Children and young adults are at the most risk when it comes to Traumatic Brain Injury (TBI). In fact, the CDC estimates that 1.5 million people in the US sustain some form of brain injury every year. Overall, it’s a major cause of death and disability. Most cases are highly complex and require some form of surgery but with varying results. Today though, there are some very promising clinical trials going on to develop cell therapy for possible treatment.
Cell Therapy and Traumatic Brain Injury
TBI is a complex issue because the damage tends to be spread out rather than localized. That’s why certain stem cells are used to treat TBI, as per the key points explained below:
- Neuronal stem cells restore damaged neurons
- Regenerate damaged nerve tissue
- Mesenchymal stem cells reduce inflammation
- Mesenchymal stem cells release trophic factors
Neuronal stem cells restore damaged neurons
Cellular therapies use stem cells that come as one of three different cell types known as embryonic stem cells, adult and induced pluripotent stem cells. Adult stem cells are only programmed to be one specific stem cell, for example, muscle, skin, and nerve cells. The other two types tend to be more multi-functional but are harder to source for cell therapy. Fundamentally though, stem cells encourage existing cells to heal. During cell therapy, they do this by secreting various growth factors that cells need.
Regenerate damaged nerve tissue
Regenerative medicine is an important part of all cell therapies and, in this case, uses neuronal stem cells. These self-renewing, multipotent cells essentially restore damaged neurons. When undergoing cell therapy, these stem cells can also differentiate themselves into specific cells that support the nervous system. Overall though, these cells also release certain molecules when used to treat brain injuries that enhance the brain’s overall structural and functional plasticity.
Mesenchymal stem cells reduce inflammation
Mesenchymal stem cells also play an important role in cell therapy for TBI. That’s because they have properties that reduce inflammation. They are also multipotent in that they can impact many different types of cells. This allows them to recruit local progenitor cells, a simpler stem cell, to replace old or damaged cells. By definition, this then reduces inflammation permanently as the patient starts healing.
Mesenchymal stem cells release trophic factors
Just like neuronal stem cells, mesenchymal stem cells also release certain molecules that enable nerve growth and stimulate the formation of blood cells and vessels. These stem cells also have an immunomodulatory function that is also critical in cell therapy because TBI tends to trigger an immune response. This then releases certain molecules that create a toxic environment for neural stem cells to develop.
Cell Therapy Process for Brain Injury
Whilst cell therapy is increasingly becoming a viable option for TBI, it’s worth understanding a little bit about the actual process and some of the risks involved.
- Source of stem cells
- Cell therapy process
- Clinical trials and risks
Source of stem cells
Neuronal stem cells may be taken from the patient’s own body. Although, their age and the extent of their injury can have a negative impact. Nevertheless, there have been many successful treatments. Nevertheless, some cases have found that newly formed cells don’t survive longer than 1 to 2 months due to a toxic environment caused by, for example, an immune system issue. Therefore, scientists need to find alternative mechanisms for neuronal stem cells to fully succeed in cell therapy.
On the other hand, mesenchymal stem cells are easily sourced from bone marrow or even donated placenta and umbilical cords. Doctors then inject these stem cells straight into the brain and to date, this has been very successful. In fact, there has been no evidence of a toxic environment whereas neurological function greatly improved.
Cell therapy process
As mentioned, doctors inject stem cells straight into the patient during cell therapy. They are first harvested though, ideally directly from the patient themselves. This is both more ethical and also logistically easier than looking for donors.
Brain injuries don’t have to be traumatic and could actually be caused by, for example, cancer tumors. In those cases, a bone marrow transplant might be required to replace damaged blood cells. This procedure is clearly more intrusive but could be the only way to save a patient’s life.
Clinical trials and risks
Today, doctors need more clinical trials to fully prove the success of cell therapy for brain injuries. Although cell therapy results are very promising. Another question that current clinical trials have brought up is how to ensure the longevity of stem cells by providing the right environment for them to do their job. Clearly, less complex and extreme TBI cases have been more successful. Not only do we still need to better understand complex brain injuries but we also have much to learn about stem cells themselves.
At this point, it’s also worth pointing out that gene therapy is another medical option that can be combined with cell therapy. This can be useful if the patient is suffering from a genetic brain disorder, for instance.
What’s Next for Cell Therapy and Brain Injuries?
The clinical trials to date show that cell therapy is promising. There’s no question that this is the future for treating brain injuries. As an individual, you can take part in breakthrough trials currently underway and become part of this journey although, of course, this is a very personal decision. Either way, there’s an exciting future ahead as doctors and scientists keep pushing the boundaries of knowledge and medicine.