The use of biologics in various diseases has dramatically increased in recent years. Stroke, a cerebrovascular disease, is the second most common cause of death, and the leading cause of disability with high morbidity worldwide. For biologics applied in the treatment of acute ischaemic stroke, alteplase is the only thrombolytic agent. Meanwhile, current clinical trials show that two recombinant proteins, tenecteplase and non-immunogenic staphylokinase, are most promising as new thrombolytic agents for acute ischaemic stroke therapy. In addition, stem cell-based therapy, which uses stem cells or organoids for stroke treatment, has shown promising results in preclinical and early clinical studies. These strategies for acute ischaemic stroke mainly rely on the unique properties of undifferentiated cells to facilitate tissue repair and regeneration. However, there is a still considerable journey ahead before these approaches become routine clinical use. This includes optimising cell delivery methods, determining the ideal cell type and dosage, and addressing long-term safety concerns. This review introduces the current or promising recombinant proteins for thrombolysis therapy in ischaemic stroke and highlights the promise and challenges of stem cells and cerebral organoids in stroke therapy.

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抗中风生物制剂：从重组蛋白到干细胞和类器官

近年来，生物制剂在各种疾病中的使用急剧增加。中风是一种脑血管疾病，是第二大常见死因，也是导致残疾的主要原因，在全世界范围内发病率很高。对于用于治疗急性缺血性中风的生物制剂，阿替普酶是唯一的溶栓剂。同时，目前的临床试验表明，替奈普酶和非免疫原性葡萄激酶这两种重组蛋白最有希望作为治疗急性缺血性中风的新型溶栓剂。此外，基于干细胞的疗法，即使用干细胞或类器官来治疗中风，已在临床前和早期临床研究中显示出有希望的结果。这些针对急性缺血性中风的策略主要依靠未分化细胞的独特特性来促进组织修复和再生。然而，在这些方法成为常规临床应用之前，还有很长的路要走。这包括优化细胞递送方法、确定理想的细胞类型和剂量以及解决长期安全问题。本综述介绍了当前或有前途的用于缺血性中风溶栓治疗的重组蛋白，并强调了干细胞和脑类器官在中风治疗中的前景和挑战。