Introduction to cell therapy in brain injury

Cell therapy represents a “third wave” of therapeutics following in the wake of the “small molecule” and “biologicals” approaches. Cell therapy targets the reparative and remodeling phase of brain injury. In this book, we cover the use of different types of “cells” from bone-marrow-derived cells such as bone marrow mononuclear cells, mesenchymal stem cells (or marrow stromal cells), and MultiStem, a proprietary plastic adherent cell, to neural stem cells, including induced pluripotent stem (iPS) cell-derived neural progenitors. We also include a chapter on the use of the conditioned media of adipose stem cells as a cell-based therapeutic approach. Different cell types justify different routes of administration (intravenous, intra-arterial, and intracerebral), and there are multiple time windows of intervention. While most of preclinical work and early clinical trials on cell therapy has been with adult stroke, we also include chapters on the use of cell therapy in traumatic brain injury, neonatal stroke, and neonatal hypoxic–ischemic encephalopathy. While cell therapy has enormous potential to improve the quality of life of many with brain injury, the field has suffered from too much “hype.” Only high-quality and rigorous preclinical studies followed by well-designed clinical trials will allow the field to advance, mature, and hopefully develop treatments to reduce disability.