In a murine model of stroke, scientists identified a population of very small embryonic-like (VSEL) stem cells (SCs) in adult murine bone marrow that could be mobilized into peripheral blood (PB). This raised the question of whether a similar population of cells is mobilized in human stroke patients. A number of cells that corresponded to VSEL SCs in the PB of 44 stroke patients and 22 age-matched controls was evaluated to answer that question.

After each patient's stroke, PB samples were harvested during the first 24 hours, on day +3, and on day +7 and then compared with normal controls. The circulating human cells with the phenotype of VSEL SCs were evaluated in PB by real-time quantitative polymerase chain reaction, fluorescence-activated cell sorting analysis, and direct immunofluorescence staining. In parallel, it has been also measured the serum concentration of stromal derived factor-1 by ELISA.

The results of the study showed that in stroke patients, an increase in the number of circulating cells expressing SC-associated antigens, such as CD133, CD34, and CXCR4 was found. More important, it was observed an increase in the number of circulating primitive cells expressing the VSEL phenotype (CXCR4(+)lin(-)CD45(-) small cells), mRNA for Octamer-4 and Nanog, and Octamer-4 protein.

All changes were accompanied by an increased serum concentration of stromal derived factor-1. Positive correlation between stroke extensiveness, stromal derived factor-1 concentration in serum, and the number of CXCR4(+) VSEL SCs circulating in the PB.

It is obvious that stroke triggers the mobilization of CXCR4(+) VSEL SCs that have potential prognostic value in stroke patients. However, the potential role of these mobilized cells in brain regeneration requires further study.