Intrathecal Infusion of Autologous Adipose-Derived Regenerative Cells in Autoimmune Refractory Epilepsy: Evaluation of Safety and Efficacy

Abstract

Objective/Purpose. Evaluation of efficacy and safety of autologous adipose-derived regenerative cells (ADRCs) treatment in autoimmune refractory epilepsy. Patients. Six patients with proven or probable autoimmune refractory epilepsy (2 with Rasmussen encephalitis, 2 with antineuronal autoantibodies in serum, and 2 with possible FIRES) were included in the project with approval of the Bioethics Committee. Method. Intrathecal injection of autologous ADRC acquired through liposuction followed by enzymatic isolation was performed. The procedure was repeated 3 times every 3 months with each patient. Neurological status, brain MRI, cognitive function, and antiepileptic effect were monitored during 12 months. Results. Immediately after the procedure, all patients were in good condition. In some cases, transient mildly elevated body temperature, pain in regions of liposuction, and slight increasing number of seizures during 24 hours were observed. During the next months, some improvements in school, social functioning, and manual performance were observed in all patients. One patient has been seizure free up to the end of trial. In other patients, frequency of seizures was different: from reduced number to the lack of improvement (3-year follow-up). Conclusion. Autologous ADRC therapy may emerge as a promising option for some patients with autoimmune refractory epilepsy. Based on our trial and other clinical data, the therapy appears to be safe and feasible. Antiepileptic efficacy proved to be various; however, some abilities improved in all children. No signs of psychomotor regression were observed during the first year following the treatment.

Adipose tissue-derived stem cells in breast reconstruction: a brief review on biology and translation

“…Both in vitro and in vivo results indicated allogeneic ADSCs presented immune tolerance and could not stimulate lymphocyte proliferation, which allows the possibility of ADSCs xenotransplantation [ 73 ]. Preclinical studies and clinical trials have shown that ADSCs have a good therapeutic effect in various autoimmune diseases [ 74 – 76 ].…”

Multipronged Attack of Stem Cell Therapy in Treating the Neurological and Neuropsychiatric Symptoms of Epilepsy

“…Importantly, the stem cell transplantation was safe, exhibiting no adverse events ( DaCosta et al, 2018 ). In another clinical trial, autologous adipose-derived regenerative cells (ADRCs) were intrathecally administered via liposuction to autoimmune refractory epileptic patients ( Szczepanik et al, 2020 ). They received treatment three times for every three months ( Szczepanik et al, 2020 ).…”

“…In another clinical trial, autologous adipose-derived regenerative cells (ADRCs) were intrathecally administered via liposuction to autoimmune refractory epileptic patients ( Szczepanik et al, 2020 ). They received treatment three times for every three months ( Szczepanik et al, 2020 ). The patients demonstrated cognitive recovery, as observed in ameliorated academic, social, and motor performance.…”

“…The patients demonstrated cognitive recovery, as observed in ameliorated academic, social, and motor performance. One subject became completely seizure free, but other patients showed less seizure mitigation or no improvement at all ( Szczepanik et al, 2020 ). Despite ADRCs apparent safety, its efficacy must be further explored in the context of epilepsy ( Szczepanik et al, 2020 ).…”

“…One subject became completely seizure free, but other patients showed less seizure mitigation or no improvement at all ( Szczepanik et al, 2020 ). Despite ADRCs apparent safety, its efficacy must be further explored in the context of epilepsy ( Szczepanik et al, 2020 ). In addition, a clinical trial utilizing pediatric patients investigated the effectiveness of autologous bone marrow stem cell transplantation in ameliorating drug-resistant epilepsy (DRE) ( Milczarek et al, 2018 ).…”