Stem Cell Therapies for Prospective Treatment of Alzheimer's Disease: A Scoping Review

Bella Permata Sari Wijaya, Amelia Nur Vidyanti; Bayu Satria Wiratama; Abdul Gofir

2023 | Skripsi | PENDIDIKAN DOKTER

Latar Belakang: Penyakit Alzheimer (AD) adalah salah satu penyakit neurodegeneratif progresif paling umum di dunia dengan jumlah yang semakin meningkat, menyebabkan penurunan kognitif pada individu terutama di atas usia 65 tahun dan sekitar 60-70% penyandang demensia. Meskipun belum terdapat pengobatan atau tindakan pencegahan yang pasti untuk AD, pendekatan medis yang menjanjikan seperti terapi sel punca sedang dikembangkan. Penting untuk menilai kemajuan perawatan sel punca yang tersedia untuk AD, termasuk temuan utama penelitian, serta menentukan keadaan bukti terkini terkait terapi sel punca umum sebagai pengobatan prospektif untuk Penyakit Alzheimer pada manusia.

Tujuan: Mengeksplorasi studi klinis dan uji klinis yang sedang berlangsung maupun yang sudah selesai, serta untuk menggambarkan temuan kunci yang ada mengenai terapi sel induk umum sebagai pengobatan prospektif Alzheimer pada manusia.

Metode: Scoping review ini menggunakan pendekatan deskriptif mengikuti The Joanna Briggs Institute Manual for Evidence Synthesis. Sampel diambil dari database online ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, PubMed, ScienceDirect dan WHO International Clinical Trials Registry Platform untuk literatur yang berasal dari pasien Alzheimer dalam studi klinis dan uji klinis tersedia daring sejak tahun 2010. Kriteria inklusi meliputi publikasi teks lengkap berbahasa Inggris yang berfokus pada satu atau lebih terapi sel punca umum yaitu sel punca pluripotent terinduksi (iPSC), mesenkimal (MSC), dan saraf (NSC), untuk pengobatan prospektif AD untuk pasien manusia segala usia dengan semua tahapan penyakit di seluruh dunia. Kriteria ekslusi terdiri dari studi non-Inggris, studi hewan, ulasan, laporan kasus, literatur abu-abu, dan publikasi dari bab buku, komentar, atau disertasi.

Hasil: Terdapat 22 studi klinis dan uji klinis yang telah diterbitkan. Dua puluh adalah uji klinis intervensi, dua studi tindak lanjut observasional, dan satu akses yang diperluas. Enam studi telah selesai dari tiga produk, menunjukan keamanan dan tolerabilitas. Tetapi, peningkatan studi harus dilakukan untuk membatasi efek samping dan meningkatkan efek klinis.

Background: Alzheimer’s Disease (AD) is one of the most common progressive neurodegenerative diseases in the world, and is increasing in number, causing cognitive decline in people notably over 65 years of age and approximately 60-70% of people with dementia. Though no set cure or preventive measure is available yet, promising potential medical approaches like stem cell therapies are being developed. It is important to assess the progress of aspiring stem cell treatments available for AD, including their key research findings, as well as to determine the current state of evidence related to common stem cell therapies as a prospective treatment for Alzheimer’s Disease in humans.

Aim: To explore ongoing and completed clinical studies and clinical trials, as well as to illustrate key findings on the current knowledge of common stem cell therapies for prospective treatment of Alzheimer’s Disease in humans.

Method: This scoping review paper uses a descriptive approach following The Joanna Briggs Institute Manual for Evidence Synthesis. Samples were taken from online databases ClinicalTrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, ScienceDirect and WHO International Clinical Trials Registry Platform for literatures derived from patients in clinical studies and clinical trials with Alzheimer’s Disease available online since the year 2010. Inclusion criteria consisted of English language full-text publications focusing on one or more of the common stem cell therapies including induced pluripotent stem cell (iPSC), mesenchymal stem cell (MSC), and neural stem cell (NSC), for prospective treatment of all-ages human patients with all stages of AD worldwide. Exclusion criteria encompasses studies conducted in non-English, animal studies, reviews, case reports, grey literatures, and publications from book chapters, comments, or dissertations.

Result: There are 22 ongoing and completed clinical studies as well as clinical trials that have been published. Twenty are interventional, two are observational, and one is expanded access. Six studies are completed from three products which showed safety and tolerability, but further improvement of studies should be conducted to limit adverse events and improve clinical effects. 

Kata Kunci : Alzheimer’s Disease, Stem Cell Therapy, Induced Pluripotent Stem Cell, Mesenchymal Stem Cell, Neural Stem Cell, Prospective Treatment, Scoping Review, Current knowledge.