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Free Download: Stem Cell Therapy for stroke

Disclaimer:
The information provided by R3 Stem Cell is for educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Individual results may vary and are not guaranteed. The FDA considers stem cell therapy experimental at this point.

Any claims made on this website refer to procedures performed OUTSIDE of the USA. R3 Stem Cell has clinics in Mexico, Philippines, South Africa, Turkey, India, Pakistan.

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Guide to Stem Cell and Exosome Therapy for Stroke

Every day, R3 Stem Cell receives inquiries worldwide from individuals asking if stem cell therapy can help after a stroke. Spoiler alert: It can help a lot! In this guide, we’ll go through the basics of how stem cells work after a stroke, the latest research, and what to expect with a regenerative procedure. 

 

Conventional treatments after a stroke are not able to regenerate and repair brain tissue significantly. They are very limited and mostly “band aids.” People often have to rely on others to complete their daily living activities or figure out other ways to achieve them as the deficits become permanent. 

 

Stem cell therapy for stroke is turning out to be an excellent opportunity for individuals to achieve speech, function and mobility improvements that are simply NOT possible with traditional therapies. Let’s dig in!

A Significant Global Issue

representing stroke damage and potential for recovery through stem cell therapy

 

Stroke is the third leading cause of death and disability worldwide, which brings a huge burden to the healthcare system. Incredibly, one in six people will suffer from a stroke in their lifetime, with over 13.7 million strokes occurring every year (more than one per second) and causing 5.8 million deaths. The major type of stroke is the ischemic stroke, which accounts for approximately 70 percent of all strokes. 

 

Although advanced treatment methods for ischemic stroke treatment have been developed in recent years, no therapy has been able to efficiently improve the overall prognosis of patients.

What happens in a stroke?

Typically, stroke can be categorized into ischemic stroke and hemorrhagic stroke. Ischemic stroke is caused by a blocked blood vessel that reduces blood flow to specific areas of the brain. Hemorrhagic stroke is caused by a blood vessel rupture in the brain, causing bleeding in the brain or subarachnoid space. 

 

If the blockage occurs locally in the brain, the condition is called thrombosis. If the blood clot travels from somewhere else in the body, it is called an embolism. Ischemic strokes are classified specifically based on where in the brain the blockage occurs and where in the body the embolism developed. 

 

An insight into the biology of ischemic stroke indicates that a stream of molecular events initiates instantly after the onset of ischemic stroke, such as oxidative stress, increased level of intracellular calcium, excitotoxicity, and inflammation, which results in apoptotic or necrotic neuronal cell death. 

 

Basically, in an effort to help the situation, the natural reaction from the surrounding area is to make it WORSE! The increased inflammation kills cells, harms the tissue surrounding nerves (myelin), and leads to significant fibrosis (scar tissue).

According to previously established studies, the ischemic avalanche followed by a stroke is comprised of three phases: 

Further insights into its molecular events indicate that the acute phase takes almost 2 weeks to complete after the incidence of the injury. The subacute or secondary phase continues its deleterious events up to 6 months after the onset of the lesion. The duration of the chronic phase could take months to years after stroke and may last for the rest of the patient’s life, along with its neurological damage. 

 

The range of therapeutic interventions has remained very limited. Stem cell therapeutic strategies have shown the potential to combat the deleterious effects of acute, subacute, and chronic phases of ischemic stroke. We’ll discuss shortly how. 

What are the reasons a stroke occurs?

There are several risk factors for strokes, some of which are controllable: 

Interestingly, age is a risk factor, with strokes being more common under the age of 1 and for older adults. Strokes occur more often in certain ethnicities, such as African Americans, American Indians, Hispanics and others. 

 

Increased air pollution may contribute, and certain genetic issues may predispose, along with having a family history. 

What are the symptoms of a stroke?

Prior to having a true stroke, a person may experience a transient ischemic attack, known as a TIA. Also known as a “mini stroke”, the symptoms go away within a few minutes. 

 

From the CDC website, here are the signs of a stroke: 

The participant endured the process excellently and did not have any serious injection related side effects. 

 

He had only early, temporary complications such as subfebrile fever, moderate headache, and muscle pain related to intramuscular injection, which were settled by symptomatic medical care within 24-48 hours. 

Traditional Treatments

Traditional therapies for ischemic stroke include acute medications and those meant for chronic use. An IV injection of recombinant tissue plasminogen activator (TPA) is the gold standard treatment for ischemic stroke. Endovascular therapy has been shown to improve outcomes and reduce long-term disability after ischemic stroke. 

 

Surgery entailing a carotid endarterectomy, angioplasty and/or stents can lower your risk of having another stroke or transient ischemic attack. Typically, long term anti-coagulants are prescribed. 

 

For a hemorrhagic stroke, blood thinners may need to be reversed. Surgery may be needed to decompress the pressure. Procedures such as clipping, coiling, or stereotactic radiosurgery may help

 

Some people recover fully, while others have long-term or lifelong disabilities. This may include issues with speech, memory, swallowing, eating, muscles, nerves, bowel, and/or bladder. 

 

The natural course of recovery (chronic phase) may last for one to 1.5 years. At that point, no previous medications or therapies have been shown to alter the stroke’s effects. People either need to live with the deficits or figure out other ways to get things accomplished. 

Stem Cell Therapy for Stroke

If a new technology, such as mesenchymal stem cell and exosome therapy, could improve the ability of stroke victims to recover, it would and should become first-line therapy. Remember, in the natural course of the brain trying to assist with recovery, there are actually quite a few detrimental effects. These may include additional neuroinflammation with accompanying cell death, myelin sheath degradation and fibrosis (scar tissue). 

 

MSC-based therapy could potentially reduce the inflammatory response and neuronal cell apoptosis (death) by modulating the immune system and impeding the secondary damage after ischemic stroke. 

 

Further studies have indicated that stem cells derived from umbilical cord lining (UC-MSCs) are profoundly immunologically immature cells, and this property makes them a promising candidate for the treatment of stroke. The immaturity makes them very powerful, along with not getting rejected by the recipient. 

 

Umbilical cord stem cells can potentially reduce the infarct size and ameliorate the functional recovery by elevating the expression of growth and neuroprotective factors such as brain-derived neurotrophic factor (BDNF) and vascular and endothelial growth factor (VEGF)

 

This includes reducing inflammation through immunomodulation, releasing trophic (growth) factors to promote therapeutic effects, inducing angiogenesis (new blood vessels), promoting neurogenesis, reducing the infarct volume, replacing damaged cells, and secreting extracellular vehicles (exosomes), which all play therapeutic roles. 

Stem cell-based therapies for stroke offer promise because of their potential to provide neurorestorative benefits. Stem cell-based therapies aim to promote neurogenesis and replacement of lost neurons or protect surviving neurons in order to improve neurological recovery. The mechanism through which stem cell treatments mediate their therapeutic effect is largely dependent on the type of stem cell and route of administration. 

 

Additionally, although stroke is a disease of the vasculature, it induces a significant immune response. The immune response is linked to healing, but also includes a neuroinflammatory component implicated in exacerbating the initial injury through the destruction of neuronal tissue. As if the stroke itself wasn’t bad enough, patients have to deal with their own body’s recovery efforts, making it worse! 

 

Some stem cell populations have demonstrated the ability to modulate the immune system and offer the promise of neuroprotective and neuroregenerative effects, enhancing the healing effects while mitigating inflammatory damage.

 

Stem cells and exosomes act in the body through several mechanisms. They do NOT become part of a patient’s DNA, which means they do not engraft into the person’s existing cells. 

They act through: 

 Proteins involved in the therapeutic mechanism of MSCs

Therapeutic Benefits Proteins Mechanisms

Attenuate inflammation through immunomodulation

IL-1, IFN-γ, TNF-α, MCP-1

Decreased pro-inflammatory cytokines to attenuate inflammation [17,18]

IL-4, IL-10, TNF-β
Increased pro-inflammatory cytokines to attenuate inflammation [17,18]
IL-4, IL-10, TNF-β
Increased pro-inflammatory cytokines to attenuate inflammation [17,18]
PGE2
Mediated the expression of TNF-α and IFN-γ [19]
HMGB1
HMGB1 Late pro-inflammatory cytokine [20,21]

Release trophic factors to promote therapeutic effects

BDNF, GDNF, NGF, VEGF
Promoted angiogenesis and axon growth, differentiation of MSCs [26-28]
Reduced infarct volume [23]
Prevented neuron apoptosis and increased neuron proliferation [24]
PDGF
Promoted the migration of cells, promoted the growth of primary cortical neurons, inhibited neuroinflammation, and promoted angiogenesis and axon growth [26-28]

Induce angiogenesis

Ang 1 and tyrosine protein kinase receptor Tie-2, VEGF and VEGF receptor 2 (Flk 1)
Increased these proteins to increase blood vessel density at the site of vascular injury [29]

Proliferate neuroblasts

Axonal growth-associated proteins and axonal growth-inhibiting proteins
Increased axonal growth-associated proteins and decreased axonal growth-inhibiting proteins to promote axonal growth [30]
Collagen IV and tight junction protein ZO-1
Increasing these proteins to decrease BBB disruption and neuronal loss [31,32]
Reduced the activity of p53 protein to decrease neuron apoptosis [33]

Replace damaged cells

MAP2 and NeuN
Differentiated into new neurons to replace damaged neurons [9]
GFAP and CNPase
Differentiated into new glial cells to replace damaged glial cells [9]

Stem Cells can also release a huge variety of molecules into the extracellular environment. These molecules, which include extracellular vesicles (exosomes), lipids, free nucleic acids, and soluble proteins, exert crucial roles in repairing damaged tissue. Along with offering stem cells for the treatment of stroke, R3 Stem Cell includes stem cell exosomes, which are a type of extracellular vesicle participating in extensive cell-to-cell communication for brain tissue repair and regeneration.

Where do the stem cells and exosomes come from?

R3 Stem Cell’s regenerative biologics originate from umbilical cord tissue that has been donated after a scheduled c-section. No baby (or mother) is harmed during the C-section procedure. The umbilical cord tissue is normally discarded, but if the mother passes the screening test, then the umbilical cord is immediately sent to the lab. 

 

The lab carefully processes the umbilical cord to generate large amounts of stem cells and exosomes that are of the highest quality possible. The lab team consists of multiple PhDs working in ISO Certified, cGMP-compliant clean rooms to ensure quality assurance that exceeds USA FDA standards. The proprietary production process combines the highest potency, safety and affordability for providers to confidently offer exosome procedures. 

 

Millions of dollars have been invested in the pharmaceutical grade production of the biologics, including first-rate clean rooms, bioreactors, nano-particle tracking analyzers, cytometers, PCR, tangential flow machines and real-time environmental monitoring. The quality assurance testing complies with screening and testing stan¬dards consistent with the American Association of Tissue Banks, cGMP standards, FDA regulations and the highest level of any regulatory agency globally. 

Is there research to back up stem cell and exosome therapy for stroke?

In recent years, a large number of studies have proved that the application of mesenchymal stem cells can reduce the area of cerebral infarction after ischemia and promote the recovery of neural function. The therapeutic mechanism of stem cells in ischemic stroke has not been fully understood, which may be related to their neuron replacement, neurogenesis, angiogenesis, and anti-inflammatory effects. 

 

The extracellular vesicles (exosomes) produced by MSCs may also play an important role in this process. In conclusion, stem cells contribute to the reconstruction of neural circuits by inducing endogenous neurogenesis, promoting axonal budding and myelin regeneration, and specific signaling pathways remain to be investigated. 

 

To date, a single phase I trial has investigated umbilical cord blood for the treatment of stroke. Umbilical cord blood was infused IV in 10 male patients, three to nine days post-onset of stroke symptoms. Patients were followed for 12 months and showed no adverse events related to treatment, and by three months, all patients had demonstrated improvements in neurological recovery (Laskowitz et al., 2018). Umbilical cord stem cell therapies for stroke may offer the most applicable neuroprotective benefits because they have the potential to be readily available to meet the critical window for intervention, are immune tolerant, and demonstrate robust immunomodulatory properties. 

A recent case report showcased a 55-year-old man who suffered an acute stroke, causing paralysis in the left upper and lower limbs. He received umbilical cord-derived stem cells twice with an eight-day interval. At 65 weeks after transplantation, the patient returned to his previous occupation as a veterinarian with no adverse reactions. 

 

One month after the first transplantation, the patient recovered from the left upper limb and facial paralysis. The patient was able to lift his left arm up to chest level, and recovery of his left arm and hand muscles allowed the patient to control the brakes of his wheelchair. After 8 weeks, the patient recovered from left leg paralysis and could walk with an orthosis. 

 

After 15 weeks, the patient showed recovery of the left lower limb muscles and could walk without an orthosis. After 60 weeks, recovery from left-sided paralysis, restoration of the respective muscular function, and a sense of balance allowed the patient to climb up and down the stairs without an orthosis. Moreover, his left arm no longer suffered from tremors, enabling the patient to perform sophisticated tasks. After 65 weeks, the patient, previously a veterinarian, could return to work, as the patient had recovered to the point that they could maintain a standing position for a long time, as required in surgery. 

Stem Cell-Derived Exosomes

R3 Stem Cell’s Centers of Excellence globally include umbilical cord stem cell-derived exosomes with umbilical cord stem cells to provide enhanced results. Exosomes are lipid-bound vesicles (acellular) produced by cells that contain a plethora of growth factors, cytokines, mRNA and other proteins. 

 

They are exceptionally helpful in cell-to-cell communication and very effective for reducing inflammation when they become ingested by their recipient cell. They act as shuttles to send nucleic acids and proteins to other cells, in this way, allowing cell-to-cell communication and transporting molecules among both close and distant cells. In general, these released proteins are important regulators of intracellular information. 

 

Exosomes could be the mediators of many stem cell-associated therapeutic activities. Considering they are 100 times smaller than stem cells, they do not have any issues passing through the blood-brain barrier to reach the brain from the bloodstream. 

Is stem cell therapy safe?

For the past decade, R3 has been successfully treating liver failure patients with IV stem cell and exosome therapy. The cells and exosomes are attracted to inflammation, which is a large component of liver failure. So they will go predominantly to the liver, but also to areas that are experiencing disease as well. 

 

Some people ask us, “I heard the stem cells get caught in the lungs and die, is that true?” The answer is that embryonic stem cells often temporarily get caught up in the lungs, but they don’t all stay there. After 12-24 hours, the vast majority are released to go to areas with inflammation, such as a failing liver. 

 

So, for example, if a person has liver failure secondary to diabetes, the cells and exosomes will also go to the pancreas to assist with function there, too. There are Centers that promote injections directly into the liver, or the hepatic artery/vein. This is not necessary and entails additional risk! 

 

R3’s providers will calculate the amount of stem cells based on patient weight and liver failure severity. It will range from 1 to 3 million stem cells/kg. Depending on the total amount, treatment may need to be broken up into two sessions, three at the most for optimal safety. 

 

R3 Stem Cell’s liver disease protocols are based on the latest research, along with Best Practice Protocols developed over the past decade to help patients achieve the best outcomes possible. Safety is paramount with the biologics products being rigorously tested prior to use, and expert providers managing each treatment as if it were a family member! 

Treatment Protocol

For the past decade, R3 has been successfully treating stroke patients with IV stem cell and exosome therapy along with either intrathecal or intranasal application. The cells and exosomes are attracted to inflammation, which is a large component of stroke aftermath. Because the blood-brain-barrier (BBB) prevents a lot of stem cells from reaching the brain, the intrathecal and intranasal applications are effective at bypassing the BBB.

 

An animal study looking at intranasal stem cells showed that diffusion into the frontal part of the brain occurred within 30 minutes after administration, and distributed throughout the whole brain after three hours. The intranasal procedure takes less than twenty minutes! The intrathecal application is performed by R3’s experienced anesthesia doctors. Not only is it very safe, but it also permits a very large amount of stem cells to reach the brain without encountering the BBB. And thankfully, no drilling of the skull is necessary! 

 

R3’s providers will calculate the amount of stem cells based on patient weight and stroke severity. It will range from 1 to 4 million stem cells/kg. Depending on the total amount, treatment may need to be broken up into two sessions, three at the most for optimal safety. 

 

R3 Stem Cell’s stroke treatment protocols are based on the latest research, along with Best Practice Protocols developed over the past decade to help patients achieve the best outcomes possible. Safety is paramount with the biologics products being rigorously tested prior to use, and expert providers managing each treatment as if it were a family member!

Why does R3 Stem Cell use donor tissue for its stem cells?

Autologous (your own) stem cells provide significant advantages, and allogeneic (donor) stem cells have more advantages. First of all, autologous MSCs need a long time to culture and expand, which limits their application in stroke treatment, while allogeneic stem cells can be obtained and expanded from the freezer more quickly, thus avoiding the delay of tthe ime window. 

 

Stroke patients need a LOT of stem cells for the outcome to be satisfactory, which is just not obtainable from one’s own stem cell harvesting. Considering that the viability of donor stem cells after cryopreservation averages 87%, patients are able to achieve the amount of cells needed without the harvesting procedure. 

 

Second, patients with ischemic stroke usually take antiplatelet or anticoagulant drugs, and the application of autologous MSCs may lead to secondary hemorrhage. Allogeneic stem cells from healthy donors have no such concerns. 

 

Third, age is a factor that affects the physiological characteristics of MSCs. Studies have shown that stem cells from elderly donors have decreased proliferation and differentiation ability. This means they are less effective!

What are the Outcomes?

Similar to the research mentioned above, R3 Stem Cell’s outcomes for stroke patients have been exceptional! The patient satisfaction rate is 85% year over year. Patients typically see increased energy, cognition, speech abilities, improved function and mobility. 

 

It may take several months to see all of the improvements, although we have had patients symptomatically feel much better within the first couple of weeks. It should be noted, again, that stem cell therapy does not bring patients back to pre-stroke function, and will need to be repeated every 6 to 12 months for additional benefits. 

Affordability

Because stem cell therapy for stroke does benefit from repeat treatments, it’s important to make it affordable. Repeat therapies can help people achieve additional speech, function and mobility improvements. So, a lot of patients seek additional treatments at R3 Stem Cell every six to twelve months. 

 

Unfortunately, stem cell clinics in Colombia, China and Panama charge over $20,000 USD for stroke treatment. Because the one treatment costs so much, how are individuals supposed to budget for that every year?? R3 Stem Cell’s fees are less than half that for 100 million high-quality stem cells! 

R3’s Experience

For the past decade, R3 Stem Cell’s Centers globally have performed over 23,000 regenerative procedures in six countries. Several hundred have been for either ischemic or hemorrhagic strokes. Patient satisfaction across all conditions treated is 85%! 

 

R3 combines safety, effectiveness and affordability for the therapies. Internationally, the Intellicell is used,  which is culturing the most active mesenchymal stem cells to create the “smartest” stem cell in the world! 

 

Our experience with stroke patients has been extensive, and our Success Stories on R3’s YouTube Channel are impressive. You can visit the channel Success Story Playlist HERE. R3 Stem Cell offers free consultations for individuals to discuss whether regenerative therapy is indicated for their stroke recovery. Simply call +1 (844) GET-STEM or +1 (480) 808-7057 to schedule yours!

References

About R3 Stem Cell

Disclaimer: This guide’s education does not constitute medical advice. The USA FDA considers stem cell therapy experimental. Any claims made in the Guide refer to procedures performed outside the USA.

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*Outcomes will vary between individuals. No claims are being made with regenerative therapies. The FDA considers stem cell therapy experimental. See our THERAPY COMMITMENT HERE.
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