Diabetes mellitus (DM) leads to a 3-4 fold higher risk of experiencing ischemic stroke. In addition, DM stroke patients are more prone to develop more and earlier white matter (WM) high-intensity lesions than non DM stroke patients. Treatment of stroke with tissue plasminogen activator (rtPA) at 2-3 hours after stroke decreases lesion volume in non-DM rats. However, tPA does not reduce lesion volume nor improve functional outcome, but increases the incidence of brain hemorrhage and blood-brain barrier (BBB) leakage in the ischemic brain of DM rats. In addition, treatment of stroke with bone marrow stromal cells (BMSCs) improves functional outcome in wild-type (WT)-stroke rats but not in DM-stroke rats. Therefore, effective therapy of stroke in the non-DM population may not necessarily transfer to the DM population, prompting the need to develop therapeutic approaches specifically designed to reduce neurological deficits after stroke in the DM population. Human umbilical cord blood cells (HUCBCs) are less mature than bone marrow and can be successfully used even when there is only a half-match. We found that treatment of stroke with HUCBCs starting at 1 or 3 days after middle cerebral artery occlusion (MCAo) improves recovery of neurological function in DM rats. In a novel and clinically relevant approach, based on our robust preliminary data, we therefore, propose to use HUCBCs for the treatment of stroke in the type two DM (T2DM) rats. The following specific aims and associated hypotheses will develop HUCBC as a safe and novel neurorestorative therapy which improves neurological function and reduces WM dysfunction and vascular damage in T2DM rats subjected to MCAo.
In Aim 1 will investigate the safety and therapeutic effect of treatment of stroke in T2DM rats with HUCBCs. In addition, we will test the therapeutic effect of combination of HUCBC with tPA in T2DM rats;we will identify any potential adverse effects of tPA on HUCBCs and determine whether HUCBC treatment attenuates tPA induced adverse effects in T2DM rats.
In Aim 2, we will elucidate the neurorestorative effect of HUCBC on WM remodeling after stroke in T2DM rats. HUCBCs have great commercialization potential as therapeutic agents, since they are readily available and easy to isolate without serious ethical and technical problems. HUCBCs can be used for autologous transplantation or allogeneic transplantation, when and if needed. The potential therapeutic impact of HUCBC on recovery on neurological function after stroke in the diabetic brain and the corresponding remodeling of the ischemic brain in DM rats opens enormous possibilities. This proposal is highly clinically relevant and if successful, will significantly impact the treatment of diabetic and possibly all stroke patients.

Public Health Relevance

Diabetes mellitus (DM) is a severe health problem associated with both microvascular and macrovascular disease and leads to a 3-4 fold higher risk of experiencing ischemic stroke. Efficacious therapies for stroke in the non-DM population do not necessarily transfer to the DM population, prompting the need to develop therapeutic approaches specifically designed to reduce neurological deficits after stroke in the DM population. Our preliminary data show that human umbilical cord blood cell (HUCBC) treatment improves functional outcome after stroke in DM rats. Thus, we propose to develop HUCBC cell-based therapy as a neurorestorative treatment for stroke in the DM population.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Small Business Technology Transfer (STTR) Grants - Phase I (R41)
Project #
5R41NS080329-02
Application #
8627662
Study Section
Special Emphasis Panel ()
Program Officer
Fertig, Stephanie
Project Start
2013-03-01
Project End
2015-02-28
Budget Start
2014-03-01
Budget End
2015-02-28
Support Year
2
Fiscal Year
2014
Total Cost
$211,473
Indirect Cost
Name
Saneron Ccel Therapeutics, Inc.
Department
Type
DUNS #
039606491
City
Tampa
State
FL
Country
United States
Zip Code
33612
Ding, Guangliang; Yan, Tao; Chen, Jieli et al. (2015) Persistent cerebrovascular damage after stroke in type two diabetic rats measured by magnetic resonance imaging. Stroke 46:507-12
Liu, Xinfeng; Ye, Ruidong; Yan, Tao et al. (2014) Cell based therapies for ischemic stroke: from basic science to bedside. Prog Neurobiol 115:92-115
Yan, Tao; Venkat, Poornima; Ye, Xinchun et al. (2014) HUCBCs increase angiopoietin 1 and induce neurorestorative effects after stroke in T1DM rats. CNS Neurosci Ther 20:935-44
Mali, Vishal R; Ning, Ruizhuo; Chen, Jieli et al. (2014) Impairment of aldehyde dehydrogenase-2 by 4-hydroxy-2-nonenal adduct formation and cardiomyocyte hypertrophy in mice fed a high-fat diet and injected with low-dose streptozotocin. Exp Biol Med (Maywood) 239:610-8
Ning, R; Chopp, M; Zacharek, A et al. (2014) Neamine induces neuroprotection after acute ischemic stroke in type one diabetic rats. Neuroscience 257:76-85