Spinal injuries are sustained by hundreds of thousands of people each year, with many patients suffering severe and often permanent loss of mobility and physical sensation as a result of zero damage.
Beyond intensive physical rehabilitation programs – which may improve outcomes in some cases – there are almost no treatment options. But new results from a phase 2 clinical trial offer new hope for treatments on the horizon.
In an experimental collaboration with scientists in Japan and the USA, 13 patients with spinal cord injury (SCI) experienced a range of functional improvements in their condition after being treated for sprains. intravenous of their own stem cells, derived from their bone marrow.
These stem cells are called mesenchymal stem cells (MSCs), which are mature adult cells with the ability to differentiate into several cell types, enabling bone, cartilage, muscle or fat compression. to repair.
Despite the potential promise of these cells, their use as a real cure has created a lot of controversy, especially after Japan obtained a quick trade permit at the end of 2018 in advance of detailed data on safety and efficacy. the experimental treatment.
Two years later, the researchers behind the treatment, called Stemirac, have more of that data, and while it won’t be enough to convince critics, the conclusions are nonetheless offers valuable new information on what MSCs are May for patients with SCI.
“The idea that we may be able to restore function after brain and spinal cord injury using the patient’s own stem cells has been around for years,” explained neurologist Stephen Waxman from Yale University, senior author of the study.
“Now we have an idea, in people, that it could be.”
In the study, the researchers find that while other experiments have also looked at the use of MSCn to treat SCI through injection methods, their own method may have specific benefits, use of intravenous infusion.
“Importantly, invasive MSCs may affect not only the site of the injury, but other parts of the central nervous system including the brain and blood vessels,” the the authors explain in their paper.
It is not clear whether that explains some of the results seen in their 13 patients, but the results themselves are unique.
Of those who were treated with Stemirac, all of whom had invertebrate SCIs (meaning their spinal cords were not broken) were held in severe physical accidents, all but one one has shown improvements in major sensory or motor functions by six months after infusion.
More than half of the group showed significant improvements in things like the ability to walk or use their hands, and in many cases, gradual improvements on a normal obstruction scale were seen as early as one day after treatment, although other cases took weeks. .
Importantly, no adverse effects were reported.
While the researchers acknowledge that theirs are a small test with various limitations – including the possibility that what has been recovered may be something unsustainable – they argue that the initial data shows that we are looking at something here that is safe, feasible and worthy of follow-up studies with more patients.
“Although this initial case study was unrelated and uncontrolled, the SCI patients appeared to show a tendency for moderate to rapid development of neurological activity that was often evident within a few days of exposure. after a spill of MSCn, “the team writes.
In terms of how the MSC implant delivers healing, results from animal studies have led researchers to think that stem cells suppress neural growth factors that restore important structures which reduces inflammation, while at the same time restoring vital chemical activity.
Regarding the rapid improvements, the team suggests that a chemical called brain-derived neurotrophic factor (BDNF) may be involved, which is known to support the health of neurons through multiple mechanisms.
We hope that more research in the future will show the true extent of the potential benefits of this treatment.
The results are reported in Journal of Clinical Neurology and Non-Surgery.