Transplantation of Autologous Activated Schwann Cells in the Treatment of Spinal Cord Injury: Six Cases, more than Five Years of Follow-up

Abstract

Schwann cells (SCs) are the main glial cells of the peripheral nervous system, which can promote neural regeneration. Grafting of autologous SCs is one of the well-established and commonly performed procedures for peripheral nerve repair. With the aim to improve the clinical condition of patients with spinal cord injury (SCI), a program of grafting autologous activated Schwann cells (AASCs), as well as a series of appropriate neurorehabilitation programs, was employed to achieve the best therapeutic effects. We selected six patients who had a history of SCI before transplantation. At first, AASCs were obtained by prior ligation of sural nerve and subsequently isolated, cultured, and purified in vitro. Then the patients accepted an operation of laminectomy and cell transplantation, and no severe adverse event was observed in any of these patients. Motor and sensitive improvements were evaluated by means of American Spinal Injury Association (ASIA) grading and Functional Independence Measure (FIM); bladder and urethral function were determined by clinical and urodynamic examination; somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) were used to further confirm the functional recovery following transplantation. The patients were followed up for more than 5 years. All of the patients showed some signs of improvement in autonomic, motor, and sensory function. So we concluded that AASC transplantation might be feasible, safe, and effective to promote neurorestoration of SCI patients.

A Systematic Review of Experimental Strategies Aimed at Improving Motor Function after Acute and Chronic Spinal Cord Injury

“…Twelve studies [14][15][16][17][18][19][20][21][22] assessed spinal integrity using magnetic resonance imaging (MRI) ( Tables 3 and 4). Five studies limited the inclusion criteria based on the MRI findings.…”

“…24 The remainder of Phase I studies have focused on cell therapies, resulting from reports of successful outcomes in experimental models of SCI. These included: cell transplantation of bone marrow derived mesenchymal stromal cells, 15 autologous activated Schwann cells, 16 and autologous activated macrophages. 17 Grossman and associates 32 performed a Phase II study to assess the feasibility, safety, and preliminary efficacy of riluzole, a sodium-channel blocking medication shown to reduce excitotoxicity and improve outcomes of motor function in animal models of SCI (and with an established safety profile in humans).…”

Current perspectives in stem cell therapy for spinal cord repair in humans: a review of work from the past 10 years

“…MRI scans revealed that the myelomalacia and cystic degeneration had also been reduced. Although this study's results were promising, it had some limitations: patients were not matched for variables such as age, time since SCI, and ASIA scale 11 . In two other longitudinal studies, Saberi et al aimed to evaluate the safety and feasibility of SC transplantation.…”

Schwann cell transplantation for spinal cord injury repair: its significant therapeutic potential and prospectus

“…Numerous preclinical studies using various SCI models across several species have not indicated safety concerns regarding SCs. Furthermore, several clinical Brought to you by | Carleton University OCUL Authenticated Download Date | 6/27/15 4:10 AM studies suggest their safety and feasibility for the treatment of human SCI (Saberi et al, 2008(Saberi et al, , 2011Zhou et al, 2012). Therefore, transplantation of SCs has significant therapeutic potential for the clinical treatment of persons with SCI.…”