Stem cells help brain repair, make new neurons and blood
vessels after stroke
(Left to Right) Dr. William D. Hill, Dr. David
Hess and research assistant Angeline-Martin Studdard look at image of a
brain that has been damaged by stroke.
In the first hours and days following a stroke, stem cells leave the bone
marrow to help the injured brain repair damaged neurons and make new neurons and
blood vessels, according to researchers at the Medical College of Georgia.
The research, reported in the May issue of Stroke, used a mouse model in
which the animals marrow was replaced with that of a transgenic mouse with
cells that make a jellyfish protein that fluoresces green so they could trace
the cells and the natural repair process that apparently occurs after stroke.
The researchers are now looking for the right factors to enhance the normal
repair mechanism, improve stroke recovery and, since the patients own cells
would be used, avoid issues such as the compatibility of donated stem cells and
the ethical controversy surrounding embryonic stem cells.
They also want to identify which bone marrow stem cell types are targeted for
this repair and how they are called to the site of injury, suspecting that
inflammation may be part of this homing process.
The image shows a slice of a mouse brain that
has been damaged by stroke on the right side; green stains show where the
cells bodies are located. Regions on the right, highlighted by asterisks,
show where neurons died.
We tried to determine whether cells that reside in your bone marrow and
circulate throughout the blood could turn into any of the major brain cells
types, said Dr. David Hess, neurologist, stroke specialist, chairman of the MCG
Department of Neurology and lead author on the study.
They found in the animal model, evidence that bone marrow cells naturally
migrate to injured regions of the brain after stroke to help repair damaged
tissue; they also become endothelial cells that form new blood vessels and what
appear to be new neurons.
Such repairs occurred naturally in response to stroke and the bone marrow is
involved in those repair mechanisms, said Dr. William D. Hill, neuroscientist
in the MCG Department of Cellular Biology and Anatomy and second author on the
research paper. We think that when you have a stroke, you have this central
core area that is highly affected. Then you have this area like a shell
surrounding the core, called the penumbra, like a shadow, that has a gradient of
damage as you move from the core of the stroke to the unaffected tissue. This is
the area that is going to be the most sensitive to being repaired. So maybe if
we can enhance that repair, we could preserve a region that would normally die
but is an area we can target to recover.
Enhancement could come through the use of growth factors that affect subsets
of bone marrow cells; possibly some already on the market, for example to help
leukemia patients rebuild bone marrow after chemotherapy, might be useful.
This image shows new blood vessel formation;
the new cells derived from the bone marrow are in green and the endothelial
or lining cells have a red marker.
If this works out, you will be able to give individuals shots following
stroke to boost their bone marrow to proliferate these stem cells to do specific
tasks, target specific groups of these stem cells important to blood vessel
repair and the genesis of new neurons, Dr. Hill said. The work has implications
for all sorts of brain injuries early and late in life such as cerebral palsy,
Parkinsons and Alzheimers disease.
This repair process mimics embryological development when stem cells from the
bone marrow help form blood vessels in the brain. There are some data that
older people dont have as many circulating stem cells as younger, healthier
people do, Dr. Hess said, so enhancing the cell number involved in repair
should enhance the natural process.
Enhancing the natural process could avoid more aggressive measures such as
transplanting cell-laden bone marrow. Why would we transplant bone marrow cells
into people when their bone marrow already has these cells? Dr. Hess said. It
makes much more sense to actually maximize what they already put out. Also,
rather than taking bone marrow out and injecting it into the brain, why not make
use, again, of this natural process that summons the cells to the location of
the brain injury?
This image shows how how bone-marrow derived
cells can be turned into new neurons. The new cells have a red dot labeling
them and green is the neuronal marker.
Finding what summons the cells to the injury site is key, and the researchers
are looking at specific molecules up-regulated in inflammation that they suspect
are also involved in homing. Certain factors released and expressed on the
surface of damaged endothelial cells may act as flags to wave down passing white
blood cells or stem cells to attach there, Dr. Hill said.
Also key is identifying which specific stem cells are summoned and are needed
to make new blood vessels, support cells and neurons. This may permit selective
recruitment and proliferation of just the cells needed for repair, Dr. Hill
said.
There are two known broad classes of these cells, hematopoetic and
mesenchymal, but there may be many unknown cell types, including a separate
group involved in making endothelial cells, Dr. Hess said.
Just last week, through a collaborative study with the Medical University of
South Carolina, they received the first mouse that, through a process called
clonal analysis, will enable them to tag a single cell, then watch for its
descendents roles in the normal repair process.
They also are collaborating with fellow MCG researcher Nevin Lambert to do a
functional analysis of the new neurons produced by the stem cells to ensure that
they not only look like but function as neurons.
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The published research was funded by the American Heart Association and has
been presented at recent meetings of the association and the Society of
Neuroscience. The scientists have received funding from the National Institutes
of Health for follow-up studies.
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