Using Neural Stem Cell Therapy to Treat TBIs

Stem cells are undifferentiated cells found inside the body and have the capability of generating lineage-specific cells. Neurons are different from other cells in our body because they don't undergo mitosis and division after determination and differentiation.

For this reason, brain injury and damaged neuronal tissue is difficult to regenerate, making TBI’s difficult to recover from. How plausible is the idea of using lineage-specific stem cells found inside the body’s central nervous system to aid in tissue recovery alongside neurogenesis, increasing the chances of functionality after a traumatic injury? In an article for The US National Library of Medicine Journal, Marcela Pekna and Milos Pekny, Professors in the Department of Clinical Neuroscience and Neuroimmunology at the University of Gothenburg, illustrate the complex intricacies and functions of our immune system on the brain.

They explain the unique nature of our neurons under injury, in comparisons to the rest of the body’s somatic cells. After initial generation, determination, and differentiation, neurons remain in the G0 phase where they will not actively divide and the mitotic process ceases to occur. This then prevents brain tissue from regenerating and healing after damage; while neurons are capable of exiting the G0 phase under severe degeneration, the brain’s immune process takes all preventive measures, neuroplasticity being an example, to make up for the inability to rapidly (if at all) regenerate brain tissue. For this reason, the possibility of using NSC therapy to initiate and stimulate the healing process can be ground-breaking in neurology.

An estimated 2.3 million people sustain a TBI annually, of which, 50,000 die. While most TBIs are mild concussions, others can be much more life threatening, resulting in a desperate need for a solution or treatment.

Heather H. Ross, an Associate Professor in the Department of Physical Therapy at Brenau University, along with her research associates evaluate the difference between Neural Stem Cells (NSC) and a progenitor cells. Their findings show that NSC undergoes asymmetric division and continually reproduce throughout an organism’s lifespan as a response to injury. These findings further support the possibility that NSC therapy can potentially be the solution to extensive brain tissue injury.

Similarly, Bo-Rim Yi a Professor at Inha University Hospital in the Department of Internal Medicine, Seung U Kim Professor at the University of British Columbia in the Division of Neurology, and Kyung-Chul Choi a professor at the University of Ulsan College of Medicine in the Department of Biomedical Sciences explore the idea of using Neural Stem Cells (NSC) as a treatment method for patients who have undergone brain injury that has resulted in a dead brain tissue. They have tested this idea in vitro settings, where the NSC was observed to flourish and regenerate, however, because of its experimental nature and lack of research on behalf of the Neurological field, this hypothesis cannot currently be tested on human and may risk violating neuroethical guidelines, which seems to be the pressing matter. Neil Levy, Head of Neuroethics at the Florey Neuroscience Institute discusses the general concept and parameters of ethical guidelines in the field of neurology. Levy illustrates what’s necessary to meet ethical relationally when conducting research, treatment, and medication in relations to neurology. An understanding of Neuroethics is necessary for the application of Neural Stem Cell therapy for the purpose of assessing if the study can be conducted and under what limitations.

Guo-li Ming and Hongjun Song, professors at Perelman School of Medicine Department of Neuroscience, explain the process of neurogenesis on the brain and hypothesize the possibility of using Neural Stem Cells (NSC) as an aid to that process in order to accelerate tissue healing and increase the chances of regaining neuron functionality. Ming and Song question whether the NSC precursors are lineage-restricted to predetermined specialized neural cells, or alternatively if they are “multipotent neural stem cells” whose fate and determination/differentiation is regulated by environmental necessities of the brain’s current state. However, because the experiment was conducted in vitro, the results may not translate when tested in vivo. Therefore further experimentation is needed to confirm the possibility of using NSC for repairing damaged brain tissue. Nonetheless, as previously mentioned, neural ethical guidelines limit the application of the study. In a similar case: Viviane Tabar, a Neurosurgeon at the Memorial Sloan Kettering cancer center, shares her findings on a recent study regarding Neural Stem Cells (NSC). Her study was based on extracting embryonic stem cells, which were later found to generate oligodendrocytes. However, the article does not specify as to whether the study was conducted in vitro or vivo, and no official confirmation as to whether the notion of NSC has gained enough credibility as a viable treatment option for humans, though much promise is seen in recent studies. In other words, the plausibility of using lineage-specific NSC therapy is completely attainable. However, due to restrictions set by neuroethics, extensive research on the topic cannot yet be done. But, with promising results and realizable applications, NSC therapy will, with time, be actualized.