Synergistic effects of electroacupuncture and bone marrow stromal cells transplantation therapy in ischemic stroke

OBJECTIVE: Animal studies and clinical trials demonstrated the effectiveness of a combination of transplanted bone marrow stromal cells (BMSC) and electroacupuncture (EA) treatment in improving neurological defi-cits. However, the ability of the BMSC-EA treat-ment to enhance brain repair processes or the neuronal plasticity of BMSC in ischemic stroke model is unclear. The purpose of this study was to investigate the neuroprotective effects and neuronal plasticity of BMSC transplantation combined with EA in ischemic stroke. MATERIALS AND METHODS: A male Sprague-Dawley (SD) rat middle cerebral ar-tery occlusion (MCAO) model was used. In-tracerebral transplantation of BMSC, trans-fected with lentiviral vectors expressing green fluorescent protein (GFP), was performed us-ing a stereotactic apparatus after modeling. MCAO rats were treated with BMSC injection alone or in combination with EA. After the treatment, proliferation and migration of BMSC were observed in different groups by fluores-cence microscopy. Quantitative real-time PCR (qRT-PCR), Western blotting, and immunohisto-chemistry were performed to examine changes in the levels of neuron-specific enolase (NSE) and nestin in the injured striatum. RESULTS: Epifluorescence microscopy re-vealed that most BMSC in the cerebrum were lysed; few transplanted BMSC survived, and some living cells migrated to areas around the lesion site. NSE was overexpressed in the stri-atum of MCAO rats, illustrating the neurologi-cal deficits caused by cerebral ischemia-reperfu-sion. The combination of BMSC transplantation and EA attenuated the expression of NSE, indi-cating nerve injury repair. Although the qRT-PCR results showed that BMSC-EA treatment elevat-ed nestin RNA expression, less robust respons-es were observed in other tests.CONCLUSIONS: Our results show that the combination treatment significantly improved restoration of neurological deficits in the ani-mal stroke model. However, further studies are required to see if EA could promote the rapid differentiation of BMSC into neural stem cells in the short term.