Table 1 Preclinical studies of MSC therapy for hemorrhagic stroke

From: Mesenchymal stem cells for hemorrhagic stroke: status of preclinical and clinical research

MSC source

Species

Stroke model

Dose, administration, and timing

Results

Ref

Human, bone marrow

Male Wistar rats (270–320 g)

100 µl autologous whole blood into right striatum

3 × 106, 5 × 106 and 8 × 106 cells, by tail vein injection, one day post-ICH

Improvement in NSS; reduced striatal tissue loss; presence of newly formed immature neurons

58

Rat, bone marrow

Sprague-Dawley rats (270–300 g), unknown sex

Collagenase type VII into left caudate nucleus

2 × 106 cells, by carotid artery/ cervical vein/ lateral ventricle injection, on days 1, 3, 5 and 7 after ICH

Improved limb motor function

30

Human, adipose

Male Sprague-Dawley rats (200–220 g)

Collagenase type VII into striatum

3 × 106 cells, by IV injection, 24 h post-ICH

Improvement in modified limb placing behavioral scores; reduced brain atrophy and glial proliferation; endothelial marker expression but not neuronal or glial markers; acute brain inflammation markers

64

Human, processed lipoaspirate (or adipose-derived)

Male Wistar rats (422 ± 28.9 g)

Collagenase type IV into caudate nucleus

3 × 106 cells, by tail vein injection, 24 h post-ICH

Improvement in Rotarod test; no lesion size difference; increase in endogenous progenitor cells

31

Human, bone marrow

Male Wistar rats (270–320 g)

100 µl autologous whole blood into right striatum

1 × 106 cells, by internal carotid artery injection, 24 h post-ICH

No improvement in NSS and corner turn tests from MSC therapy alone (only in combination with mannitol); no striatal tissue loss; presence of newly formed immature neurons

32

Human, umbilical cord

Male Sprague-Dawley rats (230–260 g)

Collagenase type VII into striatum

2 × 105 cells, by intracerebral injection, 24 h post-ICH

Improvement in mNSS and Morris water maze test; injury area significantly reduced; vascular density increased; reduced number of degenerating neurons in peri-ICH area; attenuated immune response

33

Human, umbilical cord *with gene transduction of fibroblast growth factor and hepatocyte growth factor (HGF)

Male Sprague-Dawley rats (mean of 220 g)

Collagenase into internal capsule

6 × 105 cells, by intracerebral injection, one week post-ICH

Improvement in Rotarod test; reduced demyelination

34

Human, bone marrow

Male macaca fascicularis monkeys (4.2 ± 0.2 kg) *first in primate

1.5 mL of autologous arterial blood between the right cortex and basal ganglia

(1–5) x 106 cells, by intracerebral injection, 1 week or 4 weeks post-ICH

Improvement in modified Kito score scale; reduced tissue damage; higher microvessel density

51

Rat, bone marrow (overexpressing GDNF)

Wistar rats (270–320 g), unknown sex

Collagenase type I (0.25 U) and 1 U heparin sodium into right striatum

5 × 105 cells, by intracerebral injection, 3 days post-ICH

Improvement in mNSS; reduced lesion volume

65

Rat, bone marrow

Female Wistar rats (275–300 g)

0.3 mL of blood into the subarachnoid space *first SAH model

3 × 106 cells, by tail vein injection, 24 h post-SAH

Improvement in mNSS; increased numbers of proliferating cells; fewer apoptotic cells

48

Rat, bone marrow

Female Wistar rats (200–250 g)

Collagenase type IV into the striatum

2 × 106 cells, by intracerebral injection, 2 h post-ICH

Enhanced endogenous neurogenesis; reduced apoptosis of newborn neural cells

47

Rat, bone marrow

Male Sprague-Dawley rats (270–320 g)

Collagenase type VII into the striatum

1 × 106 cells, by tail vein injection, one hour post-ICH

Improvement in mNSS; reduced hemorrhage volume; presence of newly formed immature neurons; elevated BDNF

35

Human, adipose

Male Sprague-Dawley rats (200–250 g)

Collagenase type VII into the striatum

1 × 106 cells, by right femoral vein injection, 24 h post-IHC

Improvement in mNSS

36

Human, umbilical cord

Male Sprague-Dawley rats (postnatal day 4 – weight unknown)

200 µL fresh maternal whole blood ventricles (100 µL into each ventricle)

1 × 105 cells, by intracerebral injection, 24 h post-ICH

Prevented PHH development; attenuated impairment on negative geotaxis tests and Rotarod test; reduced corpus callosum loss; increased astrogliosis; increased expression of inflammatory cytokines

59

Human, bone marrow

Male Sprague-Dawley rats (190–210 g)

collagenase type VII into striatum

2 × 105 cells, by intracerebral injection, 1 day post-ICH

Improvement in mNSS; decreased brain water content; reduced neutrophil infiltration and microglial activation in the peri-ICH area; downregulation of inflammatory mediators

37

Rat, bone marrow

Female Wistar rats (200–250 g)

Collagenase type IV (0.5 IU) into striatum

5 × 106 cells, by intracerebral injection, 2 months post-ICH

Improvement in Rotarod and Video-Tracking-Box tests; increased endogenous neurogenesis

38

Rat, bone marrow

Female Wistar rats (275–300 g)

Unheparinized blood into subarachnoid space

3 × 106 cells, by tail vein injection, 24 h post-ICH

Improvement in structural integrity of cerebral tissues (electron microscopy)

68

Rat, bone marrow

Male Sprague-Dawley rats (250–300 g)

Collagenase type IV

3 × 106 cells, by IV injection, two hours post-ICH

Reduced brain edema and blood brain barrier leakage; decreased levels of proinflammatory cytokines; reduced apoptosis; downregulated density of microglia/macrophages and neutrophil infiltration at the ICH site; attenuated ONOO- formation; increased levels of ZO-1 and claudin-5

67

Human, umbilical cord

Male Sprague-Dawley rats (250–300 g)

Collagenase type VII into the striatum

5 × 105 cells, by intracerebral injection, 2 days post-ICH

Improvement in Rotarod tests; reduced lesion volume; increased angiogenesis; reduced inflammatory factors

66

Human, Wharton’s jelly (umbilical cord) *primed for 72 h into neuron-like cells

Male Sprague-Dawley rats, (240–280 g)

Collagenase type IV into striatum

2 × 105 cells, by intracerebral injections, 1 week post-ICH

Improvement in Rotarod and limb placing test; increased blood vessel density; increased GDNF in primed cells

43

Rat, bone marrow *with hypoxic preconditioning

Male C57BL/6 mice (25–28 g)

Collagenase type IV

1 × 106 cells, by intranasal delivery, 3 and 7 days post-IHC

Improvement in mNSS, Rotarod test, adhesive removal test, and locomotor function evaluation; reduction in tissue loss; reduction in ventricular enlargement; rescued levels of growth factors; enhanced proliferation and number immature neurons

45

Rat, bone marrow

Male Spontaneously Hypertensive Rat, unknown weight

50 µL of autologous blood

1 × 106 cells, by tail vein injection, timing not recorded

Improvement in mNSS and modified limb placing test; attenuated blood brain barrier permeability; increased levels of tight junction associated protein occludin, and type IV collagen

52

Human, umbilical cord *with hematoma aspiration

Male Sprague-Dawley rats (250–280 g)

Collagenase type IV into caudate nucleus

1 × 105 by intracerebral injection, 6 h post-ICH (with hematoma aspiration)

Improvement in mNSS; reduced p53 expression around hematoma

44

Human, umbilical cord *compares IV and IC administration

Male Sprague-Dawley rats (230–260 g)

Collagenase type VII into the striatum

2 × 105 cells by intracerebral injection. 2 × 106 cells by the tail vein injection - timing not recorded

Improvement in mNSS; reduced injury volume; increased vascular density in intracerebral administration group

46

Human, amniotic membrane

Male Wistar rats (240–260 g)

Collagenase type VII into the striatum

5 × 105 cells, by intracerebral injection, 24 h post-ICH

Improvement in mNSS; increased blood vessel density; reduced apoptosis; increased proliferation and differentiation of neurons; increased growth factor levels; reduced neutrophil infiltration and microglial activation

39

Rat, bone marrow *compared to conditioned media

Male Sprague-Dawley rats (250–280 g)

100 µl autologous arterial blood into right basal ganglia

Dose not reported, by tail vein injection, immediately post-ICH.

Improvements in forelimb-placing, corner turn tests, and mNSS; no effect on Morris water maze performance; reduced brain water content; increased phosphorylation of downstream signaling molecules; decreased inflammatory cytokines

56

Rat, bone marrow *with 2nd messenger signaling inhibitors

Male rats (250–280 g)

100 µl autologous arterial blood into right basal ganglia

Dose not reported, by IV injection, 1 and 24 h post-ICH.

Improvement in mNSS which are blocked by inhibitor treatment; attenuation of second messenger signaling by inhibitors

57

Rat, bone marrow

Male Spontaneously Hypertensive Rats (250–300 g)

20 µl of hemoglobin into right caudate nucleus

1 × 106 cells, by intracerebral injection, 6 h post-ICH

Improvements in mNSS and modified limb placing test; reduced brain water content; reduced apoptosis; increased ZO-1 staining; reduced microglial activation; decreased inflammatory cytokines

40

Human, bone marrow *MSCs to prevent aneurysmal rupture

Male C57BL/6 J mice, weight unknown

Deoxycorticosterone acetate-salt to induce systemic hypertension. Elastase into the right basal cistern

1 × 106 cells, by IV injection, 6 and 9 days after aneurysm induction

Reduced both the incidence of ruptured aneurysms and rupture rate

50

Human, placenta derived

Male Sprague-Dawley rats (250–350 g)

Collagenase type IV into striatum

1 × 106 cells, by tail vein injection, one hour post-ICH

Decreased mortality rate; reduced hematoma volume and ventricular enlargement; reduced brain edema; increased ZO-1 and occludin

41

Rat, bone marrow

Male Wistar rats (300–350 g)

Perforation of the Circle of Willis

1.5 × 106 cells, by intranasal delivery, 6 days post-SAH

Improvement in sensorimotor and mechanosensory function; reduced gray and white matter loss; increased activation of astrocytes and microglia

61

  1. mNSS modified neurological severity score, BDNF brain-derived neurotrophic factor, BM bone marrow, MSC mesenchymal stem cell, GDFN glial cell-derived neurotrophic factor, SAH subarachnoid hemorrhage, ICH intracerebral hemorrhage, IC intracerebral, IV intravenous, ZO-1 zonula occludens protein-1, ONOO- peroxynitrite, PHH post-hemorrhagic hydrocephalus