Mesenchymal stem cells for the treatment of intracerebral hemorrhage: Mechanisms, optimization strategies and future challenges

Intracerebral hemorrhage (ICH) is the second most common subtype of stroke worldwide and is characterized by complex pathophysiological mechanisms. Although its etiology and diagnostic criteria are well-established, an optimal therapeutic strategy remains under active debate. Stem cell therapy has been extensively investigated for the treatment of neurological diseases over the past decade, and mesenchymal stem cell (MSC)-based therapies have emerged as a promising strategy for ICH treatment. However, accumulating evidence suggests that the therapeutic effects of MSC-based therapies are primarily mediated by the paracrine activity of MSCs. Moreover, although MSC-based therapy for ICH offers several advantages, the transplantation method and post-transplantation cell survival remain critical determinants of therapeutic efficacy. Recent advances in optimizing MSC transplantation protocols and improving post-transplantation cell survival have shown promising results. This review focuses on the research progress of MSCs in ICH therapy and the challenges involved in translating these findings from experimental to clinical applications.