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Received Aug 21, 2017; Revised Nov 17, 2017; Accepted Mar 13, 2018
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Introduction
Stroke is a leading cause of death and disability but few treatment options exist despite intensive research [1]. Recent studies have strongly suggested that cell therapy can promote functional recovery of patients with various central nervous system (CNS) diseases, including ischemic stroke. Bone marrow stromal cells (BMSCs) are considered as candidates for donor cells because of their regenerative potential. BMSCs can survive in the infarcted brain, migrate towards the ischemic lesion, express neural phenotypes, and promote functional recovery when transplanted into animal stroke models [2, 3].
However, several problems remain to be solved before launching the clinical application of BMSCs for stroke. Issues include the optimal route of donor cell delivery in the clinical situation [2]. It is essential to determine the most desirable, least invasive route of cell delivery with maximal therapeutic effects prior to clinical application of cell therapy [4]. For example, BMSCs can be transplanted into injured CNS tissue through intravenous, intra-arterial, intracerebral, or intrathecal routes. Although intracerebral injection permits the most efficient delivery of donor cells to the damaged tissue, a less invasive procedure would be optimal [2]. Intravenous or intrathecal transplantation are attractive because they are less invasive, safe techniques for the host CNS, but they result in less pronounced cell migration and functional recovery than direct cell transplantation [5]. Alternatively, the intra-arterial injection of BMSCs may be feasible to less invasively deliver them to the damaged CNS [6]. However, there are a limited number of studies that directly compare the therapeutic effects of these delivery routes under the same conditions [2].
Recently, tissue engineering has developed into a promising cell delivery method. Tissue engineering aims to provide three-dimensional (3D) constructs to serve as replacement tissues or organs by combining donor cells and scaffolds. We have already reported the application of some biomaterial scaffolds in cell therapy for animal CNS disease models. First, we reported that fibrin matrix, which is widely used as a surgical glue, provides a suitable scaffold for BMSCs transplanted to rat spinal...