Clinical study of neural stem cell transplantation for the treatment of spinal cord injury
By:Like Wu , Xiaojuan Wang , Bo Cheng, Saichun Chu, Shuangshuang Liu , Xinrui Xi , Fang Peng , Xiang Wang , Xueyan Feng
Wu Medical Center, Bejing, China
Abstract: Objective: To evaluate clinical therapeutic effect of the neural stem cell （NSC）transplantation for the treatment of spinal cord injury（SCI）.
Method: 45 SCI patients were treated with NSC transplantation. Evaluate all patients’ various neurological function before and after treatment.
Result: After treatment, 8 ALS patients in level A turned to level C, 25 patients turned to level B, 11 ALS patients in level B turned to level C, one patient's reminded unchanged. Before treatment, the patients’ average ASIA motor score was 42, after treatment, the score was 52, significantly higher than before(P＜0.05).
Conclusion: NSC transplantation has significantly changed SCI patients’ conditions including sensory, motor, perspiration.
Key words: Neural stem cell transplantation, spinal cord injury
Clinical research
SCI is a serious disease threaten human health, and brings a great deal of financial and spiritual burden to social and families. In acute stage doctors have tried varieties of methods, including decompression surgery, medication and physical rehabilitation, which has relieved pathological changes of SCI in certain degree, but these haven’t reduce Paralyzed rate.
For the patients with SCI, there was no effective treatment with traditional medicine. NSC transplantation is a new type of therapy. This paper described the clinical effect of NSC transplantation on 45 SCI patients. The result are summarized as follows:
Materials and Methods
Patient information: 45 SCI patients which were treated from Jan. 2008 to Dec. 2011, including 31 male 14 female. Their average age was 34 years old and average injury time was 3.5 years. All patients’ SCIs were diagnosed, all injury sites have removed the oppressive lesions, and other physiological indicators were in good position. ALS and nerve function evaluation: Our center did AIS evaluation to patients before surgeries, there were 33 patients in level A, 12 in level B.
Treatment: Time: 3-4 weeks, treatment method: 4 times embed neural stem cells in the spinal subarachnoid space 5 million each, 20 million in all, at the same time assisted with neural activation and rehabilitation. Our center referred American Spinal Injury Association (ASIA)’s SCI functional assessment to evaluated our patients’ neurological. We evaluated patients’ AIS(ASIA Impairment Scale，AIS) again after treatment. A-SIA assessment was including the evaluation of touching, pinpricking, sporting and perspiration.
Statistical treatment: Analyzed data using SPSS 17.0 software for processing, P <0.05 indicate a statistically significant difference.
Result
After treatment, changes of patients’ AIS :8 AIS patients in level A turned to level C, 25 patients turned to level B,11 ALS patients in level B turned to level C, one patient's reminded unchanged. Before treatment, Before treatment, the patients’ average ASIA motor score was 42, after treatment, the score was 52, significantly higher than before (P＜0.05).
Discussion
SCI can cause damage below the motor, sensory and sphincter disorders, there is still no fix authority. It will not only cause primary spinal cord tissue damage, but also lead to micro- environment changes, releases harmful cytokines cause secondary damage. Currently the major SCI treating methods are changing its growth environment, stem cell transplantation and nerve cell transplantation.
NSC is a efficacious nervous system tissue engineering seed cell. When treating SCI, NSC can generate neurons and glial cells after differentiation, these cells modulate the microenvironment of the spinal cord and inducing axonal regeneration by means of secreting a variety of neurotrophic molecules. Furthermore, NSC produces a variety of extracellular matrix to fill the cavity caused by injury and support axonal regeneration. It can also promotes residual myelin’s nerve fibers changing into new myelin to complete the nerve fibers.
After treatment the Conclusion is: Patients’ AIS changing: 8 ALS patients in level A turned to level C, 25 patients turned to level B. 11 ALS patients in level B turned to level C, one patient's reminded unchanged. The score is significantly higher than before(P＜0.05). So NSC transplantation has significantly changed SCI patients’ conditions including sensory, motor, perspiration.
