Cell therapy with autologous mesenchymal stromal cells in post-traumatic syringomyelia.

Autor: Vaquero J; Neurosurgery Service, University Hospital Puerta de Hierro-Majadahonda, Autonomous University, Madrid, Spain. Electronic address: jvaqueroc@telefonica.net., Zurita M; Neurosurgery Service, University Hospital Puerta de Hierro-Majadahonda, Autonomous University, Madrid, Spain., Rico MA; Neurosurgery Service, University Hospital Puerta de Hierro-Majadahonda, Autonomous University, Madrid, Spain., Aguayo C; Neurosurgery Service, University Hospital Puerta de Hierro-Majadahonda, Autonomous University, Madrid, Spain., Fernandez C; Neurosurgery Service, University Hospital Puerta de Hierro-Majadahonda, Autonomous University, Madrid, Spain., Rodriguez-Boto G; Neurosurgery Service, University Hospital Puerta de Hierro-Majadahonda, Autonomous University, Madrid, Spain., Marin E; Clinical Neurophysiology Service, University Hospital Puerta de Hierro-Majadahonda, Autonomous University, Madrid, Spain., Tapiador N; Rehabilitation Service, University Hospital Puerta de Hierro-Majadahonda, Autonomous University, Madrid, Spain., Sevilla M; Rehabilitation Service, University Hospital Puerta de Hierro-Majadahonda, Autonomous University, Madrid, Spain., Carballido J; Urology Service, University Hospital Puerta de Hierro-Majadahonda, Autonomous University, Madrid, Spain., Vazquez D; Urology Service, University Hospital Puerta de Hierro-Majadahonda, Autonomous University, Madrid, Spain., Garcia-Olmo D; Service of Coloproctology, Hospital General de Villalba, Madrid, Spain., Guadalajara H; Service of Coloproctology, Hospital General de Villalba, Madrid, Spain., Leon M; Service of Coloproctology, Hospital General de Villalba, Madrid, Spain., Valverde I; Service of Coloproctology, Hospital General de Villalba, Madrid, Spain.
Jazyk: angličtina
Zdroj: Cytotherapy [Cytotherapy] 2018 Jun; Vol. 20 (6), pp. 796-805. Date of Electronic Publication: 2018 May 18.
DOI: 10.1016/j.jcyt.2018.04.006
Abstrakt: Background Aims: Recently, clinical studies show that cell therapy with mesenchymal stromal cells (MSCs) improves the sequelae chronically established in paraplegic patients, being necessary to know which of them can obtain better benefit.
Methods: We present here a phase 2 clinical trial that includes six paraplegic patients with post-traumatic syringomyelia who received 300 million MSCs inside the syrinx and who were followed up for 6 months. Clinical scales, urodynamic, neurophysiological, magnetic resonance (MR) and studies of ano-rectal manometry were performed to assess possible improvements.
Results: In all the cases, MR at the end of the study showed a clear reduction of the syrinx, and, at this time, signs of improvement in the urodynamic studies were found. Moreover, four patients improved in ano-rectal manometry. Four patients improved in neurophysiological studies, with signs of improvement in evoked potentials in three patients. In the American Spinal Injury Association (ASIA) assessment, only two patients improved in sensitivity, but clinical improvement in neurogenic bowel dysfunction was observed in four patients and three patients described improvement in bladder dysfunction. Spasms reduced in two of the five patients who had them previous to cell therapy, and spasticity was improved in the other two patients. Three patients had neuropathic pain before treatment, and it was reduced or disappeared completely during the study. Only two adverse events ocurred, without relation to the cell therapy.
Conclusions: Cell therapy can be considered as a new alternative to the treatment of post-traumatic syringomyelia, achieving reduction of syrinx and clinical improvements in individual patients.
(Copyright © 2018 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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