Stroke – an acute circulatory disorder in the brain, which leads to damage and death of nerve cells. Stroke occurs in two ways: a blood vessel ruptures or high blood pressure (called hemorrhagic stroke) or is blocked by a blood clot – a clot (ischemic stroke).
due to the fact that part of the nerve cells die, the body loses the ability to perform certain functions: one is completely or partially lost the ability to move, speak, move his hand or foot . According to world statistics,
more than 80% of patients one year after a stroke survivor, but over 70% of survivors are forced to live with the consequences of the disease to the rest of his life.
Of course, people pass stroke rehabilitation – medical problem is to restore the activity of the brain cells which are close to the hearth of dead neurons. As a general rule, measures for the rehabilitation of patients are held for six months after a stroke: it is believed that six months – this is the period after which the cells are restored correctly, “get over it” is not able to.
However, a group of American researchers led by Harry Steinberg of Stanford University school of Medicine has managed to do what seemed impossible before doctors literally put on the legs of patients who have lost the ability to move and speak after a stroke. With full text the study can be found in the journal Stroke.
For the experimental treatment, scientists have selected a group of 18 people (11 women and 7 men) aged 33 to 75 years old. All patients had a stroke long before the start of the experiment (time between brain damage and the start of treatment ranged from 6 to 60 months – this means that
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people overcome the time barrier, after which further rehabilitation activities are considered to be useless).
The procedure, which is subjected to the patients was as follows: doctors drilled a hole in their skull and made in injection marrow mesenchymal stromal cells, called SB623 – is multipotent stem cells that can differentiate into other cell types (including, for example, such as bone cells, osteoblasts, cartilaginous tissue – chondrocytes, muscle – myocytes or adipose tissue – adipocytes). The stem cells were derived from bone marrow of healthy donors. Despite the fact that
people literally drilled skull operation took place quite quickly and easily: the patients were conscious and were able to leave the hospital the same day <. / span>
stem cells injected into the brain of the patients have been genetically modified: they called Notch1 gene was inserted. It activates processes that ensure the formation and development of the brain in young children
Immediately after surgery, people have experienced some side effects. Nausea, vomiting, headache. However, all of these unpleasant effects disappear after a few days. Doctors assess the condition of patients a month, six months and one year after the injection of stem cells, capturing the changes
Lead author of Harry Steinberg is trying to be cautious in their assessments of treatment outcomes:. He emphasizes that the procedures were only 18 people and proof of the effectiveness of injections was not even the main goal of the scientists – they just want to get their safety certificate
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Nevertheless, Steinberg admits that the research team was impressed by the success of the operation: the state of the seven patients out of 18 improved significantly. “This is an improvement – not the minimal changes, in which a person is not able to move my thumb, they could push. It is much more important.
For 71-year-old patient, confined to a wheelchair, back on its feet. ”
Another patient – a woman 39 years – suffered a stroke two years before the surgery and experienced problems with walking and speech. “I could not speak properly, my left leg is a bad move, and I moved in a wheelchair. My right arm was almost dead, and the shoulder is very sore, “- says the woman
According to the patient’s words, her condition prevented her to live -. She did not even want to get married. Immediately after the injection of stem cells the woman’s health was rapidly improving. In the end, she still accepted the offer of her lover, married and are now expecting a baby
Harry Steinberg stresses that stem cells injected into the brain of a patient, are not turned into neurons – instead they launched a series of biochemical processes. due to which the brain’s ability to heal itself increased. “We think that the cells change the adult human brain so that it begins to resemble a child’s brain, which is very good” repairing “itself.
Cells contribute to the development of numerous growth factors – they contribute to the restoration of the brain and stimulate the immune system. This helps to suppress inflammatory processes, “- says Steinberg.
Despite the impressive success, doctors are not in a hurry to build the treatment effects of stem cell stroke means rank, which will put on their feet all paralyzed people. Scientists are going to carry out a second, more ambitious experiment, and has recruited volunteers to participate in it. Results are expected in two years.
That make definite conclusions until early science department told Deev and Roman, PhD, Scientific Director of the Institute of human stem cells. “Obtaining a positive conclusion on the clinical study of the safety and efficacy of cell therapy – is a very important signal to the medical community. We all know that vascular events are included in the top three killers of our population, it is one of the three leading causes of disability and death in industrialized countries, – the scientist says
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– Now, it is important to carefully analyze what new information we have received. Well, first of all, the study carried out only early 1 / 2a phase clinical study on a small group of patients – only 18 people
It is important that these 18 people were selected at. scrupulous screening of 379 patients! This means that the study included only those who were sorry, “promising”;
ie modern cell therapy – is largely targeted therapy; a set of clinical, biochemical and genetic traits often can determine the success or failure of treatment. Second applied allogeneic mesenchymal cells (mesenchymal multipotent bone marrow stromal cells). This type of cell is known emergency synthetic activity in terms of the production of cytokines, growth factors, and other biologically active molecules in modulating all tissues of the body by growth processes, cell proliferation, intracellular (including for neurons) and cell regeneration, up to elimination “unnecessary” types of cells and immune responses.
But the most remarkable thing is not even that, and that, in fact, we have a complete design-cell gene therapy. To enhance the synthetic activity of the cells prior to administration were transfected with a plasmid (absolutely safe, not inserted into the genome of the vector for gene therapy). The authors felt it necessary to make a temporary, transient – namely, such an effect gives a plasmid – an expression of Notch1 protein. What kind of protein?
This is an important protein, predetermining the fate of cells in embryogenesis and in postnatal life.
In particular, the development of the central nervous system it ensures the development of the so-called radial glial cells – cells that many researchers believe stem at the base of our brain and spinal cord. It is likely that the increased production of its time in the tissues and determined the outcome of the investigation. I mean not only the security, that in similar studies has been demonstrated many times, but also the effectiveness of the important trends. However, we need to be restrained in their assessments – a total of 18 patients treated. Truth, we open only the third phase of clinical studies with this variant gene-cell therapy. »
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