Preliminary Study of Autologous Bone Marrow Nucleated Cells Transplantation in Children With Spinal Cord Injury

Abstract

The objective of this study was to assess the safety and efficacy of transplanting bone marrow nucleated cells (BMNCs) to treat children with complete interruption of spinal cord (SC) continuity. The present study was conducted from 2005 to 2011. The inclusion criteria were a magnetic resonance imaging-confirmed complete interruption of SC continuity and no improvement in neurological status within 6 months after standard therapy. Bone marrow was isolated from the iliac ala and submitted to BMNC isolation. Subsequently, the cell suspension was administered into the SC cavity and intravenously. In total, 18 of 19 intraspinal and intravenous BMNC transplantation procedures performed caused no adverse events. One case was connected with transient bradycardia. The experimental therapy showed no late complications in the 1-to 6-year follow-up evaluation period. Neurological improvement was observed in two patients who received multiple implantations. One patient demonstrated improved superficial sensation from Th3 to Th12/L1 and a restored bladder-filling sensation. In the other case, superficial sensation was improved from C2 to C5, and the respiratory drive, the swallowing reflex, and tongue movements were restored. Spasticity and quality of life were improved in three of five patients. In addition, skin pressure ulcers healed and did not recur. Our preliminary results demonstrate the safety and feasibility of BMNC transplantation in children with complete SC injury. The results indicate that a certain degree of neurological and quality-oflife improvement can be attained by children with chronic complete SC injury who receive multiple BMNC implantations. STEM CELLS TRANSLATIONAL MEDICINE 2014;3:395-404

Defining recovery neurobiology of injured spinal cord by synthetic matrix-assisted hMSC implantation

“…In conclusion, our findings corroborate the newly emerging observation that adult mammalian spinal cord contains inherent circuits that may be therapeutically recruited and modulated to restore function posttrauma (8,49,53,55). These results collectively suggest it is plausible that direct axonal connections from motor cortex neurons to spinal cord are not essential for reestablishment of basic locomotion after mammalian SCI (55)(56)(57).…”

“…Human mesenchymal stromal stem cells (hMSCs) offer autologous transplantation feasibility (1)(2)(3)(4) and have been studied both experimentally and clinically for traumatic brain injury (TBI) and spinal cord injury (SCI) (5)(6)(7)(8). Although MSCs possess homeostatic and proneurogenic activities (7,9), studies relying on neural transdifferentiation (i.e., putative differentiations of MSCs into neural cells without reentering the pluripotency phase) did not show long-term functional improvement in SCI models.…”

One-year clinical study of NeuroRegen scaffold implantation following scar resection in complete chronic spinal cord injury patients

“…Since 2005, a number of clinical trials have evaluated the safety and efficacy of autologous bone marrow cell transplantation in acute and chronic SCI patients (Deda et al, 2008;Geffner et al, 2008;Jarocha et al, 2014;Karamouzian et al, 2012;Park et al, 2005;Sykova et al, 2006;Yoon et al, 2007).…”

Rehabilitation outcomes following autologous human stem cell transplantation in a chronic complete C4 tetraplegic - the first 12 months: A case report

“…For spinal cord injuries, this has meant the prospect of improvement in, or restoration of, neurological function, despite injuries which previously resulted in catastrophic and irreversible disability [19][20] . One such development is the use of stem cell transplantation, which has shown promise in many animal and human models [20][21][22][23][24][25][26][27][28] . This could dramatically change the landscape of post spinal cord injury rehabilitation, as suddenly, persons who previously had no prospect for recovery, may have the potential to improve.…”