Intrathecal transplantation of autologous adipose-derived mesenchymal stem cells for treating spinal cord injury: A human trial

Abstract

Context: Spinal cord injury (SCI) can cause irreversible damage to neural tissues. However, there is currently no effective treatment for SCI. The therapeutic potential of adipose-derived mesenchymal stem cells (ADMSCs) has been emerged.

Objective: We evaluated the effects and safety of the intrathecal transplantation of autologous ADMSCs in patients with SCI. Participants/Interventions: Fourteen patients with SCI were enrolled (12 for ASIA A, 1 for B, and 1 for D; duration of impairments 3-28 months). Six patients were injured at cervical, 1 at cervico-thoracic, 6 at thoracic, and 1 at lumbar level. Autologous ADMSCs were isolated from lipoaspirates of patients' subcutaneous fat tissue and 9 × 107 ADMSCs per patient were administered intrathecally through lumbar tapping. MRI, hematological parameters, electrophysiology studies, and ASIA motor/sensory scores were assessed before and after transplantation.

Results: ASIA motor scores were improved in 5 patients at 8 months follow-up (1-2 grades at some myotomes). Voluntary anal contraction improvement was seen in 2 patients. ASIA sensory score recovery was seen in 10, although degeneration was seen in 1. In somatosensory evoked potential test, one patient showed median nerve improvement. There was no interval change of MRI between baseline and 8 months post-transplantation. Four adverse events were observed in three patients: urinary tract infection, headache, nausea, and vomiting.

Conclusions: Over the 8 months of follow-up, intrathecal transplantation of autologous ADMSCs for SCI was free of serious adverse events, and several patients showed mild improvements in neurological function. Patient selection, dosage, and delivery method of ADMSCs should be investigated further.

Keywords: Adipose tissue; Autologous; Intrathecal; Mesenchymal stem cells; Spinal cord injury; Transplantation.

Figures

Figure 1

T2 sagittal MR image of patient 14. There was no interval change between baseline (A) and 8 months after transplantation (B).

Figure 2

The dynamics of SSEP elicited by stimulation of the median nerve of patient 5. Before treatment, short-latency (N20P22) SSEP of left median nerve was absent (A), but at post-treatment 8-month follow-up, short latency (N20P22) components were restored (C). Even for the right median nerve, the amplitude of short-latency SSEP (N20P22) was abnormally low before the treatment (B) but increased after (D). Tests were performed 3 to 4 times respectively.