Therapeutic Applications of Stem Cells for Cerebral Palsy

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Therapeutic Applications of Stem Cells for Cerebral Palsy

   

Owen Lewis1 and Vincent S. Gallicchio1*

1Department of Biological Sciences, College of Science, Clemson University, Clemson, SC 29636

*Corresponding author: Vincent S. Gallicchio, Department of Biological Sciences, College of Science, Clemson University, Clemson, SC 29636

Citation: Lewis O, Gallicchio VS. (2022) Therapeutic Applications of Stem Cells for Cerebral Palsy. 3(1):1-8.

Received: April 11,  2022 | Published: April  27, 2022

Copyright© 2022 by Lewis O. All rights reserved. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

DOI: https://doi.org/10.52793/ACMR.2022.3(1)-26​    

Abstract

Cerebral palsy (CP) is an umbrella term that describes the consequences of brain injury during the neonatal period or postnatal period. Symptoms can range in severity but typically include muscular issues, cognitive impairment, and seizures. During the neonatal periods, the cause of brain injury is generally unknown. However, one of the primary known causes of CP is hypoxic ischemia (H/I). There is no cure for CP, and patients tend to rely on medication and or surgical procedures for symptom management. Recently stem cells have been an essential topic of therapeutic agents for CP due to their regenerative properties and the potential to restore motor and cognitive function. This article will discuss the various types of stem cells being studied for potential CP treatments and animal and clinical trials results. 

Keywords

Mesenchymal; Adipose; Embryonic; Induced pluripotent stem cells

 

 

 

 

Introduction

Cerebral palsy (CP) is an umbrella term for a collection of neuromotor disorders that typically occurs due to injury to the developing brain. Damage may occur in the prenatal stages of pregnancy or the early prenatal period. There are several causes of brain injury during these critical developmental periods, including stroke and premature birth, and one of the most common causes is hypoxia-ischemia H/I. In addition to the known causes, many CP cases result from damage prenatally due to unknown reasons. The predominant clinical manifestation of CP is damage to the periventricular white matter (PWM). Thus, CP is one of the most prevalent causes of adolescent disability [1-4]. However, most cases of CP occur during the prenatal period and have an unknown cause. The patient's symptoms vary drastically from muscle spasms, seizures, cognitive impairments, and orthopedic complications. Clinicians have various methods of classifying CP. Typically CP can be broken up further into subtypes spastic, ataxic, dyskinetic which are the predominant neurological signs [4,5]. 

The clinical management for CP is limited to physical therapy, Botox, and orthopedic surgery. In severe cases, patients may need round-the-clock care [6]. CP is incurable, and patients often struggle to maintain a decent quality of life. Patients often experience secondary conditions due to complications with CP. Currently, there is no cure for CP. This review will use stem cells as a potential therapeutic option for CP. Recently stem cells have been an essential topic in the treatment of CP due to their regenerative properties and the potential to restore motor function. This article will discuss the various types of stem cells being studied for potential CP treatments and animal and clinical trials results. The types of stem cells currently under research as potential therapeutics for CP include mesenchymal (MSC), neural (NSC), embryonic (ESC), and induced pluripotent stem cells (IPSCs).  Each type of stem cell offers various attractive characteristics that could help regenerate CNS tissue, ultimately restoring some functionality and mitigating symptoms.

Pathology

Injury to the developing brain can lead to clinical manifestation of CP. Damage can result from various insults to the developing brain, including but not limited to inflammation, infection, premature birth, H/I, and genetic disorders [1-4,7]. As a result of these insults, damage to white matter in the CNS typically suffers [1-3,8]. The damage to the white matter leads to problems in posture, cognition, and motor function.  These defined causative agents are rare, as in many cases, the causative agent of CP is unknown and occurs during the perinatal period of pregnancy [1,2]. In the study of CP incidence, there is a discrepancy in male to female occurrences. Males appear to be more susceptible to brain injury; the mechanisms are unclear. However, it is suspected that there is a difference in the neuroprotective elements present in the development of males and females [7]. Overall there are several causative agents associated with the development of CP.

CP Stem Cell Therapy

CP is one of the leading causes of pediatric disability occurring worldwide [3,7,9]. Currently, clinicians are limited to medication, physical therapy, and surgeries as a treatment for CP. In addition to the symptoms of CP, patients can often experience a plethora of comorbidities such as infections, seizures, psychological disorders, etc... [10]. Depending on the severity of the symptoms, patients could require continuous care or multiple procedures to maintain a decent quality of life. With a wide range of symptoms, patients may need to be cared for by several clinicians, from neurologists to psychiatrists, over their lifetime.

Stem cells have much to offer as a therapeutic option for CP. Applications of stem cells in patients aim to restore cognitive and motor functions via cell differentiation and proliferation into neurons and glial cell lines and release supportive elements. The application of stem cells can be a great aid in symptom management. Different cells have various appealing features to offer in regeneration and maintenance of the CNS microenvironment [5]. In CP, lesions and scarring occur primarily in the periventricular areas of the brain. However, some lesions occur in gray matter and the corticospinal tract [3,4] (Figure 1).