Recent Progress in Therapeutic Strategies for Ischemic Stroke

Cell Transplant. 2016;25(5):893-8. doi: 10.3727/096368916X690548. Epub 2016 Jan 18.


Possible strategies for treating stroke include neuroprotection in the acute phase of cerebral ischemia and stem cell therapy in the chronic phase of cerebral ischemia. Previously, we have studied the temporal and spatial expression patterns of c-fos, hypoxia inducible factor-1α (HIF-1α), heat shock protein 70 (HSP70), and annexin V after 90 min of transient middle cerebral occlusion in rats and concluded that there is a time window for neuroprotection from 12 to 48 h after ischemia. In addition, we have estimated the neuroprotective effect of glial cell line-derived neurotrophic factor (GDNF) by injecting Sendai viral vector containing the GDNF gene into the postischemic brain. This Sendai virus-mediated gene transfer of GDNF showed a significant neuroprotective effect in the ischemic brain. Additionally, we have administered GDNF and hepatocyte growth factor (HGF) protein into the postischemic rat brain and estimated the infarct size and antiapoptotic and antiautophagic effects. GDNF and HGF significantly reduced infarct size, the number of microtubule-associated protein 1 light chain 3 (LC3)-positive cells, and the number of terminal deoxynucleotidyl transferase-mediated dUTP-biotin in situ nick-end labeling (TUNEL)-positive cells, indicating that GDNF and HGF were greatly associated with not only the antiapoptotic effect but also the antiautophagic effects. Finally, we have previously transplanted undifferentiated iPSCs into the ipsilateral striatum and cortex at 24 h after cerebral ischemia. Histological analysis was performed at 14 and 28 days after cell transplantation, and we found that iPSCs could supply a great number of doublecortin-positive neuroblasts but also formed tridermal teratoma in the ischemic brain. Our results suggest that iPSCs have a potential to provide neural cells after ischemic brain injury if tumorigenesis is properly controlled. In the future, we will combine these strategies to develop more effective therapies for the treatment of strokes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Apoptosis / drug effects
  • Autophagy / drug effects
  • Brain Ischemia / pathology
  • Brain Ischemia / therapy*
  • Cell- and Tissue-Based Therapy / methods*
  • Doublecortin Protein
  • Gene Transfer Techniques
  • Genetic Therapy / methods
  • Glial Cell Line-Derived Neurotrophic Factor / genetics
  • Glial Cell Line-Derived Neurotrophic Factor / therapeutic use*
  • Hepatocyte Growth Factor / therapeutic use*
  • Infarction, Middle Cerebral Artery / pathology
  • Infarction, Middle Cerebral Artery / therapy
  • Mice
  • Microtubule Proteins / metabolism
  • Neuroprotection / drug effects*
  • Neuroprotective Agents / therapeutic use*
  • Rats
  • Stem Cell Transplantation / methods*
  • Stroke / pathology
  • Stroke / therapy*


  • Dcx protein, rat
  • Doublecortin Protein
  • Glial Cell Line-Derived Neurotrophic Factor
  • Microtubule Proteins
  • Neuroprotective Agents
  • Hepatocyte Growth Factor