In the study outlined below, researchers injected bone marrow derived stem cells that had been expanded in culture into patients with spinal cord injuries. Sixty percent of the patients noted improvement in their motor function after the treatment. Importantly, there were no complications. This is an important first study validating the approach. The details of why some patients responded and others did not will be crucial to planning further trials.
Neurosurgery. 2012 May;70(5):1238-47.
Long-term Results of Spinal Cord Injury Therapy Using Mesenchymal Stem Cells Derived From Bone Marrow in Humans.
Park JH, Kim DY, Sung IY, Choi GH, Jeon MH, Kim KK, Jeon SR.
SourceDepartments of *Neurological Surgery ‡Rehabilitation Medicine §Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
BACKGROUND: : Although the transplantation of mesenchymal stem cells (MSCs) after spinal cord injury (SCI) has shown promising results in animals, less is known about the effects of autologous MSCs in human SCI.
OBJECTIVE: : To describe the long-term results of 10 patients who underwent intramedullary direct MSCs transplantation into injured spinal cords.
METHODS: : Autologous MSCs were harvested from the iliac bone of each patient and expanded by culturing for 4 weeks. MSCs (8 × 10) were directly injected into the spinal cord, and 4 × 10 cells were injected into the intradural space of 10 patients with American Spinal Injury Association class A or B injury caused by traumatic cervical SCI. After 4 and 8 weeks, an additional 5 × 10 MSCs were injected into each patient through lumbar tapping. Outcome assessments included changes in the motor power grade of the extremities, magnetic resonance imaging, and electrophysiological recordings.
RESULTS: : Although 6 of the 10 patients showed motor power improvement of the upper extremities at 6-month follow-up, 3 showed gradual improvement in activities of daily living, and changes on magnetic resonance imaging such as decreases in cavity size and the appearance of fiber-like low signal intensity streaks. They also showed electrophysiological improvement. All 10 patients did not experience any permanent complication associated with MSC transplantation.
CONCLUSION: : Three of the 10 patients with SCI who were directly injected with autologous MSCs showed improvement in the motor power of the upper extremities and in activities of daily living, as well as significant magnetic resonance imaging and electrophysiological changes during long-term follow-up.
ABBREVIATIONS: : ADL, activities of daily livingASIA, American Spinal Injury AssociationBM, bone marrowMEP, motor evoked potentialMSC, mesenchymal stem cellP, passageSCI, spinal cord injury.