Cells (Mar 2022)

Clinical Trials Using Mesenchymal Stem Cells for Spinal Cord Injury: Challenges in Generating Evidence

  • Lila Teixeira de Araújo,
  • Carolina Thé Macêdo,
  • Patrícia Kauanna Fonseca Damasceno,
  • Ítalo Gabriel Costa das Neves,
  • Carla Souza de Lima,
  • Girlaine Café Santos,
  • Thaís Alves de Santana,
  • Gabriela Louise de Almeida Sampaio,
  • Daniela Nascimento Silva,
  • Cristiane Flora Villarreal,
  • Alessandra Casemiro de Campos Chaguri,
  • Crislaine Gomes da Silva,
  • Augusto César de Andrade Mota,
  • Roberto Badaró,
  • Ricardo Ribeiro dos Santos,
  • Milena Botelho Pereira Soares

DOI
https://doi.org/10.3390/cells11061019
Journal volume & issue
Vol. 11, no. 6
p. 1019

Abstract

Read online

Spinal cord injury (SCI) remains an important public health problem which often causes permanent loss of muscle strength, sensation, and function below the site of the injury, generating physical, psychological, and social impacts throughout the lives of the affected individuals, since there are no effective treatments available. The use of stem cells has been investigated as a therapeutic approach for the treatment of SCI. Although a significant number of studies have been conducted in pre-clinical and clinical settings, so far there is no established cell therapy for the treatment of SCI. One aspect that makes it difficult to evaluate the efficacy is the heterogeneity of experimental designs in the clinical trials that have been published. Cell transplantation methods vary widely among the trials, and there are still no standardized protocols or recommendations for the therapeutic use of stem cells in SCI. Among the different cell types, mesenchymal stem/stromal cells (MSCs) are the most frequently tested in clinical trials for SCI treatment. This study reviews the clinical applications of MSCs for SCI, focusing on the critical analysis of 17 clinical trials published thus far, with emphasis on their design and quality. Moreover, it highlights the need for more evidence-based studies designed as randomized controlled trials and potential challenges to be addressed in context of stem cell therapies for SCI.

Keywords