Abstract
Background:
Cell therapy is emerging as a promising treatment for stroke. We recently we demonstrated the efficacy of intra-arterial delivery of MSCs (IA MSCs) at 24h after a reversible middle cerebral artery occlusion (MCAo). Our study also identified a maximum tolerated dose of MSCs that could be delivered IA without compromising middle cerebral artery flow. The IA approach avoids first-pass trapping of MSCs in the lungs and liver as seen with intravenous delivery. Intra-arterial treatment is also minimally invasive and widely available in clinical practice and thus appealing for clinical translation. Since majority of ischemic strokes in women occur after onset of menopause it is crucial that we test the efficacy of IA MSCs in reproductively senescent females consistent with STAIR recommendations. We aimed to validate the efficacy of IA MSCs in reproductively senescent female rats. Methods: Retired breeder female (9-11 months; 280-350 g) Sprague-Dawley rats showing estrous acyclicity were exposed to MCAo (90 min). A day later, rats were treated with IA MSCs (1x10^5 cells) or phosphate-buffered saline (PBS). MSCs or PBS treated rats were sacrificed at 28-30 days for infarct volume measurement using histology. To test motor function, the rotarod test was performed. Rats were trained for 3 consecutive days for the rotarod test before undergoing the MCAo procedure. The mean duration (in seconds) on the device was recorded from 3 rotarod measurements 1 day before surgery. The rats were tested at 1, 7, 15 and 28-30 days after MCAo. Results: We observed significantly lower mean infarct volume in the MSC-treated group (12 ± 3 mm3; n=6) compared to the PBS-treated group (29 ± 7 mm3; Mean ± SEM; n=4, p<0.05). Treatment at 1 day after MCAO with MSCs significantly improved functional recovery, as evidenced by improved rotarod test results and neurological scores at 7, 15 and 30 days (P<0.05) compared with the PBS-treated group. Conclusions: Intra-arterial stem cell treatment reduces ischemic brain injury and improves functional outcomes in reproductively senescent female rats. Validating the efficacy of IA MSC treatment using a reproductively senescent animal stroke model suggests high potential for future clinical translation in a population at high risk for stroke.