Frontiers in Medicine (Sep 2024)

Transplantation of autologous mesenchymal stromal cells in complete cervical spinal cord injury: a pilot study

  • Carolina Thé Macêdo,
  • Carolina Thé Macêdo,
  • Carolina Thé Macêdo,
  • Bruno Solano de Freitas Souza,
  • Bruno Solano de Freitas Souza,
  • Bruno Solano de Freitas Souza,
  • Cristiane Flora Villarreal,
  • Cristiane Flora Villarreal,
  • Daniela Nascimento Silva,
  • Daniela Nascimento Silva,
  • Kátia Nunes da Silva,
  • Kátia Nunes da Silva,
  • Clarissa Lima e Moura de Souza,
  • Clarissa Lima e Moura de Souza,
  • Daniela da Silva Paixão,
  • Milena da Rocha Bezerra,
  • Antônio Olímpio da Silva Moura Costa,
  • Eduardo Santos Brazão,
  • Josildo Pereira Marins Filho,
  • André Costa Matos,
  • Ricardo Ribeiro dos Santos,
  • Ricardo Ribeiro dos Santos,
  • Ricardo Ribeiro dos Santos,
  • Milena Botelho Pereira Soares,
  • Milena Botelho Pereira Soares,
  • Milena Botelho Pereira Soares

DOI
https://doi.org/10.3389/fmed.2024.1451297
Journal volume & issue
Vol. 11

Abstract

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ObjectiveSpinal cord injury (SCI) is a serious condition that can lead to partial or complete paraplegia or tetraplegia. Currently, there are few therapeutic options for these conditions, which are mainly directed toward the acute phase, such as surgical intervention and high-dose steroid administration. Mesenchymal stromal cells (MSC) have been shown to improve neurological function following spinal cord injury. The aim of the study was to evaluate the safety, feasibility, and potential efficacy of MSC transplantation in patients with cervical traumatic SCI.MethodsWe included seven subjects with chronic traumatic SCI (> 1 year) at the cervical level, classified as American Spinal Cord Injury Association impairment scale (AIS) grade A. Subjects received two doses of autologous bone marrow derived MSC, the first by direct injection into the lesion site after hemilaminectomy and the second three months later by intrathecal injection. Neurologic evaluation, spinal magnetic resonance imaging (MRI), urodynamics, and life quality questionnaires were assessed before and after treatment.ResultsCell transplantation was safe without severe or moderate adverse effects, and the procedures were well tolerated. Neurological evaluation revealed discrete improvements in sensitivity below the lesion level, following treatment. Five subjects showed some degree of bilateral sensory improvement for both superficial and deep mechanical stimuli compared to the pretreatment profile. No significant alterations in bladder function were observed during this study.ConclusionTransplantation of autologous MSC in patients with chronic cervical SCI is a safe and feasible procedure. Further studies are required to confirm the efficacy of this therapeutic approach.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT02574572, identifier NCT02574572.

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