Kajian: Aplikasi Sel Punca Mesenkim pada Tata Laksana Klinis Penyakit Stroke

Review: Application of Mesenchymal Stem Cells in Clinical Management of Stroke

  • Ariyani Noviantari Puslitbang Biomedis dan Teknologi Dasar Kesehatan, Badan Penelitian dan Pengembangan Kesehatan
  • Tati Febrianti Puslitbang Biomedis dan Teknologi Dasar Kesehatan, Badan Penelitian dan Pengembangan Kesehatan
Keywords: in vivo, sel punca mesenkim, stroke, terapi, in vitro, mesenchymal stem cells, therapy

Abstract

Stroke is a neurodegenerative disease that can cause disability to death. Stroke therapy useing stem cells is starting to be considered as an alternative in terms of availability, propagation potential, and differentiation ability. Stem cells are cells that have the ability to reproduce (self-renewal), do not yet have a specific shape and functions (undifferentiated), but have the ability todifferentiate into other cells. One type of stem cell is mesenchymal stem cell (MSC) which can differentiate in vitro into other cells including neurons. In addition MSC can secrete various neurotrophic factors that can play a role in angiogenesis and synaptic formation, so that, it is relevant to stroke therapy. This paper describes the research and development of stem cell applications in stroke therapy through several research results. This paper is in the form of a literature review obtained through literature searches. The results showed that MSC is able to differentiate and replace damaged neurons after transplantation based on the results of studies in vitro, in vivo, and several clinical trials. The technique in the differentiation of MSC
into neurons is the addition of certain growth factors to the culture medium in vitro. Meanwhile, in vivo studies have shown that that administration of MSC can replace damaged cells, provide neuroprotective effect, induce axon growth, stimulate angiogenesis, and neurogenesis in stroke animal models using the middle cerebral artery occlusion (MCAO) method. Therefore, MSCs have the potential to treat degenerative diseases, especially stroke. From the results of clinical trials, it can be seen that stem cells are safe to give to stroke patients, there is clinical improvement, and neurological improvement, as well as a reduction in brain lesions. However, there are several challenges for the development and application of MSS for stroke therapy in the future such as concerns about tumorigenesis and high cost. 

Abstrak

Stroke adalah penyakit neurodegeneratif yang dapat menyebabkan kecacatan hingga kematian. Terapi stroke menggunakan sel punca mulai dipikirkan sebagai alternatif dilihat dari aspek ketersediaan, potensi perbanyakan, dan kemampuan diferensiasinya. Sel punca merupakan sel yang memiliki kemampuan memperbanyak diri (self renewal), belum mempunyai bentuk dan fungsi yang spesifik (undifferentiated), namun memiliki kemampuan untuk berdiferensiasi menjadi sel lainnya. Salah satu jenis sel punca adalah sel punca mesenkim (SPM) yang dapat berdiferensiasi secara in vitro menjadi sel lain termasuk neuron. Selain itu, SPM dapat menyekresikan berbagai faktor neurotrofik yang dapat berperan dalam angiogenesis dan pembentukan sinaptik sehingga relevan terhadap terapi terhadap stroke. Tulisan ini menguraikan tentang penelitian dan pengembangan sel punca dalam terapi stroke melalui beberapa hasil penelitian. Tulisan ini berupa review literatur yang didapatkan melalui penelusuran pustaka. Hasilnya menunjukkan bahwa SPM mampu berdiferensiasi dan menggantikan neuron yang rusak setelah transplantasi berdasarkan hasil penelitian secara in vitro, in vivo, dan beberapa uji klinis. Teknik dalam diferensiasi SPM menjadi neuron adalah dengan penambahan faktor-faktor pertumbuhan tertentu ke dalam medium kultur secara in vitro. Sedangkan studi secara in vivo menunjukkan bahwa pemberian SPM dapat menggantikan sel yang rusak, memberi efek neuroprotektif, menginduksi pertumbuhan akson, menstimulasi angiogenesis, dan neurogenesis pada hewan model stroke dengan metode middle cerebral artery occlusion (MCAO). Oleh sebab itu, sel punca mesenkim berpotensi dalam terapi penyakit degeneratif terutama stroke. Dari hasil uji klinis terlihat bahwa sel punca aman diberikan kepada pasien stroke, terjadi perbaikan klinis, dan perbaikan neurologis, serta terjadi pengurangan lesi di otak. Namun, terdapat beberapa tantangan untuk pengembangan dan aplikasi SPM untuk terapi stroke dimasa mendatang, seperti kekhawatiran terjadinya tumorigenesis dan biaya yang cukup mahal.

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Published
2021-12-31
Section
Articles