Autologous cord blood cell infusion in preterm neonates safely reduces respiratory support duration and potentially preterm complications

Abstract

Preterm birth and its complications are the leading cause of neonatal death. The main underlying pathological mechanisms for preterm complications are disruption of the normal maturation processes within the target tissues, interrupted by premature birth.Cord blood, as a new and convenient source of stem cells, may provide new, promising options for preventing preterm complications. This prospective, nonrandomized placebo controlled study aimed at investigating the effect of autologous cord blood mononuclear cells (ACBMNC) for preventing preterm associated complications. Preterm infants less than 35 weeks gestational age were assigned to receive ACBMNC (5 × 10 7 cells/kg) intravenous or normal saline within 8 hours after birth. Preterm complication rates were compared between two groups to demonstrate the effect of ACBMNC infusion in reducing preterm complications. Fifteen preterm infants received ACBMNC infusion, and 16 infants were assigned to the control group. There were no significant differences when comparing mortality and preterm complication rates before discharge. However, ACBMNC infusion demonstrated significant decreases in duration of mechanical ventilation (3.2 days vs 6.41 days, P = .028) and oxygen therapy (5.33 days vs 11.31 days, P = .047). ACBMNC infusion was effective in reducing respiratory support duration in very preterm infants. Due to the limited number of patients enrolled, powered randomized controlled trials are needed to better define its efficacy. K E Y W O R D Sautologous cord blood cells, effect, preterm complication, prevention

Safety and Effectiveness of Human Stem Cells for Bronchopulmonary Dysplasia in Preterm Infants: A Systematic Review and Meta-analysis

“…Yun et al 25 , Xian et al 26 and Steven et al 27 treated patients with MSCs infusions. Zhu et al 28 and Jie et al 29 administered autologous cord blood cells to infants. All the subjects in the 7 studies were premature infants with gestational ages of less than 37 weeks.…”

Feasibility of Umbilical Cord Blood Collection in Neonates at Risk of Brain Damage—A Step Toward Autologous Cell Therapy for a High-risk Population

“…Because none of the children with IUGR suffered from brain lesions, we suggest that this group may be excluded for a more efficient approach in the future. Other neonatological populations that may benefit from autologous cord blood are preterm infants developing bronchopulmonary dysplasia or neonates undergoing surgical correction of congenital cardiac defects 47 , 56 – 59 .…”

Oligodendrocyte Development and Implication in Perinatal White Matter Injury

“…As inflammation and cellular degeneration play a major role in pathological cascade of WMI, UCBCs with established immunomodulatory, anti-apoptotic, and neurotrophic properties are a promising autologous cell source for WMI cell therapy. Indeed, a number of preclinical and clinical studies have demonstrated that UCBC administration protects white matter development via prevention of OLs loss, restoration of pmOLs maturation, and exhibition of anti-inflammatory and antioxidant functions ( Li et al, 2016 ; Paton et al, 2018 ; Ren et al, 2020 ). To date, more than 20 clinical trials for CP treatment using UCB have been registered from clinicaltrials.gov ( Table 2 ).…”