The potential for stem cell therapies to have an impact on cerebral palsy: opportunities and limitations

Authors

  • Crystal A Ruff,

    1. Division of Genetics and Development, Toronto Western Research Institute, Toronto, Canada
    2. Institute of Medical Science, University of Toronto, Toronto, Canada
    3. Spinal Program, University Health Network, Toronto Western Hospital, Toronto, Canada
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    • These authors contributed equally to this article.
  • Stuart D Faulkner,

    1. Division of Genetics and Development, Toronto Western Research Institute, Toronto, Canada
    2. Institute of Medical Science, University of Toronto, Toronto, Canada
    3. Spinal Program, University Health Network, Toronto Western Hospital, Toronto, Canada
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    • These authors contributed equally to this article.
  • Michael G Fehlings

    Corresponding author
    1. Institute of Medical Science, University of Toronto, Toronto, Canada
    2. Spinal Program, University Health Network, Toronto Western Hospital, Toronto, Canada
    3. Division of Neurosurgery, University of Toronto, Toronto, ON, Canada
    • Division of Genetics and Development, Toronto Western Research Institute, Toronto, Canada
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Correspondence to Dr Michael G Fehlings, Division of Neurosurgery, University Health Network, Toronto Western Hospital, 399 Bathurst Street 4WW-449, Toronto, ON M5T 2S8, Canada. E-mail: michael.fehlings@uhn.on.ca

Abstract

Cerebral palsy (CP) is a chronic childhood disorder described by a group of motor and cognitive impairments and results in a substantial socio-economic burden to the individual, family, and healthcare system. With no effective biological interventions, therapies for CP are currently restricted to supportive and management strategies. Cellular transplantation has been suggested as a putative intervention for neural pathology, as mesenchymal and neural stem cells, as well as olfactory ensheathing glia and Schwann cells, have shown some regenerative and functional efficacy in experimental central nervous system disorders. This review describes the most common cell types investigated and delineates their purported mechanisms in vivo. Furthermore, it provides a cogent summary of both current early-phase clinical trials using neural precursor cells (NPCs) and the state of stem cell therapies for neurodegenerative conditions. Although NPCs are perhaps the most promising candidates for cell replacement therapy in the context of CP, much still remains to be understood regarding safety, efficacy, timing, dose, and route of transplantation, as well as the capacity for combinatorial strategies.

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