Intravenous infusion of mesenchymal stem cells promotes functional recovery in a rat model of chronic cerebral infarction

J Neurosurg. 2018 Oct 1:1-8. doi: 10.3171/2018.5.JNS18140. Online ahead of print.

Abstract

OBJECTIVE: Intravenous infusion of mesenchymal stem cells (MSCs) derived from adult bone marrow improves behavioral function in rat models of cerebral infarction. Although clinical studies are ongoing, most studies have focused on the acute or subacute phase of stroke. In the present study, MSCs derived from bone marrow of rats were intravenously infused 8 weeks after the induction of a middle cerebral artery occlusion (MCAO) to investigate whether delayed systemic injection of MSCs improves functional outcome in the chronic phase of stroke in rats. METHODS: Eight weeks after induction of the MCAO, the rats were randomized and intravenously infused with either MSCs or vehicle. Ischemic volume and behavioral performance were examined. Blood-brain barrier (BBB) integrity was assessed by quantifying the leakage of Evans blue into the brain parenchyma after intravenous infusion. Immunohistochemical analysis was also performed to evaluate the stability of the BBB. RESULTS: Motor recovery was better in the MSC-treated group than in the vehicle-treated group, with rapid improvement (evident at 1 week post-infusion). In MSC-treated rats, reduced BBB leakage and increased microvasculature/repair and neovascularization were observed. CONCLUSIONS: These results indicate that the systemic infusion of MSCs results in functional improvement, which is associated with structural changes in the chronic phase of cerebral infarction, including in the stabilization of the BBB.

Keywords: BBB = blood-brain barrier; DMEM = Dulbecco’s modified Eagle medium; EvB = Evans blue; H & E = hematoxylin and eosin; MCA = middle cerebral artery; MCAO = MCA occlusion; MSC = mesenchymal stem cell; NDS = normal donkey serum; PBS = phosphate-buffered saline; PBS-T = PBS 0.1% and Tween 20; SEM = standard error of the mean; chronic; i.p. = intraperitoneal; mesenchymal stem cell; stroke; transplantation; vascular disorders.