Publication date: 2025

DOI: 10.1016/j.hest.2025.01.002

Intracerebral hemorrhage (ICH) is one of the most devastating and life-threatening forms of stroke, characterized by bleeding within the brain parenchyma. The condition is associated with a high mortality rate and significant long-term disabilities among survivors, underscoring the urgent need for innovative therapeutic strategies that go beyond managing symptoms to actively promote brain repair and functional recovery. Current treatment options are largely limited to supportive care, including surgical interventions to alleviate intracranial pressure and management of underlying risk factors such as hypertension. These approaches, however, fail to address the extensive neurological damage caused by ICH. Emerging evidence highlights the potential of stromal vascular fraction (SVF) cell therapy as a novel regenerative treatment for ICH. SVF, derived from adipose tissue through enzymatic digestion, is a heterogeneous mixture of cells, including mesenchymal stem cells (MSCs), endothelial cells, pericytes, immune cells, and progenitor cells. This cellular composition contributes synergistically to the repair and regeneration of damaged tissues. The mechanisms of action of SVF encompass inflammation modulation, neuroprotection, angiogenesis, and immunomodulation. MSCs within SVF release anti-inflammatory cytokines such as interleukin-10 (IL-10) and transforming growth factor-beta (TGF-β), reducing secondary injury caused by excessive inflammation. Endothelial cells and pericytes promote the formation of new blood vessels, restoring oxygen and nutrient supply to ischemic regions. Neurotrophic factors such as brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) further support neuronal survival and repair of neural circuits. Preclinical studies in animal models have consistently demonstrated the efficacy of SVF therapy, including reductions in brain edema, oxidative stress, and inflammatory cytokines, alongside improvements in angiogenesis, neuronal survival, and functional recovery. Early-phase clinical trials and case studies provide preliminary evidence of safety, feasibility, and potential therapeutic benefits in human patients with acute and chronic ICH. However, significant challenges remain, including the variability in SVF composition, optimal delivery methods, timing of intervention, and long-term safety considerations. This review comprehensively examines the biological properties of SVF, the mechanisms underlying its therapeutic effects, and the preclinical and clinical evidence supporting its use in ICH. Additionally, it explores future directions, including the development of standardized protocols, optimization of delivery techniques, integration with combination therapies, and the potential for personalized medicine approaches. As ongoing research and clinical trials refine these strategies, SVF therapy holds transformative potential to revolutionize ICH treatment by addressing its complex pathophysiology and improving patient outcomes. This novel approach not only promises to mitigate the immediate impacts of ICH but also offers hope for long-term recovery and enhanced quality of life for affected individuals. © 2025 International Hemorrhagic Stroke Association

Издатель: KeAi Communications Co.

Тип: Article