Article

Autologous bone marrow mesenchymal cells that include stem cells
(MSCs) are a clinically attractive cellular therapy option to try to treat severe
spinal cord injury (SCI). OBJECTIVE: To study the possible value of MSCs injected
intrathecally to enhance rehabilitation. METHODS:
This case control, convenience
sample included 64 patients, at a mean of 3.6 years after SCI. Forty-four
subjects received monthly intrathecal autologous MSCs for 6 months and 20
subjects, who would not agree to the procedures, served as controls. All subjects
received rehabilitation therapies 3 times weekly. Subjects were evaluated at
entry and at 12 months after completing the 6-months intervention. By the ASIA
Impairment Scale, ASIA grading of completeness of injury, Ashworth Spasticity
Scale, Functional Ambulation Classification, and bladder and bowel control
questionnaire. RESULTS: No differences were found in baseline measures and
descriptors between the MSC group and control group. Although a higher percentage
of the MSC group increased motor scores by 1-2 points and changed from ASIA A to
B, no significant between-group improvements were found in clinical measures.
Adverse effects of cells included spasticity and, in 24 out of the 43 patients
developed neuropathic pain. One subject with a history of post-infectious
myelitis developed encephalomyelitis after her third injection. CONCLUSION:
Autologus MSCs may have side effects and may be contraindicated in patients with
a history of myelitis. Their utility in treating chronic traumatic SCI needs
further study in pre-clinical models and in randomized controlled trials before
they should be offered to patients.

Langue : ANGLAIS