Stem cells and vascular dementia: from basic science to the clinic
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MINI REVIEW
Stem cells and vascular dementia: from basic science to the clinic Wenxia Jiang . Lei Gong . Fang Liu . Jun Mu
Received: 2 December 2019 / Accepted: 23 March 2020 Ó Springer Nature B.V. 2020
Abstract Vascular dementia (VD) is the second most common cause of dementia following Alzheimer’s disease (AD). The major symptoms of VD including memory loss, language deficits and impairment of executive functions. Its specific etiology and pathogenesis remain unknown. Currently, treatment options of VD are still limited. The therapeutic strategies aim to control the vascular risk factors and improve the cognitive function. In recent years, cell therapy for neurodegenerative diseases has attracted a great deal of attention. Evidence suggested that stem cell transplantation could improve the symptoms of cerebral infarction and AD. Therefore, it may serve as a potential therapy for VD. We summarized the latest research results both in vitro and in vivo. Further, the clinical trial of stem cell transplantation in VD patients was also reviewed. Finally, the limitations and future directions of cell therapy in VD treatment were discussed.
W. Jiang L. Gong F. Liu J. Mu (&) Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No.1 Yixueyuan Road, Chongqing, China e-mail: [email protected] W. Jiang e-mail: [email protected] L. Gong e-mail: [email protected] F. Liu e-mail: [email protected]
Keywords Stem cells Vascular dementia Transplantation Neurogenesis Therapy
Introduction Vascular dementia (VD) is the second most common type of dementia following Alzheimer’s disease (AD). In a recent study from the United States, the prevalence of VD was about 15% among Medicare recipients (Goodman et al. 2017). Growing with age, the risk of VD almost doubled every 3–5 years. Worse still, 3 months after stroke, 15–30% of patients will develop dementia. (O’Brien and Thomas 2015). The vascular impairment of cognition classification consensus study (VICCCS) classified VD into 8 subtypes: vascular mild cognitive impairment, multi-infarct dementia (cortical VD), subcortical ischemic VD, strategic-infarct dementia, hypoperfusion dementia, hemorrhagic dementia, dementia caused by specific arteriopathies, mixed AD and VD (Skrobot et al. 2017). Due to the different cause and type of VD, the symptoms may vary (Kalaria 2018). VD is a neurocognitive disorder that impairs memory, language, reasoning and executive functions. In addition, the locomotor and autonomic functions may also be compromised. Until now, the specific etiology of VD is unclear. It is well known that cerebral small vessel disease is the most important risk factor of VD (Horsburgh et al. 2018). Other risk factors include age,
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genetics factors, history of stroke, hypertension, cardiac disorders, atherosclerosis, diabetes, metabolic syndrome and even cranial radiotherapy (Wilke et al. 2018; Venkat et al. 2015). Unfortunately, mechanisms
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