
  • Brain Ischemia / therapy*
  • Cell Proliferation
  • Disease Models, Animal
  • Doublecortin Protein
  • Gliosis / diagnostic imaging
  • Gliosis / metabolism
  • Gliosis / pathology
  • Gliosis / therapy
  • Humans
  • Male
  • Mice, Nude
  • Microglia / metabolism
  • Microglia / pathology
  • Motor Activity
  • Neovascularization, Pathologic / diagnostic imaging
  • Neovascularization, Pathologic / metabolism
  • Neovascularization, Pathologic / pathology
  • Neovascularization, Pathologic / therapy
  • Neurons / metabolism
  • Neurons / pathology
  • Random Allocation
  • Stem Cell Transplantation* / adverse effects
  • Stem Cells / cytology
  • Transplantation, Heterologous