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Thread: Transdifferentiated bone marrow mesenchymal cells used, 2 pt chronic SCI in Argentina

  1. #41
    Interesting... This report on their website reads differently, with the 21yr old women having motor and sensory levels between T8-T10. Hmmm.

    Results: At present two patients have been treated. Patient 1 is a nineteen year old man, who presented T8 paraplegia and T6 sensitive level. He received two AT Cell – NSC treatments and neurorehabilitation for six months. At present he has a S1 motor Level and S4 sensitive level and can walk helped by two canes.

    Patient 2 is a twenty-one year old woman who had a C3 - C5 lesion. Prior to her first therapeutic cycle she had severe quadriplegia and C2 sensitive level. After 3 months of treatment her motor and sensitive levels are within T8 and T10. She can use her hands and sit without support.



    Andy.
    Last edited by Andy C; 07-05-2006 at 09:25 PM.
    C5/6 Tetraplegic, injured since 1990.

  2. #42
    Quote Originally Posted by Andy C
    Interesting... This report on their website reads differently, with the 21yr old women having motor and sensory levels between T8-T10. Hmmm.

    Results: At present two patients have been treated. Patient 1 is a nineteen year old man, who presented T8 paraplegia and T6 sensitive level. He received two AT Cell – NSC treatments and neurorehabilitation for six months. At present he has a S1 motor Level and S4 sensitive level and can walk helped by two canes.

    Patient 2 is a twenty-one year old woman who had a C3 - C5 lesion. Prior to her first therapeutic cycle she had severe quadriplegia and C2 sensitive level. After 3 months of treatment her motor and sensitive levels are within T8 and T10. She can use her hands and sit without support.



    Andy.
    Hmmm, that is interesting. I wonder why the contradiction.
    Last edited by antiquity; 07-05-2006 at 10:46 PM.

  3. #43
    The real key to all of this is if other research centers or laboratories can duplicate approximate results using the same methodologies.

  4. #44
    Quote Originally Posted by antiquity
    Hmmm, that is interestinmg. I wonder why the contradiction.
    Maybe she improved?


  5. #45
    Quote Originally Posted by Andy C
    Interesting... This report on their website reads differently, with the 21yr old women having motor and sensory levels between T8-T10. Hmmm.

    Results: At present two patients have been treated. Patient 1 is a nineteen year old man, who presented T8 paraplegia and T6 sensitive level. He received two AT Cell – NSC treatments and neurorehabilitation for six months. At present he has a S1 motor Level and S4 sensitive level and can walk helped by two canes.

    Patient 2 is a twenty-one year old woman who had a C3 - C5 lesion. Prior to her first therapeutic cycle she had severe quadriplegia and C2 sensitive level. After 3 months of treatment her motor and sensitive levels are within T8 and T10. She can use her hands and sit without support.



    Andy.

    There are 2 reports, and although they are not dated, one seems to be a preliminary report and the second a more detailed report that appears to have been done some months later after further treatment and intensive rehabilitation. The one you are quoting Andy is the 1st preliminary report.

    Leif, I wouldn't be quite as sceptical as you just yet - publishing these results in a scientific journal in English doesn't necessarily mean they are shopping for willing customers. From what I have heard generally of private medical treatment in Buenos Aires, it is really very very good, with top experts in many fields. It isn't so out of the realm of possibilities that someone there has developed a treatment with such potential. We need to find out more before passing judgement either way. I wonder if these are the only 2 they have treated? Are there more whose results haven't yet been publicly documented?
    Last edited by carbar; 07-06-2006 at 03:54 AM.

  6. #46
    Quote Originally Posted by antiquity
    Hi Wise, I have a few questions after reading the paper:

    By lesion, I assume they're referring to a contusion injury?
    • I assume that the two people had typical spinal cord injury resulting from contusion and compression. This was one disappointing aspect of the study. because there was insufficient description of their neurological status, the causes of injury, the surgery carried out, and details of what happened to them. For example, it was not clear whether the patients were "complete" and their ASIA classification.

    Patient 1 was apparently a 19-year old with a T6 paraplegia from 8 months before. He apparently had a "prosthesis" that became infected and for which he received antibiotics for over a year. Does this meant that the treatment was given to a patient with an ongoing infection? Was the prosthetic (presumably rods and hooks) removed? The patient was not able to maintain posture with his trunk. This is a little unusual for a person with a T6 injury. The statement that this patient was able to brush his own teeth and feed himself is surprising considering that all patients with a T6 level should be able to do this. The authors go on to state that both MRI and evoked potentials "improved". The improvement of the evoked potentials was not particularly impressive. At best, the signals were very small and noisy, perhaps less than 10% of normal. The MRI showed (figure 3-4) showed a fracture displacement at 3 days that appeared to have completely crushed the cord and shockingly no decompression of the spinal cord at 6 weeks. I don't consider either of these to be impressive recovery.

    Patient 2 was apparently a C2 due to a C3-C5 injury. They made no mention at all of her respiratory status. If she had a C3 injury, she should be on a respirator. The fact that she was not suggests that she may have an incomplete injury. Apparently, she had MRI changes that extended down to C7. After intensive "neurorehabilitation", she recovered some slight movements of her wrists but she could not "even hold an object". The fact that they point out that she could hold her head up "with some difficulty" suggests that the authors have little knowledge of spinal cord injury and the neurological functions subserved by different levels of the spinal cord. It is clear to me that the authors did not know the neurological examination of a patient with cervical spinal cord injury and this does not give me any confidence in their description or judgment of her recovery. Their description of her somatosensory evoked potential (SEP) was shockingly ignorant. For example, they pointed out that the most significant change in her SEP was her N20 which "used to arrived at 50 microseconds" and 8 weeks later improved to "28 microseconds". N20 should be at 20 millseconds. These authors did not know the difference between microseconds and milliseconds, a surprising lapse of peer review. None of this gives me confidence in the paper.

    In your opinion, was the methodology used to culture the cells sound?
    • This is what I was hesitant to judge. The authors used a complicated protocol that relied almost completely on the identification of cell markers. I am not expert enough to know whether the marker criteria that they used are representative of mesenchymal stem cells (MSC's) but, to my knowledge, there are no markers that are well-accepted for such cells. The demonstration that these are pluripotent cells would require more than markers. I have not had time to read the other papers and will need to do so before passing judgment but the above alone does not give me confidence that they have the kinds of cells they claim.

    The paper says that intravascular administration was the delivery route and that the cells were naturally drawn to the lesion site. So why do you say that there was no evidence that the cells are getting into the spinal cord? Are these not good routes for cell transplantation?
    • Intravascular adminsitration of cells, particularly in chronic spinal cord injury, does not guarantee entry of the cells into the spinal cord. In any case, the picture that they show for patient 1 does not reflect what they claim. I don't think that the authors know how to read MRI's.

    Regarding the patient results, I wish pre and post BBB scores were included. It didn't say whether the para recovered bowel or bladder control which are sacral level functions.
    • BBB scores are for rats only.

    The 2nd patient was 2.5 years post and didn't improve much from physical therapy which is typical for high complete quadriplegia. To recover from C2/3 to T1/2 is very significant. The sensation and non-functional motor control restored in her trunk and lower limbs would qualify her as an incomplete quad but it doesn't say if bowel control was recovered so technically, she'd be a complete C8/T1 quad. I wouldn't interpret her recovery as T1/2 unless muscle weakness is masking the regeneration.
    • I don't trust their description of the patients at all.

    In summary, I am very disappointed in their description of the patients and am not convinced that there has been much recovery. I am withholding judgment on the cell preparation method until I read the rest of their work but so far it is not promising.

    I will comment more when I get a chance.

    Wise.
    Last edited by Wise Young; 07-06-2006 at 04:12 AM.

  7. #47
    Thanks Wise,

    Something doesn't seem to add up but I'm sure some details will be revealed in time

  8. #48
    Thanks Wise. I thought their diagnosis of the quad was off. The movement and sensation reported after treatment was consistent with low quadriplegia, not high paraplegia. Not all neurologists understand the intricacies of paralysis. Hopefully, we'll have more to go on as more info. comes in.

  9. #49
    wcr,

    I agree.

    I took a look again at the MRI of patient 1 in the paper. I wonder what you think. I was quite surprised to see that they did not do anything to straighten out the spine in patient 1. The fact that these were MRI's suggest strongly that the first one (taken 3 days after injury) and the second one (taken 6 weeks after the treatment) were before the prosthesis was placed and after the prostheses were removed. The other really interesting thing is that the MRI itself is labelled D10 and D11 (the European nomenclature for T10 and T11). So, this cannot be T6. It is possible that they did laminectomy to decompress the cord and this may be what is allowing the spinal cord diameter to increase. In any case, there are just too many details that don't make sense.

    Wise.
    Last edited by Wise Young; 07-06-2006 at 10:58 PM.

  10. #50
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    Quote Originally Posted by carbar
    Leif, I wouldn't be quite as sceptical as you just yet - publishing these results in a scientific journal in English doesn't necessarily mean they are shopping for willing customers. From what I have heard generally of private medical treatment in Buenos Aires, it is really very very good, with top experts in many fields. It isn't so out of the realm of possibilities that someone there has developed a treatment with such potential. We need to find out more before passing judgement either way. I wonder if these are the only 2 they have treated? Are there more whose results haven't yet been publicly documented?
    When I see websites offering a lot of stem cell treatments this alone makes me sceptical, below is some illnesses and injuries they offers stem cell treatments for;

    Trauma de medula espinal (Spinal cord injuries).
    Infarto agudo de miocardio (Heart attack of myocardium).
    Diabetes (Diabetes).
    Accidente cerebrovascular (Cerebrovascular accidents, CVA).

    Esclerosis lateral amiotrofica (ALS).
    Enfermedad de Parkinson (Parkinson’s disease).
    Esclerosis multiple (MS).
    Leucodistrofias (Zellweger syndrome?) – According to NIH there is no cure for this.
    Nefropatia autoimmune?

    And when they can’t handle even two SCI “patients” (wonder if there was any?) without mixing them in the reports I’m even more sceptical. To me it seems like they have just made a collage of known research and mixed it with some of their own ideas and then put a couple of “patients” into the papers to make it look like a real deal so that people from all over the world will go there and give them their money – one word, crooks!

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