Peripheral Blood Mononuclear Cells and Growth Factor Therapy for Cerebral Palsy

• Published in: Journal of Korean medical science 2018, 33(21), , pp.1-3
• Main Authors: Cho, Kye Hee, Kim, MinYoung
• Format: Article
• Language: English
• Subjects: Cerebral Palsy; Child; Cytokines; Granulocyte Colony-Stimulating Factor; Granulocytes; Humans; Leukocytes, Mononuclear; 의학일반
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2018.33.e176

Perinatal hypoxic-ischemic brain injury is a main cause of cerebral palsy, the most representative disability during childhood. The developing brain differs from the adult brain in response to damage, which is defined as a “tertiary mechanism of injury” characterized by persistent inflammation and epigenetic changes that induce injury-prone status and hinder regeneration.1 To resolve the pathophysiology, various approaches have been investigated including infusion of peripheral blood mononuclear cells and administration of growth factors. In the past, stem cell therapy was expected to exert efficacy by replacing lost tissue with regenerated cells. However, an increasing number of reports show the importance of cytokines as part of the therapeutic mechanism in stem cell therapy. Growth factors have been used in stem cell therapy to modulate pathophysiological changes after the injury. Growth factors added to culture or secreted by stem cells are often potent on cell fate, cell to cell contact in cell tracking, proliferation and lineage induction. Among candidate growth factors revealed as efficacious in preclinical experiments, erythropoietin and granulocyte- colony stimulating factors (G-CSF) were used in clinical trials. A previous clinical study of intravenously introduced cord blood cells and erythropoietin combination therapy showed positive effects in motor improvement.2 It was also reported that infusion of cord blood cells elevated systemic levels of interleukin (IL)-8, pentraxin 3, and toll-like receptor 4, which were known as pro-inflammatory, however, later found to be associated with neurogenesis and angiogenesis. The changes occurred within 12 days after the therapy and were significantly correlated with long-term functional outcome, while fluorodeoxyglucose positron emission tomography (FDG-PET) revealed anti-inflammatory response in the brain tissue.3 Therefore, administration of stem cells seems to induce systemic changes that ultimately affect brain plasticity through anti-inflammatory and immune modulatory actions. KCI Citation Count: 0