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Potencial terapĂȘutico de cĂ©lulas estaminais no AVC
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Authors
Abstract(s)
O Acidente Vascular Cerebral corresponde a uma emergĂȘncia mĂ©dica e representa a
segunda maior causa de mortalidade global, sendo responsåvel por milhÔes de mortes e por
incapacidade temporĂĄria ou permanente em numerosos sobreviventes. Carateriza-se por
um dĂ©fice focal ou global da função cerebral, de inĂcio sĂșbito, sendo classificado em dois
tipos, o AVC isquĂ©mico, o mais comum e resultante da obstrução do fluxo sanguĂneo num
vaso a nĂvel cerebral, e o AVC hemorrĂĄgico, o menos comum e proveniente do rompimento
de um vaso a nĂvel cerebral. Os sinais mais comuns para o diagnĂłstico do AVC incluem a
fraqueza, a paralisia e a perda de sensibilidade de um lado do corpo, a afasia, as alteraçÔes
motoras, a perda de acuidade visual e, por fim, as alteraçÔes ao nĂvel da consciĂȘncia.
A rapidez do tratamento do AVC Ă© crucial para minimizar os danos cerebrais, consistindo
na trombĂłlise intravenosa e trombectomia endovascular no AVCI e na cirurgia e controlo
da pressĂŁo arterial no AVCH. Apesar dos seus comprovados benefĂcios, estas terapias
apresentam diversas limitaçÔes e critérios de inclusão e exclusão, levando a que muitos dos
pacientes não sejam intervencionados com estas técnicas.
O tratamento com células estaminais surge assim como uma proposta promissora para a
recuperação funcional pós-AVC, oferecendo uma nova perspetiva para a regeneração
neuronal. O mecanismo de ação das células estaminais no tratamento do AVC envolve a
substituição das células neuronais degeneradas ou disfuncionais, restabelecimento das
conexĂ”es nervosas e formação de novos vasos sanguĂneos que promovem a irrigação da ĂĄrea
afetada. A eficĂĄcia desta abordagem terapĂȘutica depende de mĂșltiplos fatores, incluindo o
tipo de cĂ©lulas utilizadas, a dose administrada, a via de administração, as caracterĂsticas
individuais do paciente e o timing da intervenção em relação ao evento vascular.
Desta forma, esta revisĂŁo analisa o potencial terapĂȘutico das propriedades das cĂ©lulas
estaminais, exclusivamente investigadas em estudos prĂ©-clĂnicos e clĂnicos, nos processos
de angiogénese, neurogénese, migração e diferenciação, destacando o seu papel na
reparação neuronal após um AVC. Com vista, a incentivar a realização de pesquisas
adicionais que validem os resultados obtidos, definam protocolos otimizados para a
administração destas células e assegurem a segurança em todas as etapas, desde a recolha
até à sua aplicação.
Cerebral Vascular Accident is a medical emergency and the second leading cause of global mortality, responsible for millions of deaths and temporary or permanent disability in many survivors. It is characterized by a focal or global impairment of brain function, of sudden onset. It is classified into two types: ischemic stroke, the most common and results from the obstruction of blood flow in a cerebral vessel, and hemorrhagic stroke, the least common and results from the rupture of a cerebral vessel. The most common signs for diagnosing a stroke include weakness, paralysis and loss of sensation on one side of the body, aphasia, motor changes, loss of visual acuity, and, finally, changes in consciousness. Rapid treatment of stroke is crucial to minimizing brain damage, consisting of intravenous thrombolysis and endovascular thrombectomy in ischemic stroke and surgery and blood pressure control in hemorrhagic stroke. Despite their proven benefits, these therapies have some limitations and inclusion and exclusion criteria, meaning many patients are not treated with these techniques. Stem cell treatment has thus emerged as a promising proposal for post-stroke functional recovery, offering a new perspective for neuronal regeneration. The mechanism of action of stem cells in the treatment of stroke involves the repair of degenerated or dysfunctional neuronal cells, the re-establishment of nerve connections, and the formation of new blood vessels that promote irrigation of the affected area. The effectiveness of this therapeutic approach depends on multiple factors, including the type of cells used, the dose administered, the route of administration, the individual characteristics of the patient, and the timing of the intervention concerning the vascular event. Therefore, this review addresses the therapeutic potential that the properties of stem cells, exclusively investigated in preclinical and clinical studies, offer in the processes of angiogenesis, neurogenesis, migration, and differentiation for neuronal repair after a stroke. It aims to encourage further research to validate the results obtained, look for new methods of enhancing this cell therapy and guarantee safety in both their collection and use.
Cerebral Vascular Accident is a medical emergency and the second leading cause of global mortality, responsible for millions of deaths and temporary or permanent disability in many survivors. It is characterized by a focal or global impairment of brain function, of sudden onset. It is classified into two types: ischemic stroke, the most common and results from the obstruction of blood flow in a cerebral vessel, and hemorrhagic stroke, the least common and results from the rupture of a cerebral vessel. The most common signs for diagnosing a stroke include weakness, paralysis and loss of sensation on one side of the body, aphasia, motor changes, loss of visual acuity, and, finally, changes in consciousness. Rapid treatment of stroke is crucial to minimizing brain damage, consisting of intravenous thrombolysis and endovascular thrombectomy in ischemic stroke and surgery and blood pressure control in hemorrhagic stroke. Despite their proven benefits, these therapies have some limitations and inclusion and exclusion criteria, meaning many patients are not treated with these techniques. Stem cell treatment has thus emerged as a promising proposal for post-stroke functional recovery, offering a new perspective for neuronal regeneration. The mechanism of action of stem cells in the treatment of stroke involves the repair of degenerated or dysfunctional neuronal cells, the re-establishment of nerve connections, and the formation of new blood vessels that promote irrigation of the affected area. The effectiveness of this therapeutic approach depends on multiple factors, including the type of cells used, the dose administered, the route of administration, the individual characteristics of the patient, and the timing of the intervention concerning the vascular event. Therefore, this review addresses the therapeutic potential that the properties of stem cells, exclusively investigated in preclinical and clinical studies, offer in the processes of angiogenesis, neurogenesis, migration, and differentiation for neuronal repair after a stroke. It aims to encourage further research to validate the results obtained, look for new methods of enhancing this cell therapy and guarantee safety in both their collection and use.
Description
Keywords
Avc CĂ©lulas Estaminais Enfarte Terapia Celular Transplante de CĂ©lulas Estaminais