The Contribution of Mesenchymal Stromal Cells in Traumatic Brain Injury

Traumatic brain injury (TBI) is the leading cause of mortality and disability among young people in high-income countries. No single-agent treatment has been successfully translated to the clinical setting, hence there is still the need to focus on strategies that simultaneously act on multiple injury mechanisms. Mesenchymal stem/stromal cells (MSCs) are ideal candidates since they act on multiple mechanisms of protection and repair, improving structural and functional outcome after experimental TBI. The magnitude of protection varies extremely in different studies. Besides conceptual issues and methodological differences between injury models and laboratories, heterogeneity of MSC populations also affects the outcomes. This chapter focuses on the biology of MSCs, on mechanisms of brain protection and repair and on open questions that need to be addressed in order to increase effectiveness, reduce variability and safely move from preclinical studies to clinical application.