Co-transplantation of autologous bone marrow mesenchymal stem cells and Schwann cells through cerebral spinal fluid for the treatment of patients with chronic spinal cord injury: safety and possible outcome

• Published in: Spinal cord 2016-02, Vol.54 (2), p.102-109
• Main Authors: Oraee-Yazdani, S, Hafizi, M, Atashi, A, Ashrafi, F, Seddighi, A-S, Hashemi, S M, Seddighi, A, Soleimani, M, Zali, A
• Format: Article
• Language: English
• Subjects: 13; 13/100; 59/57; 692/308/2171; 692/308/2779; 692/617; Adult; Anatomy; Biomedical and Life Sciences; Biomedicine; Cerebrospinal Fluid - cytology; Chronic Disease; Combined Modality Therapy - adverse effects; Combined Modality Therapy - methods; Feasibility Studies; Female; Human Physiology; Humans; Male; Mesenchymal Stem Cell Transplantation - adverse effects; Mesenchymal Stem Cell Transplantation - methods; Middle Aged; Neurochemistry; Neuropsychology; Neurosciences; original-article; Schwann Cells - cytology; Schwann Cells - transplantation; Spinal Cord Injuries - cerebrospinal fluid; Spinal Cord Injuries - diagnosis; Spinal Cord Injuries - therapy; Spinal Cord Regeneration; Transplantation, Autologous - adverse effects; Transplantation, Autologous - methods; Treatment Outcome
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sc.2015.142

Study design: This is a clinical trial (phase 1). Objectives: The objective of this study was to asses the safety and feasibility of bone marrow mesenchymal stem cell (MSC) and Schwann cell (SC) co-injection through cerebral spinal fluid (CSF) for the treatment of patients with chronic spinal cord injury. Methods: Six subjects with complete spinal cord injury due to trauma according to International Standard of Neurological Classification for Spinal Cord Injury (ISNCSCI) developed by the American Spinal Injury Association were enrolled. They received autologous co-transplantation of MSC and SC through lumbar puncture. Neurological status of the patients was determined by ISNCSCI, as well as by assessment of functional status by Spinal Cord Independent Measure. Before and after cell transplantation, magnetic resonance imaging (MRI) was performed for all the patients. Before the procedure, all the patients underwent electromyography, urodynamic study (UDS) and MRI tractograghy. After transplantation, these assessments were performed in special cases when the patients reported any changes in motor function or any changes in urinary sensation. Results: Over the mean 30 months of follow-up, the radiological findings were unchanged without any evidence of neoplastic tissue overgrowth. American Spinal Injury Association class in one patient was changed from A to B, in addition to the improvement in indexes of UDS, especially bladder compliance, which was congruous with axonal regeneration detected in MRI tractography. No motor score improvement was observed among the patients. Conclusion: No adverse findings were detected at a mean of 30 months after autologous transplantation of the combination of MSCs and SCs through CSF. It may suggest the safety of this combination of cells for spinal cord regeneration.