BackgroundCurrently available treatments for secondary progressive multiple sclerosis(SPMS) have limited efficacy and/or safety concerns. Adipose-mesenchymal derived stem cells(AdMSCs) represent a promising option and can be readily obtained using minimally invasive procedures.Patients and methodsIn this triple-blind, placebo-controlled study, cell samples were obtained from consenting patients by lipectomy and subsequently expanded. Patients were randomized to a single infusion of placebo, low-dose(1x106cells/kg) or high-dose(4x106cells/kg) autologous AdMSC product and followed for 12 months. Safety was monitored recording adverse events, laboratory parameters, vital signs and spirometry. Expanded disability status score (EDSS), magnetic-resonance-imaging, and other measures of possible treatment effects were also recorded.ResultsThirty-four patients underwent lipectomy for AdMSCs collection, were randomized and thirty were infused (11 placebo, 10 low-dose and 9 high-dose); 4 randomized patients were not infused because of karyotype abnormalities in the cell product. Only one serious adverse event was observed in the treatment arms (urinary infection, considered not related to study treatment). No other safety parameters showed changes. Measures of treatment effect showed an inconclusive trend of efficacy.ConclusionInfusion of autologous AdMSCs is safe and feasible in patients with SPMS. Larger studies and probably treatment at earlier phases would be needed to investigate the potential therapeutic benefit of this technique.
The promotora delivery model has promise for program sustainability with both promotoras and participants alike expressing interest in leading future programs.
Despite the burgeoning U.S. Latino population and their increased risk of chronic disease, little emphasis had been placed on developing culturally sensitive lifestyle interventions in this area. This article examines older Latinas' sociocultural context relative to health with the goal of developing a culturally sensitive health behavior intervention. Photo-elicitation indicated two emerging themes that influenced lifestyle choices: family caregiving and religion. Researchers partnered with a faith-based organization to develop and implement a 6-month lifestyle intervention for Latinas ages 50 and older: Abuelas en Acción (AEA). At completion, interviews were conducted to understand women's experiences and the influence AEA had on their lifestyles and health. Findings suggest that religious content empowered and deeply affected women; however, the intergenerational content presented significant challenges for instruction, retention, and implementation. We discuss findings in relation to the health intervention literature and provide suggestions for future interventions drawing on religion, family, and health behavior change.
The development of cell therapy medicinal products constitutes an alternative therapeutic strategy to conventional clinical therapy, for which no effective cure was previously available.
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