Case report on the clinical results of a combined cellular therapy for chronic SCI

[wildwilly]

Decided to post this under cure (versus clinical research). I thought it was interesting and potentially more people would comment. I'm not familar with the group.




Spinal Cord. 2009 Feb 17.

Case report on the clinical results of a combined cellular therapy for chronic spinal cord injured patients.

Moviglia GA, Varela G, Brizuela JA, Moviglia Brandolino MT, Farina P, Etchegaray G, Piccone S, Hirsch J, Martinez G, Marino S, Deffain S, Coria N, Gonzáles A, Sztanko M, Salas-Zamora P, Previgliano I, Aingel V, Farias J, Gaeta CA, Saslavsky J, Blasseti N.

[1] 1Fundación Regina Mater, Buenos Aires, Argentina [2] 2Centro de Investigación en Ingeniería de Tejidos y Terapia Celular (CIITT), Universidad Maimónides, Buenos Aires, Argentina.

Objectives:With the intention to ameliorate the clinical condition of patients with chronic spinal cord injury (SCI), a program that combines three cell therapies and an appropriate neurorehabilitation program were used to recreate and enhance the natural conditions of SCI repair.Methods:Vascularization recovery is approached by selective artery infusion of BMMNCs (bone marrow mononuclear cells) to the disrupted area. Eighteen days later, with the aim to restore the specific inflammatory activity, an i.v. infusion of spinal cord specific ETCs (effector T cells) is carried out. With the intention of supplying cellular components for the process of repair, an infusion of autologous neural stem cells (NSCs) through selective feeding artery infusion is carried out, followed by an appropriate neurorehabilitation program.Results:A total of eight ASIA (American Spinal Injury Association) A patients (five with jeopardized brachial plexus and three without) received the treatment. No severe adverse events was observed in any of the receptor patients: five patients evolved from ASIA A to ASIA D and regained the ability to stand up and, with varying effectiveness, to walk; two patients remained in the same condition, but exhibited motor and sensitive improvements; and one patient could not be evaluated.Conclusions:These reports suggest that the biological characteristics of acute SCI may be recreated in a comprehensive, safe and effective manner.Spinal Cord advance online publication, 17 February 2009; doi:10.1038/sc.2008.164.

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum

[Leo]

thanks wildwilly,

am i seeing this as 3 seperate steps

bone marrow

t-cells

neural


if real those are great results

[carbar]

I seem to remember that Cherry spoke with the Regina Mater medics some time ago (maybe as much as 2 years ago) to try to find out more about what they were doing after reading a 2006 report on 2 patients who also had seemingly dramatically good results. I can't remember the outcome but imagine that it turned out to be not all that it seemed. But these are newer studies so....

[Wise Young]

willy, I looked at the paper.

While I can't post the paper in its entirety here, I can say that it is quite a short paper and doesn't describe the sources of the cells at all, except that they come from the patients themselves. The treatment that was delivered consisted of three types of cells, described in the abstract. The first was a bone marrow mesenchymal stem cell preparation that was infused intravenously to the arteries feeding the injury site, apparently to increase vascularization. This was followed by an intravenous infusion of what they call "spinal cord specific effector T-cells" 18 days later. I don't know what they are referring to and have never heard of such cells. Presumably, they collected these cells from the peripheral blood. Finally, they then selectively infuse so-called neural stem cells to the spinal cord. In the paper, they do not specify where these cells come from and how they were prepared. Given the lack of details concerning these cells, I am skeptical.

Moviglia (the senior author, whom I have met in Beijing last year and will be seeing again in April) says that all the patients were ASIA A. Strangely, five of the patients have damage to their brachial plexus and 3 did not. He claims that 5 of the patients recovered from ASIA A to D. Two did not change and one apparently could not be evaluated. However, based on the data presented in the paper, I am doubtful that there were five conversions to ASIA D. This is not apparent from their table of neurological scores. I attach Table 2 from their article here which gives the neurological scores.

Wise.