Effects of neural progenitor cells transplantation in children with severe cerebral palsy

Luan, Zuo; Liu, Weipeng; Qu, Suqing; Kan, Du; Sheng, Hwai-Ping; Wang, Zhaoyan; Yang, Yinxiang; Wang, Caiying; Gong, Xiaofeng

doi:10.3727/096368911x633806

Cited by 4 publications

(14 citation statements)

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“…We included four RCTs [21–24] plus one nonrandomized clinical trial (CT) [25] that evaluated the short‐term effectiveness of stem cell intervention for improving the gross motor function of people with cerebral palsy. Three of the five studies compared stem cells with rehabilitation to rehabilitation alone [21, 23, 25]. One trial was a three‐group RCT comparing (a) stem cells plus erythropoietin plus rehabilitation versus (b) erythropoietin plus rehabilitation versus (c) rehabilitation alone [24], whereas one trial compared stem cells alone to placebo [22].…”

Section: Resultsmentioning

confidence: 99%

“…All five studies included 100% of participants with the diagnosis of cerebral palsy. Only one study specified which subtypes of cerebral palsy were included [23], which were spastic, dyskinetic, and mixed. Three of the five studies specified the participant's gross motor function level at enrollment: all GMFCS levels were included in Kang and Luan's studies [22, 23], whereas Chen's 2013 study [25] focused on those with more severe physical disability—levels III–V.…”

Section: Resultsmentioning

confidence: 99%

“…The age range of participants varied. Three trials studied children less than 12 years old [21, 23, 24], whereas, two trials studied both children and adults simultaneously [22, 25].…”

Section: Resultsmentioning

confidence: 99%

“…All five trials narratively reported benefits from stem cell intervention on gross motor function, as measured on the GMFM. Four of five trials reported statistically significant between‐group differences on GMFM favoring stem cell intervention, but one trial did not calculate between‐group differences [23]. Overall, stem cells with or without rehabilitation had a greater effect on gross motor function (as measured on the GMFM) than rehabilitation alone, SMD = 1.27 [95% CI 0.22–2.33] (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…However, there was significant heterogeneity between studies ( I 2 = 92%). In addition, some trials collected extra motor data before and after stem cell intervention, including strength measured on the manual muscle test [22], fine motor function measured on the Peabody Developmental Motor Scales (PDMS) [23], and developmental motor measured on the Bayley Scales of Infant Development (Version III) [24]. These data were heterogeneous and could not be pooled.…”

Section: Resultsmentioning

confidence: 99%

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Concise Review: Stem Cell Interventions for People With Cerebral Palsy: Systematic Review With Meta-Analysis

Novak

Walker

Hunt

et al. 2016

Stem Cells Translational Medicine

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Evidence for stem cells as a potential intervention for cerebral palsy is emerging. Our objective was to determine the efficacy and safety of stem cells for improving motor and cognitive function of people with cerebral palsy. Searches were conducted in October 2015 in CENTRAL, EMBASE, MEDLINE, and Cochrane Libraries. Randomized controlled trials and controlled clinical trials of stem cells for cerebral palsy were included. Two authors independently decided upon included trials, extracted data, quality, and risk of bias. The primary outcome was gross motor function. Secondary outcomes were cognitive function and adverse events (AEs). Effects were expressed as standardized mean differences (SMD) with 95% confidence intervals (CI), using a random-effects model. Five trials comprising 328 participants met inclusion criteria. Four cell types were studied: olfactory ensheathing, neural, neural progenitors, and allogeneic umbilical cord blood (UCBs). Transplantation procedures differed from central nervous system neurosurgical transplantation to intravenous/arterial infusion. Participants were followed short-term for only 6 months. Evidence of variable quality indicated a small statistically significant intervention effect from stem cells on gross motor skills (SMD 1.27; 95% CI 0.22, 2.33), with UCBs most effective. There were insufficient and heterogeneous data to compare cognitive effects. Serious AEs were rare (n = 4/135 [3%] stem cells; n = 3/139 [2%] controls). Stem cells appeared to induce short-term improvements in motor skills. Different types of stem cell interventions were compared, meaning the data were heterogeneous and are a study limitation. Further randomized controlled trials are warranted, using rigorous methodologies. STEM CELLS TRANSLATIONAL MEDICINE 2016;5:1014-1025 SIGNIFICANCE Stem cells are emerging as a scientifically plausible treatment and possible cure for cerebral palsy, but are not yet proven. The lack of valid animal models has significantly hampered the scope of clinical trials. Despite the state of current treatment evidence, parents remain optimistic about the potential improvements from stem cell intervention and feel compelled to exhaust all therapeutic options, including stem cell tourism. Receiving unproven therapies from unvalidated sources is potentially dangerous. Thus it is essential that researchers and clinicians stay up to date. A systematic review and meta-analysis summarizing and aggregating current research data may provide more conclusive evidence to inform treatment decision making and help direct future research.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…The age range of participants varied. Three trials studied children less than 12 years old [21, 23, 24], whereas, two trials studied both children and adults simultaneously [22, 25].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Concise Review: Stem Cell Interventions for People With Cerebral Palsy: Systematic Review With Meta-Analysis

Novak

Walker

Hunt

et al. 2016

Stem Cells Translational Medicine

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Hydrogel-Based Bioprocess for Scalable Manufacturing of Human Pluripotent Stem Cell-Derived Neural Stem Cells

Lin

et al. 2018

ACS Appl. Mater. Interfaces

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Neural stem cells derived from human pluripotent stem cells (hPSC-NSCs) are of great value for modeling diseases, developing drugs, and treating neurological disorders. However, manufacturing high-quantity and -quality hPSC-NSCs, especially for clinical applications, remains a challenge. Here, we report a chemically defined, high-yield, and scalable bioprocess for manufacturing hPSC-NSCs. hPSCs are expanded and differentiated into NSCs in microscale tubes made with alginate hydrogels. The tubes are used to isolate cells from the hydrodynamic stresses in the culture vessel and limit the radial diameter of the cell mass to less than 400 μm to ensure efficient mass transport during the culture. The hydrogel tubes provide uniform, reproducible, and cell-friendly microspaces and microenvironments for cells. With this new technology, we showed that hPSC-NSCs could be produced in 12 days with high viability (∼95%), high purity (>90%), and high yield (∼5 × 10 cells/mL of microspace). The volumetric yield is about 250 times more than the current state-of-the-art. Whole transcriptome analysis and quantitative real-time polymerase chain reaction showed that hPSC-NSCs made by this process had a similar gene expression to hPSC-NSCs made by the conventional culture technology. The produced hPSC-NSCs could mature into both neurons and glial cells in vitro and in vivo. The process developed in this paper can be used to produce large numbers of hPSC-NSCs for various biomedical applications in the future.

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Wharton’s Jelly Mesenchymal Stem Cell Administration Improves Quality of Life and Self-Sufficiency in Children with Cerebral Palsy: Results from a Retrospective Study

Boruczkowski

Zdolińska-Malinowska

2019

Stem Cells International

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The aim of this paper was to describe the outcome of the therapeutic administration of allogenic mesenchymal stem cells obtained from Wharton’s jelly (WJ-MSCs) in children with cerebral palsy (CP) during a medical therapeutic experiment. We retrospectively analyzed the records of 109 patients recruited in daily clinical practice. Each patient received 1–10 injections and was examined by the same neurologist (study investigator (SI)) on the day of each infusion. The SI used a 6-point Likert scale to assess the quality of life (QoL) and self-sufficiency of the patients on the basis of the neurological examination. Children with >50% follow-ups after this administration were included into the quantitative analysis. In addition, the assessments of the parents and other health care professionals were obtained for 23 patients and compared with those of the SI. Forty-eight of 54 analyzed patients (88.9%) achieved some improvement in health status. Forty-eight (88.9%) patients experienced an increase in their QoL, and 21 patients (38.9%) achieved an increase in their self-sufficiency level. Improvement was achieved in 17 areas. Adverse events were mild and temporary except one case of epilepsy deterioration leading to treatment discontinuation. Age, body mass, and cell dose were not significant predictors of QoL response, contrary to epilepsy; developmental breakthrough was dose-dependent.

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Effects of neural progenitor cells transplantation in children with severe cerebral palsy

Cited by 4 publications

References 0 publications

Concise Review: Stem Cell Interventions for People With Cerebral Palsy: Systematic Review With Meta-Analysis

Concise Review: Stem Cell Interventions for People With Cerebral Palsy: Systematic Review With Meta-Analysis

Hydrogel-Based Bioprocess for Scalable Manufacturing of Human Pluripotent Stem Cell-Derived Neural Stem Cells

Wharton’s Jelly Mesenchymal Stem Cell Administration Improves Quality of Life and Self-Sufficiency in Children with Cerebral Palsy: Results from a Retrospective Study

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