The preclinical and clinical trials of mesenchymal stem cell's secretome in traumatic brain injury: Review of basic science.

Background: Traumatic brain injury (TBI) presents with associated neurologic and vascular damage triggers a chain of events that lead to a secondary brain injury. Proper prevention may limit undesirable outcomes. Mesenchymal stem cells (MSCs) and their secretome are promising therapeutic agents for a variety of neurological injuries, including TBI, due to their neuroprotective effects. This paper offers a concise overview of the use of MSCs and secretomes to prevent secondary brain injury and improve functional outcomes in TBI patients.

Methods: An electronic database search on PubMed, Cochrane, Scopus, and clinicaltrials.gov was performed to include all relevant studies. Our framework incorporates an analysis of preclinical and clinical studies investigating the effects of MSCs and secretome on clinically relevant neurological and histopathological outcomes.

Results: Immunomodulation by molecular factors secreted by MSCs is considered to be a key mechanism involved in their multi-potential therapeutic effects. Regulated neuroinflammation is required for healthy remodeling of the central nervous system during development and adulthood. Moreover, immune cells and their secreted factors can also contribute to tissue repair and neurological recovery following acute brain injury. The use of secretome has key advantages over cell-based therapies, such as lower immunogenicity and easy production, handling, and storage.

Conclusion: Compared with traditional therapies, MSC and secretome treatment can directly improve TBI-induced pathological changes and promote recovery of neurological function. MSCs and their secretome hold great promise to bridge this gap in translation for TBI. Further clinical trials are needed to confirm its efficacy and safety.